Pandemic morality-in-action: Accounting for social action during the COVID-19 pandemic

Global health pandemics (such as COVID-19) can result in rapid changes to sanctionable behaviour, impacting society and culture in a multitude of ways. This study examined how pandemic culture and accompanying moral order was produced within and through social interaction during the first and second waves of COVID-19 in Australia. The data consisted of a corpus of 29 video-recorded paediatric palliative care consultations and were analysed using conversation analysis. Analysis showed how adherence to pandemic rules became morally expected, and moral concerns about actual or potential violations to these rules became relevant in and through social interaction during this period. The COVID-19 pandemic provided a natural experiment for how accountable actions and a moral order are negotiated in and through our social interactions when our taken-for-granted ?natural facts of life? change in response to a global public health crisis.

The pervasive relevance of COVID-19 within routine paediatric palliative care consultations during the pandemic: A conversation analytic study.

BACKGROUND: The importance of caring for children with complex and serious conditions means that paediatric palliative care must continue during pandemics. The recent pandemic of Coronavirus Disease 2019 (COVID-19) provides a natural experiment to study health communication during pandemic times. However, it is unknown how communication within consultations might change during pandemics. AIM: This study, a sub-study of a larger project, aimed to examine real-world instances of communication in paediatric palliative care consultations prior to and during the COVID-19 pandemic to understand how clinicians and families talk about the pandemic. DESIGN: Paediatric palliative care consultations prior to, during, and immediately following the initial peak of COVID-19 cases in Australia were video recorded and analysed using Conversation Analysis methods. SETTING/PARTICIPANTS: Twenty-five paediatric palliative care consultations (including face-to-face outpatient, telehealth outpatient and inpatient consultations) were video recorded within a public children's hospital in Australia. Participants included 14 health professionals, 15 child patients, 23 adult family members and 5 child siblings. RESULTS: There was a pervasive relevance of both serious and non-serious talk about COVID-19 within the consultations recorded during the pandemic. Topics typical of a standard paediatric palliative care consultation often led to discussion of the pandemic. Clinicians (55%) and parents (45%) initiated talk about the pandemic. CONCLUSIONS: Clinicians should not be surprised by the pervasiveness of COVID-19 or other pandemic talk within standard paediatric palliative care consultations. This awareness will enable clinicians to flexibly address family needs and concerns about pandemic-related matters that may impact health and wellbeing.