Principles for pandemics: COVID-19 and professional ethical guidance in England and Wales

Helen Smith, Peta Coulson-Smith, Mari-Rose Kennedy, Giles M Birchley, Richard Huxtable*, Jonathan C S Ives

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

1 Citation (Scopus)
4 Downloads (Pure)



During the arrival of the COVID-19 pandemic, various professional ethical guidance was issued to (and for) health and social care professionals in England and Wales. Guidance can help to inform and support such professionals and their patients, clients and service users, but a plethoraPe of guidance risked information overload, confusion, and inconsistency.


During the early months of the pandemic, we undertook a rapid review, asking: what are the principles adopted by professional ethical guidance in England and Wales for dealing with COVID-19? We undertook thematic content analysis of the 29 documents that met our inclusion criteria.


The 29 documents captured 13 overlapping principles: respect, fairness, minimising harm, reciprocity, proportionality, flexibility, working together, inclusiveness, communication, transparency, reasonableness, responsibility, and accountability.


We intend this attempt to collate and outline the prominent principles to be helpful, particularly, for healthcare practice during the COVID-19 pandemic and, hopefully, for future pandemic planning. We also offer some reflections on the guidance and the principles therein. After describing the principles, we reflect on some of the similarities and differences in the guidance, and the challenges associated not only with the specific guidance reviewed, but also with the nature and import of “professional ethical guidance”.
Original languageEnglish
Article number78 (2021)
Pages (from-to)78
Number of pages15
JournalBMC Medical Ethics
Issue number1
Early online date24 Jun 2021
Publication statusPublished - 24 Jun 2021

Structured keywords

  • Covid19


  • clinical ethics
  • COVID-19
  • Coronavirus
  • ethical guidance
  • professional guidance


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