Half of 1,257 healthcare workers caring for COVID-19 patients in 34 hospitals in China reported depression, 45% reported anxiety, 34% reported insomnia, and 71.5% reported psychological distress, according to a recent study.1

These findings point to significant ethical concerns regarding clinicians’ well-being. “Society depends on healthcare workers who use their skills to provide for the best interests of patients,” says James G. Adams, MD, senior vice president and chief medical officer at Northwestern Medicine in Chicago.

Clinicians always face some risk as they carry out routine duties, including acquiring infection or sustaining injury. However, the pandemic has significantly increased these risks, with healthcare providers around the world acquiring the infection at work.

“Importantly, healthcare workers have transmitted the virus to others, including family members, co-workers, and other patients who were previously uninfected,” Adams notes. Many healthcare workers have recovered, but some have died. “In this context, there is an obligation to ensure that the healthcare workers are protected,” Adams says. There are a few relevant ethical considerations:

  • Inadequate protection could result in insufficient numbers of healthcare workers.
  • Healthcare workers are not ethically obligated to assume undue, excessive risk of harm to carry out their professional duties.
  • There is a duty to protect healthcare workers to prevent harm to others (family members, colleagues, and other patients for whom they provide care).
  • As healthcare workers care for patients, it is reasonable for society to ensure these people are protected. “Without a sense of reciprocal obligation, the social compact between healthcare workers and patients will weaken,” Adams cautions.

People understand well healthcare workers’ professional obligations to patients. The reverse is not. “The obligation of society and the hospital to healthcare workers is not clear, and is not explicitly and broadly recognized,” Adams adds.


  1. Lai J, Ma S, Wang Y, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open 2020;3:e203976.