When pandemic and everyday ethics collide: supporting ethical decision-making in maternity care and paediatrics during the Covid-19 pandemic

The response to Covid 19 (C19) will have far reaching consequences for the NHS. This project focuses on how this response has created significant ethical issues for providers of non-C19 services when deciding how to prioritise and reconfigure services. Our central aim is to evaluate and support ethical decision-making in two non-C19 areas: maternity and paediatrics. We have chosen these areas because they have been significantly affected by the C19 response, with professional and patient organisations highlighting the problematic effects on both areas (First 1001 Days, Royal College of Midwives, Make Births Better). Objectives 1. Conduct a rapid review of current local policies and policy-making processes for non-C19 maternity and paediatric services. 2. Examine how the policies are applied in clinical practice and pilot test approaches to ethics support. 3. Make recommendations for ethics support at local policy-making and practitioner levels; and develop tools to support good decision-making practice. This inter-disciplinary project is an empirically informed ethical analysis of current policies, processes and practice in non-C19 maternity and paediatrics. Design: empirical ethics, employing Frith's symbiotic empirical ethics approach, where philosophical theory is used to explore the data, draw normative conclusions, and make policy and practice recommendations. Methods: rapid review of local policies and decision-making processes; analysis (against the national ethics framework for pandemics) of the values being engaged; interviews with key stakeholders involved in policy formation, and healthcare practitioners to understand how the policies are being applied in clinical practice and what support they might need in their ethical decision-making.