Moral decision making in healthcare and medical professions during the COVID-19 pandemic

With coronavirus disease 2019 (COVID-19) outbreak, healthcare and medical professions face challenging situations. High number of infected patients, scarce resources, and being vulnerable to the infection are among the reasons that may influence clinicians’ decision making and puts them in a moral situation. Furthermore, they may be carriers of coronavirus, resulting their social interactions to involve moral decision making. The aim of this study was to examine the moral decision making in clinicians during the COVID-19 pandemic and to find its relation to psychological, cognitive, and behavioral correlates. 193 clinicians who worked in hospitals allocated to coronavirus disease patients, participated in our study. We designed an online survey containing 8 dilemmas to test moral decision making in clinicians. Information on clinicians’ behavior, cognition and psychological state during the COVID-19 pandemic, including the degree of respect to social distancing, sources of stress, and dead cases of COVID-19 they confronted with were collected. The relation between these measures and moral decision making was assessed. Based on our results, clinicians’ most important source of stress was the infection of their families. There was a positive correlation between utilitarian responses and clinicians’ stress level, and number of dead cases they confronted with. Moreover, degree of utilitarian behavior was positively correlated to social distancing. Both age and sex contributed to individual differences in respecting social distancing, stress and utilitarian behavior. With increasing stress and encountering more deaths, clinicians tended to decide based on the outcome. Our results have critical implications in implementing policies for healthcare principals.