ETHICAL DILEMMAS IN THE DOCTOR–PATIENT RELATIONSHIP IN A POST-PANDEMIC CONTEXT: A LITERATURE REVIEW
DOI:
https://doi.org/10.29302/Pangeea25.23Keywords:
bioethics, medical ethics, doctor–patient relationship, post-pandemic, autonomy, distributive justice, telemedicine, informed consentAbstract
The COVID-19 pandemic has profoundly reconfigured the doctor–patient relationship, bringing to the fore ethical dilemmas related to informed consent in conditions of uncertainty, the balance between individual well-being and public health, resource allocation, confidentiality in telemedicine, and the risk of structural discrimination. This literature review critically examines the transformations in the role and moral responsibility of physicians after 2020 through the lens of the main bioethical frameworks (principlism, physician–patient relational models, virtue ethics, capabilities) and professional guidelines published during and after the crisis. Four areas of tension are analyzed: (2) beneficence/non-maleficence in therapies with limited evidence; (3) distributive justice in resource allocation; (4) confidentiality, privacy, and relationship quality in the virtual environment. The paper argues that, in the post-pandemic stage, medical ethics calls for an "ethics of extended responsibility," which combines traditional standards of the clinical relationship with obligations to the population, deliberative transparency, and digital skills. It proposes directions for ethical education, updating telemedicine guidelines, and participatory risk communication mechanisms.
References
1. Beauchamp, T. L., & Childress, J. F. (2019). Principles of biomedical ethics (8th ed.). Oxford University Press.
2. Bugnariu, A. I. (2021). Ethical challenges in social work. Pangeea, 21(21), 111-115.
3. Bugnariu, A. I. (2018). The perception of the medical staff on the role of emergency room social worker – An exploratory study. Pangeea, 18(18), 123–125.
4. Daniels, N. (2008). Just health: Meeting health needs fairly. Cambridge University Press.
5. Emanuel, E. J., & Emanuel, L. L. (1992). Four models of the physician–patient relationship. JAMA, 267(16), 2221–2226. https://doi.org/10.1001/jama.1992.03480160079038
6. Gostin, L. O., & Meier, B. M. (2018). Global health law. Harvard University Press.
7. Greenhalgh, T., Wherton, J., Shaw, S., & Morrison, C. (2020). Video consultations for COVID-19. BMJ, 368, m998. https://doi.org/10.1136/bmj.m998
8. Mackenzie, C., & Stoljar, N. (Eds.). (2000). Relational autonomy: Feminist perspectives on autonomy, agency, and the social self. Oxford University Press.
9. Nussbaum, M. C. (2011). Creating capabilities: The human development approach. Harvard University Press.
10. Pellegrino, E. D., & Thomasma, D. C. (1993). The virtues in medical practice. Oxford University Press.
11. Persad, G., Wertheimer, A., & Emanuel, E. J. (2009). Principles for allocation of scarce medical interventions. The Lancet, 373(9661), 423–431. https://doi.org/10.1016/S0140-6736(09)60137-9
12. Prainsack, B., & Buyx, A. (2017). Solidarity in biomedicine and beyond. Cambridge University Press.
13. Ruger, J. P. (2010). Health and social justice. Oxford University Press.
14. Sen, A. (2009). The idea of justice. Harvard University Press.
15. Tronto, J. C. (1993). Moral boundaries: A political argument for an ethic of care. Routledge.
16. World Health Organization. (2021). Risk communication and community engagement (RCCE) action plan guidance: COVID-19 preparedness & response. WHO.
