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Dr Elizabeth Fistein talks about ethical decision making during the Covid pandemic

In the early months of 2020, many hospital leaders watched the spread of Covid-19 with alarm. The pictures emerging from Wuhan in China, and then from Northern Italy, demonstrated a need for unprecedented restrictions on the public to prevent the spread of disease. The risk of a surge in demand for Intensity Therapy Unit beds overwhelming the available supply raised the possibility that clinicians would have to make previously unthinkable decisions about rationing. For local medical leadership, the question of how to manage the available resources fairly and transparently, maximizing the good that could be done, whilst protecting themselves and their teams from moral injury, loomed large. In this context, interest in clinical ethics, and the potential benefits of working with clinical ethics committees or advisory groups began to emerge. Dr Fistein told the story of how she set up clinical ethics advisory groups at a district general hospital (West Suffolk) and a highly specialized tertiary centre (Royal Papworth), using a model for practical ethical deliberation (Helen Manson’s Core-Values Framework).

About the speaker

Dr Elizabeth Fistein is a Fellow and Director of Clinical Studies at Lucy Cavendish College. She works in the School of Clinical Medicine, where she is responsible for delivery of the Professional Responsibilities curriculum (ethics & law, reflective practice, teaching skills, leadership & management, multi-professional team-working, patient safety and personal development). She is a Medical Member of the First Tier Tribunal (Mental Health), having previously worked as a Consultant Psychiatrist in Cambridgeshire & Peterborough NHS Foundation Trust where she specialized in rehabilitation psychiatry for people with severe and enduring mental ill-health. She also sits on the Psychology Research Ethics Committee, the University Research Ethics Committee and the Approved Clinicians appointment panel for the Midland & East of England, and is an Associate of the Centre for Law, Medicine & Life Sciences in the Faculty of Law.