Day 6·Q&A

With protective gear in short supply, do doctors have a duty to provide COVID-19 care?

As shortages of personal protective equipment cause distress for frontline healthcare workers, cardiologist-turned-ICU-doctor Sandeep Jauhar warns we shouldn't take their duty to provide care for granted.

Doctors refusing to work 'would be a catastrophe ... of almost biblical proportions,' says Dr. Sandeep Jauhar

Nurse Amy O'Sullivan walks outside of Wyckoff Hospital in the Borough of Brooklyn on April 6, 2020 in New York. ( Bryan R. Smith/AFP/Getty Images)

Dr. Sandeep Jauhar is fully dedicated to the COVID-19 patients he treats in the ICU at the Long Island Jewish Medical Center in New York.

But he knows that his job is putting his loved ones at risk.

Amid global shortages of N95 masks and other personal protective equipment, Dr. Jauhar says there's a limit to what can be reasonably expected of healthcare workers.

In a recent opinion piece for The New York Times, he said his colleagues are struggling to reconcile their professional obligations with their desire to protect themselves and their families from harm.

He told Day 6 host Brent Bambury that there could be dangerous consequences if healthcare workers' professional obligations are taken for granted.

Dr. Sandeep Jauhar is a cardiologist in New York City. Lately, he's been redeployed to an ICU to help treat COVID-19 patients. (Beowulf Sheehan)

Here's part of their conversation.

You know that physicians have died after contracting COVID-19. Do you feel like you're taking a risk simply by showing up to work?

I mean, yeah, obviously we're all taking a risk. There's no question about that. 

The personal protective equipment issue has been mitigated somewhat over the last, you know, week or two weeks. But early on, before we really knew the scope of the pandemic out here, we were seeing patients without the proper masks. 

So there's no question that there's a risk associated with it. The question, really, is: what level of risk do our professional obligations demand that we take on? And that is a difficult question. 

Firefighters are supposed to rescue people from burning buildings, but not without proper protective equipment, and certainly not when the building's about to collapse.- Dr. Sandeep Jauhar

But do health-care workers have the right to refuse to work in conditions that they're not comfortable with?

You know, it's a dilemma. And by that I mean, there are two reasonable choices, right? There's the duty to oneself and one's family, and there's a duty to one's patients and to one's profession.

Now, I believe that the duty to my profession has outweighed the risk that I would take on and my family would take on. But the reality is that physicians may have a different sense of what this dilemma means for them. So there are no clear answers.

I think that even though the obligation is very strong, it's not absolute. You know, firefighters are supposed to rescue people from burning buildings, but not without proper protective equipment, and certainly not when the building's about to collapse.

So there are limitations that we do place on professional duties. It's not an absolute obligation. And I think that's important, because it also then reminds people, society [and] politicians of their own obligations in this pandemic. 

Do you see this as part of a social contract, that a physician's willingness and acceptance of the conditions that they're working under depends on the society obeying certain conditions as well?

I think that there is a social contract that is in play. And I think that most people would regard that as a very reasonable stance. Yes, health-care workers need to take care of sick patients, but society has an obligation to make sure that we are protected with proper equipment. 

And at the same time, society is obligated to try to mitigate the extent and the spread of the pandemic with social distancing. I mean, if people were going to, you know, start flocking to the bars and spread the infection so that hospitals are once again overwhelmed in New York City, for example — then I worry about what my colleagues would do in that instance. 

Physical and occupational therapists bring individual bags of personal protective equipment (PPE), to don before entering the room of a COVID-19 patient in a Stamford Hospital ICU, on April 24 in Stamford, Conn. Stamford, with its close proximity to New York City, has the highest number of coronavirus patients in Connecticut. (John Moore/Getty Images)

If people are going to venture out, I think they have to understand that there is a lot of anxiety in the health-care profession right now, and that there is a point at which people might rebel. I don't know whether that point will occur, but I worry about it.

It certainly happened in West Africa in the Ebola epidemic where doctors didn't show up on the job. And there were dying patients who were not taken care of. It happened in Toronto in the SARS outbreak where health care workers didn't show up, and many lost their jobs. 

And, you know, if doctors didn't uphold what I think universally is considered a professional obligation ... because people weren't doing the basics that allow us to protect ourselves and them, then I worry about the breakdown of social order.

That would be a catastrophe, right now, of almost biblical proportions. 

Written and produced by Annie Bender. Q&A edited for length and clarity.

To hear the full interview with Dr. Jauhar, download our podcast or click 'Listen' above.

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