Medical students in the COVID-19 pandemic response in Brazil: ethical reflections

Abstract

Abstract: Introduction: In times of pandemics, the uncertainties and lack of evidence allow each country to conduct its response as it deems the most appropriate. This setting also facilitates the approval of public measures without adequate ethical analysis, due to its inherent urgency. With that said, the objective of this study is to promote a hermeneutical approach to the Brazilian Government proposals of including medical students in the fight against COVID-19 (Coronavirus Disease 2019) pandemic through an ethical perspective. Development: The governmental resolutions, published in the Brazilian Official Gazette, were discussed in the light of the Universal Declaration on Bioethics and Human Rights (UDBHR) and the Brazilian Medical Student Code of Ethics (CEEM), as the first one guides the debate through a pluralist, multi-, inter- and transdisciplinary bioethics, and the latter brings specified guidance to the studied population group. To better articulate the discussion, the main measures were subdivided into 3 sections: about the risk assessment; about the participation of 5th- and 6th-year students; about the early graduation. In the first one, the creation of participation alternatives has been proposed, including remote participation, without direct contact with patients, aiming to ensure the students’ integrity and to maximize the potential positive effects with minimum harm. After that, the predicted obligatory enrollment for undergraduate students attending the final years of medical school and the possibility of obtaining credit hours for the curricular internship in exchange for participation in the strategic action “O Brasil Conta Comigo” were assessed. Finally, the graduation anticipation and the need for a guarantee that the new graduates have the required knowledge and expertise for the medical profession were questioned. Conclusions: For an effective response against the disease, it’s necessary to collectively structure the adopted measures, benefiting from the capabilities that the students already have, while respecting their limitations, vulnerabilities, and freedoms. It should also be emphasized that any ethical decisions in the context of Medicine and of future generations of professionals can have immeasurable consequences for these individuals, their patients, and communities and thus, one must ensure that the benefits will be the best and greatest possible.