The COVID-19 pandemic brought many troubling ethical issues to the frontlines of clinical care, creating significant distress for clinicians, patients, and families. Behind the scenes, clinical ethicists managed those issues to support front-line workers and were integral to hospital operations.

Until now, little has been published about the expanded role clinical ethicists played during this time and their role in supporting hospital operations across the country. A new study from the University of Pennsylvania School of Nursing (Penn Nursing) reports how clinical ethicists provided consultation and guidance in situations of uncertainty, distress, or disagreement, often with imperfect information.

“Although the clinical ethicists’ role has been studied under usual circumstances, very little is understood about their experience during the pandemic, the ethical challenges they faced, and how they addressed their own ethical challenges or received support,” says the study’s lead investigator, Connie M. Ulrich, PhD, RN, FAAN, Lillian S. Brunner Chair in Medical and Surgical Nursing, Professor of Nursing and Professor of Medical Ethics and Health Policy at Penn Nursing.

The results of the study have been published in the journal AJOB Empirical Bioethics. The article “Ethical Challenges Experienced by Clinical Ethicists During COVID-19” is available online.

“By understanding the experiences of clinical ethicists during the COVID-19 pandemic and the ethical challenges they faced, we can better understand how their expanded role links to both clinical and organizational outcomes,” says Dr. Ulrich. “Moreover, it is important to know whether this role has now moved beyond traditional conceptions and the resulting future educational needs.”

Co-authors of the article include Janet A. Deatrick, PhD, RN, FAAN, Professor Emerita of Nursing; Jesse Wool, MBE, BSN; and Liming Huang, all of Penn Nursing; Nancy Berlinger of the Hastings Center; and Christine Grady of the National Institutes of Health.