This pre-print of a forthcoming article provides recommendations for several pressing ethical challenges based on existing frameworks from the Hastings Center and the American College of Surgeons.

The article notes that the ethical issues raised by an infectious disease pandemic such as COVID-19 combine the challenges of contagious disease and those of scarce resource allocation. Reference points for the analysis therefore include well-established ethical reasoning from both the HIV/AIDS pandemic and organ transplant allocation.

Specific ethical dilemmas addressed include:

• Professional responsibilities of health care workers and duty to provide care;
• Patient confidentiality and duty to report positive cases to public agencies;
• Screening and testing for patients and health care providers;
• Allocation of scarce resources such as ICU beds, ventilators, and certain medications;
• Relaxation of treatment approval and credentialing guidelines; and
• End of life issue and goals of care discussions.

The authors offer conclusions and recommendations based on the duties outlined in the Hastings Center’s pandemic response ethical framework (duty to plan, duty to safeguard, and duty to guide) and the American College of Surgeons’ resource allocation ethical framework (transparency, advocacy, and commitment to support all affected directly or indirectly).