An Ethical Analysis of COVID-19 Visitation Policies: A Scoping Review
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Date
2024-05
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The Ohio State University
Abstract
During the COVID-19 pandemic, hospitals instituted strict restrictions on inpatient visitation to protect vulnerable individuals, prevent the spread of the virus and conserve limited supply of personal protective equipment (PPE). These measures resulted in negative consequences for healthcare staff, patients, and families. These visitation policies raised ethical questions about how best to balance the beneficial and harmful consequences. The purpose of this review is to identify and describe the ethical issues and dilemmas associated with hospital visitation restrictions during the COVID-19 pandemic on patients, families, and healthcare staff members. A scoping review was conducted using criteria to search two health databases, PubMed and CINAHL, covering publications from March 2020 to March 2023. We included articles with ethics, morals, or ethical challenges in the title or abstract within any inpatient specialty unit, any country or state, and all ages. Excluded articles were those outside the targeted time range, in other settings such as prisons, schools, and dorms, and travel restrictions. Our initial search yielded 485 articles. After scanning the titles and abstracts followed by full-text reviews, data were extracted, using Covidence, from 25 articles. NVivo software was then used to synthesize data from each article. Information was highlighted and placed in “nodes” or categories using NVivo. We used qualitative thematic analysis to examine ethical concepts regarding COVID-19 visitation policies. Upon review, six main themes, and 41 sub-themes, were established: autonomy, benefit and harm, ethical justification, policy-issues, virtual visitation, and impact on well-being. These themes and sub-themes are the basis of our synthesis of evidence. Findings from this study may assist healthcare institutions to consider ethical implications as part of policy decisions related to the balance of limited visitation and patient safety during a public health crisis.
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Keywords
COVID-19, ethical challenges/dilemmas, visitation, policies and/or restrictions