'Other patients become a secondary priority:' perceptions of Estonian frontline healthcare professionals on the influence of COVID-19 on health (in)equality and ethical decision-making. (Special Issue: COVID-19 and health inequities: insights from communication research and practice.)

Background: The COVID-19 pandemic has posed many challenges to societies, individual healthcare systems and global public health. Manifestations of increasing health inequalities, social stigmatization and challenging ethical decision-making have been previously noticed. The aim of this article is to analyse the perceptions of frontline healthcare professionals regarding the potential impact of COVID-19 on the provision of healthcare services and the ethical challenges it may entail. Method: This research is a part of a larger research project which was conducted among frontline healthcare professionals in Estonia and used both quantitative and qualitative methods of data collection. In this article, answers to specific open-ended questions from the questionnaire (n = 116) and in-depth interviews (n = 8) were analysed. For data analysis, inductive content analysis was used. The research was granted ethical approval.

Ethical conflicts during the COVID-19 pandemic

The COVID-19 pandemic has caused unprecedented interest in ethics, as societies are confronted with difficult ethical choices: life versus economic well-being, individual freedom versus health, free movement of people versus public health. All democratic societies have witnessed disagreements concerning restrictions to the free movement of people, vaccination policies, and distribution of healthcare resources. The adopted policies and formulated guidelines showed that different countries prioritized values differently. Amongst the most challenging ethical debates during the COVID-19 pandemic were attempts to formulate clinical ethical guidelines on how limited medical resources and services ought to be allocated should the need exceed availability. This article provides an overview of the process of compiling the clinical ethics recommendations for Estonian hospitals concerning the allocation of limited healthcare resources during the COVID-19 pandemic. The article describes the stakeholder involvement, engagements with comparable international documents, main internal debates and lessons learned for the future. © 2021 Eesti Keele InstituutÂÂÂ. All rights reserved.