Ethical Decision-Making Model by Hospital Nurses Providing Nursing Care to COVID-19 Patients

Nurses often experience ethical dilemmas in decision-making while providing nursing care to clients, especially COVID-19 patients. This study aimed to identify an ethical decision-making model used by hospital nurses in East Nusa Tenggara (ENT) Province, Indonesia, in providing nursing care to COVID-19 patients. This article is based on a research and development cross-sectional study. The population comprised 330 hospital nurses who provided nursing care to COVID-19 patients in ENT. The sample was derived via two-stage cluster sampling and consisted of 175 respondents. The research was conducted from January to June 2022. The independent variables were consequences of actions, deontological ethics, intuition, and the stigma towards COVID-19 patients. Furthermore, the sub-variables of deontological ethics were generosity, justice, autonomy, honesty, and obedience. Meanwhile, the dependent variable was ethical decision-making. Data was collected using questionnaires as instruments. The authors analyed the data partially with chi-square and simultaneously with multiple logistic regression tests. There were correlations between the consequences of action and ethical decision-making (p=0.003). In addition, there were correlations between generosity, justice, autonomy, honesty, and obedience and ethical decision-making (p=0.001). Furthermore, there was a correlation between intuition and ethical decision-making (p=0.0001). Moreover, there was a correlation between the stigma towards COVID-19 patients and ethical decision-making (p=0.0001). Multiple logistic linear test results showed that the significant variables in the ethical decisionmaking model were generosity (p=0.0001), autonomy ( p=0.0001), justice (p=0.001), and honesty ( p=0.0001). In conclusion, generosity, autonomy, justice, and honesty have a 40% influence on ethical decision-making by hospital nurses in East Nusa Tenggara in providing nursing care to COVID-19 patients.

ORGANIZATIONAL FACTORS AND ETHICAL DECISION-MAKING PROCESS DURING THE COVID-19

Aim. The researcher's goal is to investigate how organizational characteristics affect the process of making ethical decisions. Methods. The study's focus was on certified accountants working in Kosovo during the Covid19 era. The task is qualitative in nature;SPPS is used to process the data after Excel has done so. This study used descriptive and regression analysis. Results. The study demonstrated that organizational criteria like size, industry, the presence of an ethics code, and ethical climate have an impact on how decisions are made. To identify organizational elements and, as a result, improve the ethical decision-making process, the paper's findings may have policy implications. Conclusions. This study provided insight into how to increase the influence of organizational elements in ethical decision-making, particularly in the accounting field. A sound foundation for an ethical decision-making process that is sustainable is provided by the recommendations at the end of the paper. © 2023, Institute for Human Rehabilitation. All rights reserved.

Why the COVID-19 Crisis Is an Ethical Issue for Business: Evidence from the Australian JobKeeper Initiative.

The COVID-19 virus was unveiled to the world as a health crisis and later also as an economic crisis. For some organisations, it has become an ethical crisis. This is certainly the case for large organisations in Australia, where the way many enterprises handled a government wage subsidy called JobKeeper led to a public backlash, media pressure, and a variety of responses ranging from 'We acted legally' to the full return of the subsidy. Some organisations later reported profits, and the public response indicated concern about this behaviour, many considering it immoral despite it being legally compliant. It is, we contend, a question to which stakeholder theory can be applied, examining how organisations view and respond to the public. We use content analysis of mainstream media to provide information about public reactions and information from official sources to confirm corporate action. We show that there is a significant ethical component in the public response to the behaviour of organisations as they respond to the crisis. COVID has been an ethical, health, and financial crisis for these organisations. Public pressure, exerted in and through the media, made the general public a definite stakeholder.

A Framework for Authentic Ethical Decision Making in the Face of Grand Challenges: A Lonerganian Gradation.

This paper contributes to the contemporary business ethics narrative by proposing an approach to corporate ethical decision making (EDM) which serves as an alternative to the imposition of codes and standards to address the ethical consequences of grand challenges, like COVID-19, which are impacting today's society. Our alternative approach to EDM embraces the concept of reflexive thinking and ethical consciousness among the individual agents who collectively are the corporation and who make ethical decisions, often in isolation, removed from the collocated corporate setting. We draw on the teachings of the Canadian philosopher and theologian, Fr. Bernard Lonergan, to conceptualize an approach to EDM which focuses on the ethics of the corporate agent by nurturing the universal and invariant structure that is operational in all human beings. Embracing Lonergan's dynamic cognitive structure of human knowing, and the structure of the human good, we advance a paradigm of EDM in business which emboldens authentic ethical thought, decision making, and action commensurate with virtuous living and germane to human flourishing. Lonergan's philosophy guides us away from the imposition of over-arching corporate codes of ethics and inspires us, as individual agents, to attend to the data of our own consciousness in our ethical decision making. Such cognitional endowment leads us out of the ethics of the 'timeless present' (Islam and Greenwood in Journal of Business Ethics 170: 1-4, 2021) towards ethical authenticity in business, leaving us better placed to reflect upon and address the ethical issues emanating from grand challenges like COVID-19.

Does the COVID-19 Pandemic have Implications for Machine Ethics?

Algorithms have advanced in status from supporting human decision-making to making decisions for themselves. The fundamental issue here is the relationship between Big Data and algorithms, or how algorithms empower data with direction and purpose. In this paper, I provide a conceptual framework for analyzing and improving ethical decision-making in Human-AI interaction. On the one hand, I examine the challenges and the limitations facing the field of Machine Ethics and Explainability in its aim to provide and justify ethical decisions. On the other hand, I propose connecting counterfactual explanations with the emotion of regret, as requirements for improving ethical decision-making in novel situations and under uncertainty. To test whether this conceptual framework has empirical value, I analyze the COVID-19 epidemic in terms of "what might have been” to answer the following question: could some of the unintended consequences of this health crisis have been avoided if the available data had been used differently before the crisis happened and as it unfolded? © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Introducing Interprofessional Roles/Responsibilities and Ethical Decision Making Through Guided Questions and a COVID- 19 Case Discussion

Introduction: Interprofessional education (IPE) is an imperative to prepare pharmacy students for contemporary practice. There has been a significant move by health professions educators to engage students of various professions with one another. Of the four IPE competency domains, there is sparse literature in values/ethics domain. Research Question or Hypothesis: Does guided questions/discussion around COVID-19 case followed by debrief enhance pharmacy and medical students' confidence in knowledge about interprofessional roles/responsibilities and ethical decision making ability? Study Design: Retrospective pre-post survey assessing students' confidence in knowledge about roles/responsibilities and proficiency in making ethical decisions. Methods: Interprofessional teams of first year pharmacy and medical students participated in a COVID-19 vaccine case discussion. In small groups, learners developed a vaccine distribution priority list. Groups presented their recommendations during faculty facilitated large group debrief. Students also engaged in small group discussion in answering guided questions about each profession's roles/responsibilities. Large group debrief provided clarification of roles/responsibilities. Quantitative data was assessed on a Likert scale: Not confident at all(1) to very confident(5). A Fisher's Exact Test assessed the proportional differences. Qualitative comments were collated and thematic analysis was performed using the constant comparison method. Results: 303 students (156 pharmacy, 147 medicine) participated. Self-rating of confidence in roles/responsibilities knowledge improved: -not confident at all/not confident- decreased from 90 to 18 (p<0.001) and -confident/very confident- increased from 83 to 191 (p<0.001). Similarly, confidence in ethical decision making ability improved: 'not confident at all/not confident' decreased from 55 to 9 (p<0.001) and 'confident/very confident - increased from 119 to 204 (p<0.001). Three themes of learning emerged from 266 qualitative comments: knowledge about roles/responsibilities, insights into communication and teamwork, and managing ethical dilemmas. Conclusion: This learning engagement had a positive impact on students' self-perception of confidence in knowledge of roles/ responsibilities and ethical decision making ability. Future studies directly assessing learning in these areas could further validate these findings.

Being ethically resilient during COVID-19: a cross-sectional study of Indian supply chain companies

Purpose: The present study aims to examine the relationship between techno-ethical orientation and ethical decision-making (EDM) in Indian supply chain companies during the COVID-19 pandemic. It also aims to explore the moderating role of technological frames (TF) in the relationship between techno-ethical orientation and EDM. Design/methodology/approach: The relationship between techno-ethical orientation and EDM is examined using correlation and regression analysis. The moderating effect of five dimensions of TFs (personal attitude, application value, organisational influence, supervisor influence and industry influence) is analysed using structural equation modelling. Findings: The correlation coefficient between techno-ethical orientation and EDM is 0.513. Also, the regression coefficient (β = 0.213) is significant at 0.05, establishing a positive linkage between the two. R-square values showed a 45.2% variation in EDM is explained by techno-ethical orientation. Similarly, all variables of TFs have a positive and significant moderating effect on the relationship between techno-ethical orientation and EDM. Originality/value: This is one of the pioneer studies exploring techno-ethical orientation’s impact on EDM in supply chain companies. © 2022, Emerald Publishing Limited.

Physicians' perceptions of patient participation and the involvement of family caregivers in the palliative care pathway.

INTRODUCTION: Patient participation is essential for quality palliative care, and physicians play a crucial role in promoting participation. This study explores physicians' perceptions of patients and family caregivers' involvement in the different phases of the palliative pathway and employs a qualitative design with thematic analysis and a hermeneutic approach. METHODS: A purposive sampling included physicians who worked in different phases of the palliative pathway. In-depth, semi-structured interviews were conducted with 13 physicians in Norway between May and June 2020. RESULTS: Three main themes illustrate physicians' perceptions of patients' and family caregivers' involvement: (1) beneficence for the patient and the family caregivers in the early phase, (2) autonomy and shared decision-making in the middle phase, and (3) family involvement in the terminal phase. CONCLUSION: The physicians perceived bereavement conversations as essential, particularly if the pathway had been challenging. They also perceived patient participation and family caregivers' involvement as contextual. The results reveal that participation differs across the different phases of the palliative pathway. This type of knowledge should be included in the education of health-care professionals. Future research should explore elements vital to successful patient participation and family involvement in the different phases of care. PATIENT OR PUBLIC CONTRIBUTIONS: Family caregivers were involved in a previous study through individual interviews. The same interview guide used for the family caregivers was used when interviewing the physicians. The family caregivers' contribution led to nuanced questions in the interviews with the physicians, questions leaning on their stories told.

Privacy matters: impact of ethical organization care and government regulations on customer patronage

Purpose The coronavirus disease 2019 (COVID-19) epidemic has given an upsurge to online retailing in Pakistan. This shift has escalated the issues about privacy concerns among consumers. Keeping in view the growing concerns, the objective of this study is to investigate customer patronage in online shopping and the role of privacy concerns in this relationship. Design/methodology/approach To generalize the relationship between antecedents and outcomes of privacy concerns, a cross-disciplinary macro model was used. Data were collected through a survey method from the consumers who used credit and debit cards during online shopping. Findings Results show that government regulations have a significant positive relationship with privacy concerns and customer patronage. Privacy concerns are found to have a significant negative relationship with organizational ethical care while customer patronage was found to have a significant positive relationship with organizational ethical care. Customer patronage was also found to have a significant negative relationship with privacy concerns. Privacy concerns mediated the relationship between government regulations and customer patronage, whereas privacy concerns does not mediate the relationship between organizational ethical care and customer patronage. Originality/value The research adds to the existing literature and highlights the customer behavior toward online shopping/e-commerce in developing economies. The research gives a direction to stakeholders to counter privacy concerns and ensure safer e-commerce practices.

A Theoretical Framework for Ethical Decision-Making During Public Health Emergencies / Un marco teórico para la toma de decisiones éticas durante emergencias de salud pública / Um referencial teórico para tomada de decisão ética durante emergências de saúde pública

Abstract: The new theoretical ethical framework is a general frame or tool for ethical agents, developed to guide ethical reasoning during public health emergency preparedness and response. The TEF is based on the assumption that no existing ethical discourse in medical ethics alone is sufficient to address ethical issues of a PHE. The solutions suggested by existing approaches are limited in practicability and effectiveness, because they cannot address root problems and interplay among ethical problems. The reason for this insufficiency rests on the argument that ethical problems of PHEs have causal and reciprocal relationships, and any ethical decision-making framework should provide a wide enough perspective to consider relevant ethical norms and theories to suggest practical, implementable, coherent solutions compatible with the communal values and cultural norms. The TEF we suggest for PHEs embraces a holistic and integrated ethical perspective that enables us to comprehend that ethical problems that arise in various settings caused by PHE phenomena are in relationship with each other instead of addressing them as a standalone problem. The TEF provides decision-makers to achieve a coherent web of considered judgements compatible with ethical values and principles in various settings. This type of conceptualization offers a wide perspective to see causal and relational relationships among problems and produce outcomes that would not be possible by eclectic approaches.

Resumen: El nuevo Marco Ético Teórico (MET) es una estructura general o herramienta para eticistas, desarrollada para guiar el razonamiento ético durante la preparación y respuesta a emergencias de salud pública (ESP). Supone que no existe un discurso ético en la ética médica que por sí solo sea suficiente para abordar temas éticos de ESP. Las soluciones sugeridas de aproximaciones existentes son limitadas en la práctica y en la efectividad, debido a que no pueden abordar problemas de raíz sin considerar las interacciones entre los problemas éticos. Esta insuficiencia es porque los problemas éticos de ESP tiene relaciones causales y recíprocas, y cualquier estructura de toma de decisiones éticas debería proporcionar una perspectiva suficientemente amplia como para considerar normas éticas y teorías relevantes, y sugerir soluciones prácticas que sean coherentes y compatibles con valores comunes y normas culturales. El MET que sugerimos para ESP abarca una perspectiva ética integral e integrada, que posibilita la comprensión de que los problemas éticos que surgen en varías situaciones causadas por fenómenos ESP se hallan en relación entre ellos, en vez de abordarlos como un problema aislado. El MET proporciona a los que toman decisiones el lograr una red coherente de juicios compatibles con los valores y principios éticos en varias situaciones. Este tipo de conceptualización ofrece una amplia perspectiva para ver relaciones causales y relacionales entre problemas y producir resultados que no serían posibles mediante aproximaciones eclécticas.

Resumo: O novo referencial ético teórico (NT: TEF, sigla em inglês) é um referencial geral ou instrumento para agentes éticos, desenvolvido para guiar o raciocínio ético durante o preparo e resposta a emergências de saúde pública (NT: PHE, sigla em inglês). O TEF é baseado na suposição de que nenhum discurso ético existente em ética médica sozinho é suficiente para abordar aspectos éticos de uma PHE. As soluções sugeridas pelas abordagens existentes são limitadas em praticabilidade e efetividade, porque elas não podem abordar problemas fundamentais e inter-relacionar problemas éticos. A razão para essa insuficiência repousa no argumento de que problemas éticos de PHEs têm relações causais e recíprocas, e qualquer referencial para tomada de decisão ética deve propiciar uma perspectiva ampla o suficiente para considerar normas e teorias éticas relevantes para sugerir soluções práticas, implementáveis e coerentes, compatíveis com valores comunitários e normas culturais. A TEF que sugerimos para PHEs abarca uma perspectiva ética holística e integrada que nos permite compreender que os problemas éticos que surgem em diversos ambientes causados pelo fenômeno da PHE estão em relação entre si, ao invés de abordá-los como um problema isolado. O TFE propicia a tomadores de decisões alcançar uma rede de julgamentos considerados compatíveis com valores e princípios éticos em ambientes diversos. Esse tipo de conceitualização oferece uma perspectiva ampla para observar relações causais e relacionais entre problemas e produzir desfechos que não seriam possíveis por abordagens ecléticas.

CSR and CEO's Moral Reasoning in the Automotive Industry in the Era of COVID-19

This paper assesses whether and to which extent the COVID-19 pandemic, which represents a scenario of high moral intensity, is influencing the moral reasoning of top CEOs (chief executive officers) in the paradigmatic case of the automotive industry and how this moral reasoning relates to their CSR response to the crisis and their CSR plans in the long run. To this end, we took the CEO letters before and after the pandemic outbreak of the top 15 automotive companies, and applied Weber's method to conduct a moral reasoning categorization, along with an examination of their CSR approach and initiatives. The results show a predominant moral paralysis among these CEOs, where positive reactions addressed are philanthropic in nature and more likely to be a transient response to the crisis, rather than a sustained long-term improvement of their CSR rooted in a significant moral approach enhancement. Furthermore, CEOs at the lowest stages of moral reasoning, primarily focused on their own business and immediate stakeholders, are less likely to highlight these philanthropic initiatives. The outcome evidences the convenience of addressing CSR from the lens of moral reasoning, and it further draws the attention of the scientific community, companies and their top management, stakeholders, and society to the relevance of investigating and considering the moral reasoning of top management in large corporations and its implications.

Dying Wish: A Case of Controversial Covid Vaccination Near the End of Life

Background: This case describes the circumstances of an older woman and her daughter faced with the dilemma of whether or not to receive the COVID-19 vaccine at the end of life. Methods: Ms. V was a 90-year-old woman with past medical history of major neurocognitive disorder, asthma, and hypertension on home hospice after experiencing a rapid decline beginning in November 2020. By January 2021, she had significantly deteriorated with a prognosis of weeks. At this time, the COVID-19 vaccine had become available to high-risk individuals and their household members. Because Ms. V lacked capacity to make her medical decisions, her daughter and healthcare power of attorney, Ms. B, had to determine her wishes. Ms. V's goals were comfort care and to avoid hospitalization. Although she had worked as a nurse, she had declined her annual influenza vaccine in the past. However, Ms. B felt that her mother would have wanted to help her children and caretakers get the vaccine, which would only be possible if she got the vaccine first. Results: Extensive conversations with Ms. V's children, hospice team, and geriatrician were held utilizing the 4-box approach to ethical decision making.1 Ms. B decided that her mother would have wanted to receive the vaccine for the main purpose of also vaccinating her children, who both had advanced heart failure and were at high risk for complications from COVID-19. She received one dose of the Pfizer COVID-19 vaccine and died ten days later. Her children and live-in caregiver all received the Pfizer Covid-19. Conclusion: Although Ms. V had previously refused annual influenza vaccinations, her daughter felt that her mother would have gotten the vaccine to provide protection for her children and caregiver. While it was acknowledged that Ms. V would probably gather little immunity benefit from the vaccine due to her poor prognosis, her daughter felt that the benefits of the entire household receiving the vaccine outweighed any potential risks. Her family called this final act of protection her dying wish.

Frontline Healthcare Professionals' Views Regarding the Impact of COVID-19 on Ethical Decision-Making: A Multicentre Mixed-Methods Study from Estonia.

BACKGROUND: The objective of the study was to investigate frontline healthcare professionals' experiences and attitudes in relation to the COVID-19 pandemic's ethical and psychosocial aspects in Estonia. There were two research foci: first, ethical decision-making related to treating patients in the context of potential medical resource scarcity, and second, other psychosocial factors for healthcare professionals pertaining to coping, role conflicts, and the availability of institutional support. METHODS: An online survey was conducted in the fall of 2020 amongst the frontline healthcare professionals working in the three most impacted hospitals; respondents were also drawn from two ambulance services. The focus of the survey was on the first wave of COVID-19 (spring 2020). A total of 215 respondents completed the quantitative survey and qualitative data were gathered from open comments. RESULTS: Over half of the surveyed healthcare professionals in Estonia expressed confidence in their roles during the pandemic. More than half cited the complex ethical aspects related to their decisions as their main source of doubt and uncertainty. In response to this uncertainty, Estonian healthcare professionals drew on their previous training and experience, the policies and guidelines of their institution, and support from their colleagues, to aid their decision-making during the pandemic. CONCLUSIONS: Although frontline healthcare professionals faced difficult decisions during the first wave of the pandemic, overall, most agreed that experiencing the pandemic reconfirmed that their work mattered greatly.

Inmate cancer patient - Highlighting the importance of a holistic approach to oncological care

Purpose: Inmate oncologic patients' rates increased drastically worldwide. Elderly, limited exercise, unhealthy diet, hepatitis, HIV + status, tobacco and alcohol use, constitute the main cancer risk factors. We present an outline of practical oncological management and ethical thinking, in the specific environment of a detention facility. Methods: PubMed, Cochrane Database of Controlled Trials, SCOPUS and grey literature were extensively searched up to October 2021. Incarcerated oncologic patients experience various everyday challenges:their confinement in high security facilities, the lack of access to critical care and related ethical dilemmas inherent to the context of a correctional facility. Results: The detention facilities may be inadequate in providing early cancer diagnosis and appropriate care mainly due to a lack of specialized personnel, b) in-house or in external specialized cancer hospitals, care variability (e.g. admissions in small local or regional hospitals), c) delays in providing access and d) gatekeeper systems. There is a paucity of administration of a)systemic therapy (chemotherapy, targeted drug therapy etc),b)radiotherapy, c) palliative care, and d)enrollment in clinical trials. Conclusions: Correctional facilities must encourage teamwork between healthcare and correctional professionals in order to improve the provided anticancer care.

Nepotistic Hiring and Poverty From Cultural, Social Class, and Situational Perspectives.

Being poor can influence how one makes ethical decisions in various fields. Nepotism is one such area, emerging as kinship-based favoritism in the job market. People can be poor on at least three levels: one can live in a poor country (cross-cultural poverty), be poor compared to others around them (socio-economic poverty), or feel poor in their given situation (situational poverty). We assumed that these levels can simultaneously influence nepotistic hiring decisions among Hungarian (N = 191) and US participants (N = 176). Prior cross-cultural, non-experimental studies demonstrated that nepotism is more prevalent in poorer countries such as Hungary than in richer countries such as the United States. However, contrary to our expectations, in our non-representative, preliminary study, US participants showed stronger nepotistic behavioral tendencies than Hungarians (cross-cultural level). Furthermore, people with lower socioeconomic status had less nepotistic intentions than richer people (socio-economic level). When participants were asked to imagine themselves as a poor person (situational level), they tended to be more nepotistic than had they imagined themselves to be rich. Finally, nepotistic hiring intentions were in general stronger than non-nepotistic hiring intentions. These seemingly paradoxical results were interpreted in the light of the COVID-19 job market context and were explained by the mechanisms described by research on wealth and immoral behaviors, as well as the presence of risk aversion.

Ethics and Occupational Health: From the changing world of work to the future challenges of the COVID-19 pandemic

Introduction: The ethical dilemmas confronting occupational health are becoming more complex as they reflect changes in the world of work, demographic shifts, new technologies and future challenges to public health due to the spread of the COVID-19 pandemic. This scenario is setting new contexts for occupational health physicians (OHPs) in their tasks and professional conduct, emphasizing the role of OHPs in balancing between individual (i.e. the health and working capacity of individual employees), enterprise (i.e. maximize the production) and community (i.e. the health and safety of the community at large) interests. This study looks at the problems raised by these ethical concerns in occupational health and proposes some solutions Materials and Methods: Thanks to a comprehensive analysis of ethical decision-making models in occupational health, we identified some drivers and barriers for correct professional ethics that can represent a starting point to acknowledge some proposals for ethical solutions Results: There has been no systematic attempt to study the true extent of ethical issues and how they are resolved in practice. In fact, the presence of numerous variables to be taken into consideration, as well as the growing number of potential stakeholders involved in ethical choice, prevented the identification of an ideal proposal able to solve ethical challenges in OHPs practice Conclusions: To deal with the ethical dilemmas in today’s changing world of work and the pandemics, the logic of an integrated approach must take account the importance of all three types of ethics: personal (individual), professional and institutional.

Ethical considerations of school leaders responding to COVID-19

The dual purpose of this qualitative narrative-phenomenological study was, first, to understand the lived experiences of school leader's decision-making during the spring 2020, COVID-19 school shut down and how the experience shaped the re-entry plan creation, implementation, and adjustment during the 2020-2021 school year. The second purpose of the study was to discover how school leaders' perceptions amidst the turbulence and Contextual Forces helped shape their ability to make ethical decisions and respond to Contextual Forces as the leaders created and implemented school re-entry plans during the 2020-2021 school year. The framework of this study was based on Lewin's (1947) 3-Step Change Theory and Shapiro and Gross' (2013) Multiple Ethical Paradigm and Turbulence Theory. With research question one, this study supported prior research on the themes of collaboration, communication, relationships, student achievement, and power of position within public school districts. When considering purpose two of the study, the Ethical Paradigms of Shapiro and Gross (2013) played an integral role in school leader decision-making within the COVID phenomenon during the spring 2020 shutdown through the 2020-2021 school year. School leaders during this time utilized the Ethic of Justice, which emphasizes legal guidance, and the Ethic of Care, which emphasizes concern for individuals' welfare, when considering their ethical decisions. However, as the year progressed, the Ethics of Justice began to be challenged by school leaders by the Ethic of Profession to reconcile decisions within community codes and ethos. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Ethical decision-making of social workers in Spain during COVID-19: Cases and responses.

In this article we address the ethical decision-making processes of social work professionals in Spain during the first wave of COVID-19. We present some of the findings from a broader international research project led by professor Sarah Banks and carried out in collaboration with the International Federation of Social Workers. The first wave of COVID-19 had a major impact in Spain, hitting harder the most vulnerable groups. In this unprecedented and unexpected context, social workers had to make difficult ethical decisions on fundamental issues such as respecting service-user's autonomy, prioritizing wellbeing, maintaining confidentiality or deciding the fair distribution of the scarce resources. There were moments of uncertainty and difficult institutional responses. The broader international project was carried out using an online questionnaire addressed to social work professionals in several countries. In this article, through several specific cases, we examine the ethical decision-making processes of social work professionals in Spain, as well as the way to resolve that situations. We have used a qualitative content analysis with a deductive approach to analyze the responses and cases. Findings show many difficult situations concerning the prioritization of the wellbeing of users without limiting their autonomy, the invention of new organizational protocols to provide support and resources for vulnerable people… Social workers had to manage the bureaucracy and had to solve some emergency situations getting personally involved or developing other cooperation mechanisms. The pandemic forced them to look for new forms of social intervention.