Table 1.

Examples of major ethical principles challenged by the COVID-19 outbreak

	Principles	Examples
A	Equity	Everyone has the same opportunity to acquire good heath Blacks, Native Americans, diabetics are at high risk for COVID compromising their acute and future health
B	Justice	The same regimens are uniformly available In the developing world access to vaccines and pharmaceutical are severely impaired
C	Autonomy	Patients can accept to reject a course of medical action In acute situations decisions are made arbitrarily by ER doctors
D	Transparency	Medical decisions are made with honesty, reliability and integrity Some medical trial regarding hydroxychloroquine were not carried out ethically
E	Solidarity	Benefits and obligations are carried out equally throughout society Some vaccine trials benefited primarily those in the developed world
F	Good science	The principles of scientific investigation, such as Koch principles are carriedout and used to make decisions Leaders touted unproven forms of therapy
G	Concern for the disadvantaged	The underprivileged, the impoverished are given particular concern
H	Duty to treat	Providers may not discriminate against patients based on disease or medical status Shortages of supplies and nurses were common in many areas during the outbreak
I	Proportionality	The benefits of a policy outweigh the burdens Do lockdown measures prevent disease more than deflate the economy?
J	Beneficence	The best interests of patients are given primary concern Triage decisions may make beneficence difficult
K	Nommalfeasance	Doing no harm is a mainstay of medical care Appropriate therapies are not universally espoused by providers