From an ethical perspective our nation's response to the COVID-19 pandemic has been disastrous. For example, as has been widely reported, our nation has failed to protect the most vulnerable among us, for example, nursing home residents have suffered approximately one-third of all COVID-19-related deaths. As for other disenfranchised, African Americans have been were more than twice as likely as non-Hispanic Whites to die of COVID-19 complications. Health care providers have been and continue to be inadequately protected requiring them to work in lethal environments. Instead of providing service workers, moreover minorities, health insurance, sick leave and a livable wage, we now define them “essential workers” and give them a hand clap. As for our the federal government's response, the president's sensitivity goes so far as his recently stating “it is what it is” - that the urban dictionary defines as a business phrase that can literally be translated as “fuck it.” As for the Congress's response, 75% of direct and indirect CARES Act moneys went to corporations and any forthcoming or additional federal response must include COVID-related legal immunity protection for the health care industry. The nation's response to the pandemic exposes the rift that continues to exist between medical ethics, that requires the health care industry to support the betterment of public health and a responsibility to seek policy reforms that are in the best interests of patients, and health care delivery ever-increasingly designed to generate financial profits.
During this 30 minute discussion Dr. Binkley provides, in sum, an assessment of the extent to which the federal policy makers and the health care industry have lived up to their ethical obligations in response to the pandemic and what reforms national policy makers should take in providing health care that satisfies or at least approximates ethical norms.
Dr. Charles Binkley is currently the Director of Bioethics at Santa Clara University's Markkula Center for Applied Ethics. Previously, Dr. Binkley was a practicing hepatobiliary and pancreas surgeon with the Kaiser Permanente Medical Group. in San Francisco. He also served as Chairman of the Kaiser's San Francisco Medical Center Ethics Committee, President of the Professional Staff, and Chief of Inpatient Quality. Dr. Binkley also served on the Committee on Ethical, Legal, and Judicial Affairs of the California Medical Association, as well as on the Board of Directors of the San Francisco Medical Society, and on the program committee of the Society for Surgery of the Alimentary Tract. Dr. Binkley is also a Fellow of the American College of Surgeons. Dr. Binkley has been an invited speaker at medical centers and hospitals in the United States and internationally, and acted as an ethics consultant to the American Gastroenterological Association. His writings have appeared in the Journal of the American College of Surgeons, Annals of Surgery, Molecular and Cellular Biology, Cancer Research, Verdict, and Bioethics.net. After completing his undergraduate degree in Classics and Philosophy at St. Meinrad Seminary, Dr. Binkley attended Georgetown University School of Medicine, graduating magna cum laude. He completed his surgery residency at the University of Michigan, spending two years as an NIH-sponsored Gastrointestinal Surgery Fellow.
Information on the Markkula Center is at: https://www.scu.edu/ethics/
Don Berwick's "moral determinants" June JAMA essay noted during this discussion is at: https://jamanetwork.com/journals/jama/fullarticle/2767353
Crosby and Annas's NEJM essay regarding medical ethics and human rights in immigration detention centers, also noted during this discussion, is at: https://www.nejm.org/doi/full/10.1056/NEJMp2003050?af=R&rss=currentIssue
The Alexander Cockburn's essay, "Elder Abuse, Nursing Homes, the Coronavirus, and the Bottom Line," appears in the September 2020 issue of Harper's Magazine.
Though unmentioned, see also, Osmundson and Nathan's, "COVID-19 and the Limits of American Moral Reasoning," in the July 30 issue of The New Republic, at: https://newrepublic.com/article/158660/covid-19-limits-american-moral-reasoning
For information on the AMA's code of medical ethics go to: https://www.ama-assn.org/delivering-care/ethics
Dr. Charles Binkley Discusses Medical Ethics in the Time of COVID-19 (August 24th)