Guidelines for Ethical Healthcare Decision-Making
in Pakistan in Covid-19 Times

(Click here to view guidelines)

As the Covid-19 pandemic unfolded in Pakistan, with a daily increase in the number of cases, senior faculty members at CBEC were approached by various healthcare professionals working locally on the frontline with questions pertaining to ethical delivery of healthcare in this crisis situation.  Taking this into consideration, one of CBEC’s key contributions was to draw up a guidance document for ethical decision-making contextualized to the realities of Pakistan.

The guidelines, formulated in a timely fashion, were circulated to several key stakeholders in public and private medical institutions, and civil society members. Since then, the National Bioethics Committee of Pakistan has also ratified the guidelines which are now available on CBEC’s website.

The aim of these guidelines is to provide an ethical framework to healthcare professionals and institutions for drawing up Standard Operating Procedures allowing maximization of benefits to the public. One of the core features of the document is prioritization of access to treatment for healthcare professionals and ancillary staff at the frontline based on the principle of reciprocity. Given the collectivist nature of Pakistani society, this provision also includes first-degree relatives of healthcare providers (HCPs) and ancillary staff.

Since their formulation, the guidelines have been widely disseminated both nationally and internationally. HCPs working in Pakistan have found these guidelines “timely, “succinct”, “useful” and “easy to read.” American scholar and writer, Dr. Judith Swazey, who is a close associate of CBEC, compared triage decisions about ventilators in Covid-19 times to “the early days of dialysis in the 1960s,” calling these “painful decisions” for HCPs to make. The inclusion of the clause calling upon institutions to provide mental healthcare services to HCPs was also widely appreciated among the group that received the guidelines. It is hoped that the document will be useful for individual institutions, providing them guidance as the pandemic takes its course in the country.