Should neurosurgeons continue to work in the absence of personal protective equipment during the COVID-19 era?

Eijkholt, Marleen; Hulsbergen, Alexander; Muskens, Ivo; Mathiesen, Tiit Illimar; Bolger, Ciaran; Feldman, Zeev; Kitchen, Neil; Samprón, Nicolás; Sandvik, Ulrika; Tisell, Magnus; Broekman, Marike

The COVID-19 pandemic has resulted in a widespread shortage of personal protective equipment (PPE). Many healthcare workers, including neurosurgeons, have expressed concern about how to safely and adequately perform their medical responsibilities in these challenging circumstances. One of these concerns revolves around the pressing question: should providers continue to work in the absence of adequate PPE? Although the first peak of the COVID-19 crisis seems to have subsided and supply of PPE has increased, concerns about insufficient PPE availability remain. Inconsistent supply, limited efficacy, and continued high demand for PPE, combined with the continued threat of a second COVID-19 wave, mean that the issues surrounding PPE availability remain unresolved, including a duty to work. This paper offers an ethical investigation of whether neurosurgeons should perform their professional responsibilities with limited availability of PPE. We evaluate ethical considerations and conflicting duties and thereby hope to facilitate providers in making a well-considered personal and moral decision about this challenging issue.