Expertise Gained During the COVID-19 Pandemic: Exploring Ethical Implications Through Practitioners’ Narratives

Abstract

The COVID-19 pandemic necessitated a transition to telehealth. Research supports the use of telehealth; however, there is a paucity of literature on the ethical considerations of this shift. This study explored ethics through narratives of practitioners’ lived experiences of transitioning to telehealth. Semi-structured interviews were conducted virtually with 10 pediatric health care professionals. Transcripts were analyzed from a narrative phenomenological perspective. Discussed themes include responding to the rapid redirection, collaborating with colleagues and caregivers, applying therapeutic use of self, and evolving pragmatic clinical reasoning. Transitioning to telehealth resulted in ethical dilemmas pertaining to clients and practitioners. The need for additional support was salient to ensure clients received beneficial services that would not cause harm (non-maleficence). Communities of practice formed organically as forums to explore strategies for sharing comprehensive and equitable information (veracity and justice). Knowledge generated through providers’ experiences may inform future guidelines on service delivery transitions.

Plain Language Summary

Knowledge Gained during the COVID-19 Pandemic: Exploring Ethical Principles in Stories Shared by Practitioners

During the COVID-19 pandemic, practitioners changed from largely in-person to telehealth (e.g., Zoom) service delivery models. Past research on telehealth has reported positive and negative effects but has not fully explored the ethical considerations. To understand how practitioners were able to make this transition and the ethical implications, we interviewed 10 practitioners about doing telehealth sessions. We analyzed the data using a framework (narrative phenomenology) to guide our exploration into the conflict, setting, and characters in the stories shared by providers. The stories were organized into four themes: responding to the rapid redirection, collaborating with colleagues and caregivers, applying therapeutic use of self, and evolving pragmatic clinical reasoning. Practitioners said they needed more training and support during changes in service delivery. They worked together to share resources and new information. This helped to ensure high-quality services that followed ethical principles (doing the right thing). The information learned here may inform guidelines for transitioning between service delivery models.