An Internal Moral And Ethical Conflict Doctors Face Every Day During This Pandemic

One of the most memorable milestones in my life was my journey to becoming a doctor. A path that I look upon so fondly as it marks a time that molded much of who I am today. Charles Dickens describes my experience perfectly, “It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness …”

Like many of the milestones in my life, I cherish the memory of a promise I made to myself and to my community to protect, serve, share, teach and bear witness to life’s most precious gift. This sacred oath forms the foundation and rite of passage to all medical students globally, and it exemplifies the hallmark of a doctor’s promise: The Hippocratic oath. While we always recall the most famous line, “I will do no harm,” we all know that it is so much more than that. It’s a promise that binds all doctors together as we share our journey into medicine.

I never expected I would revisit this oath I made over a decade ago. Who knew that during a global crisis and perhaps during man’s most crucial time of need, that I (unknowingly) would pause and re-evaluate my pledge. What kind of sacrifice will I make? Will I risk my own health? What about my family’s health? What other measures outside of the hospital should I make for the community’s safety?

If you had asked me these questions when I first started my training, I would have formulated my answers a lot faster. Today, however, circumstances are different. My life has changed in many ways I could have never predicted and have gained new responsibilities and people to care for over the years. So with these changes, what does the Hippocratic oath mean to me now, and more importantly, what does it mean to everyone else who took the same pledge I did?

And before we had time to formulate our answers, we already had expectations and answers for us from the world. As a physician during the pandemic, your role expands beyond that of a bystander in the community. We are viewed as a separate entity, the solution to the problem at hand, and are expected to play an active role in healing the community’s sickest patients at our own risk. You are, to some extent, selfless because you chose to be a doctor. We took an oath to care for those in need and to provide help to the community with the assumption that other people’s needs would be placed above our own. While it is not written in our oaths, it is a practice that is grounded in our core traditions.

We sacrificed years of our time to become a doctor. Many of us went into debt and risked financial instability. Some of us deferred having a married life with children, and for others, they sacrificed their own health to work long hours in the hospital. The community gave us our answer before we had time to process what it meant us. Those answers came in forms of a donated meal, discounted child care, hand-sewn face mask, an afternoon community applause, or simply: thank you. Thank you for your sacrifice, and thank you for choosing to be selfless.

While many of us are willing to put our own health on the line, never have we all had to ask if we are willing to put our loved ones’ life at risk. Did swearing this oath also mean my family faced the sacrifice of my decision?

And should you ever show the fear for your own personal safety, it is perceived as being selfish. A word that doesn’t fit into the brand of being a doctor. This virus has forced each of us to face the hardest question of all: How selfish or selfless are you?

What I’ve come to conclude is that, like everyone else, doctors are human. We have fears, anxiety, and apprehension during a pandemic like any other human being. During these times, we seek help and shelter in each other and in the community, a behavior that shocks the world.

When we advocate for personal protective equipment, it can be perceived as selfish. When we try to limit or replace bedside interactions, it’s perceived as less humane. When we leave the hospital early to limit our exposure risk, it is seen as being insensitive or uncaring.

It is an internal moral and ethical conflict we face every day during this pandemic. Doctors everywhere are digging deep to find an answer that they are personally comfortable with. We are all struggling to find a medium that we are proud of, whatever degree of being selfish or selfless that answer is. Some people have chosen to separate from their families completely while others find strength and support when they return home. Some made choices to sit at the bedside of their dying patient while others help coordinate family good-byes on an iPad. No matter the story, no matter the choice, no matter the outcome, there is no right or wrong answer.

But the answers we have found have made us question and re-evaluate the deepest foundation of our medical journey: Our oath to help the sick and our sacrifices we are willing to make to keep that oath.

While coronavirus has really made me re-evaluate my choice and journey to becoming a doctor, it has also reminded me of all the beautiful and honorable reasons why I am so proud to be a part of the medical community.

Monica Peng is a pediatric hospitalist.

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