This expert commentary addresses two key ethical issues facing healthcare professionals providing frontline care during the COVID-19 pandemic: allocation of scarce lifesaving resources and whether to respond despite risks involved.

Regarding allocation of scarce resources, the article emphasizes first the need to do everything possible to avoid or delay rationing, including strategic preparation and planning and efforts to obtain, conserve, reuse, adapt, or substitute resources. If rationing becomes necessary, it should be guided by the principle of distributive justice, which requires that scarce resources be distributed fairly and provided to those most in need by impartial and neutral decision makers treating like cases alike. If no alternatives are available, the removal of a resource for reallocation to a patient with higher likelihood of benefit may be justified.

Regarding the duty to treat despite risks, the article notes that the duty is not absolute and depends on a professional’s own risk assessment and value system, including both personal and professional factors. The author also notes that willingness to respond may vary between different types of professional and non-professional staff, with a high likelihood that support personnel (e.g., materials and supply, logistics, cleaning, information technology, maintenance, and refuse removal) may not be as willing to accept risks in responding, in part due to concerns that their personal safety is insufficiently addressed by administrators. The author emphasizes the importance of communicating timely, relevant, and credible information to all staff to encourage maximal personnel response, and the need to provide all members of the healthcare system with as much support and security as possible.