| Keywords [eng] |
Healthcare crises, Ethical dilemmas, Medical ethics, Physicians, COVID-19 pandemic, Resource allocation, Triage, Patient autonomy, End-of-life care, Disaster medicine, Crisis standards of care, Umbrella review |
| Abstract [eng] |
Healthcare crises, such as pandemics, infectious disease outbreaks, and other large-scale emergencies, place significant pressure on healthcare systems and pose complex ethical challenges for physicians. This study aimed to synthesize and analyze the existing literature to identify ethical dilemmas encountered by physicians during healthcare crises. An umbrella review was conducted using PubMed, Scopus, and Google Scholar to identify relevant review articles published between 2000 and 2025. Predefined inclusion and exclusion criteria were applied to ensure relevance to ethical issues in healthcare crises. A total of 714 records were identified, and after screening and full-text assessment, 15 review articles were included in the final analysis. Data were extracted and analyzed using a narrative synthesis approach. The findings of this review indicate that ethical dilemmas commonly occur in situations where healthcare resources are limited and clinical decisions must be made under pressure. The most commonly identified challenges included allocation of scarce medical resources, triage and patient prioritization, professional responsibilities and duty to care, and difficulties maintaining patient autonomy and end-of-life communication. The reviewed studies additionally emphasized the emotional and moral burden experienced by healthcare professionals when making ethically complex decisions during crises. Overall, the findings suggest that ethical dilemmas in healthcare crises are influenced by both clinical and systemic factors. The presence of clear ethical guidelines, structured decision-making frameworks, and institutional support may help healthcare professionals manage these challenges more effectively. In conclusion, ethical challenges are an inherent part of healthcare crises, and improving ethical preparedness within healthcare systems may support better decision-making and improve the quality of care during healthcare emergencies. |
