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. 2023 Dec;44(12):2044-2049.
doi: 10.1017/ice.2023.121. Epub 2023 Jul 10.

An ethical framework adapted for infection prevention and control

Charlie Tan  1   2 , Marianna Ofner  1   3 , Heather L Candon  1 , Kevin Reel  4   5 , Sally Bean  3   4 , Adrienne K Chan  1   2   3 , Jerome A Leis  1   2   3
Affiliations

An ethical framework adapted for infection prevention and control

Charlie Tan et al. Infect Control Hosp Epidemiol. 2023 Dec.

Abstract

Objective: The ethical implications of infection prevention and control (IPAC) are recognized, yet a framework to guide the application of ethical principles is lacking. We adapted an ethical framework to provide a systematic approach for fair and transparent IPAC decision making.

Methods: We conducted a literature search for existing ethical frameworks in IPAC. Working with practicing healthcare ethicists, an existing ethical framework was adapted for use in IPAC. Indications were developed for application to practice, with integration of ethical principles and process conditions specifically relevant to IPAC. Practical refinements were made to the framework based on end-user feedback and application to 2 real-world situations.

Results: In total, 7 articles were identified that discussed ethical principles within IPAC, but none proposed a systematic framework to guide ethical decision making. The adapted framework, named the Ethical Infection Prevention and Control (EIPAC) framework, takes the user through 4 intuitive and actionable steps, centering key ethical principles that facilitate reasoned and just decision making. In applying the EIPAC framework to practice, weighing the predefined ethical principles in different scenarios was a challenge. Although no hierarchy of principles can apply to all contexts in IPAC, our experience highlighted that the equitable distribution of benefits and burdens, and the proportional impacts of options under review, are particularly important considerations for IPAC.

Conclusions: The EIPAC framework can serve as an actionable ethical principles-based decision-making tool for use by IPAC professionals encountering complex situations in any healthcare context.

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Conflict of interest statement

All authors report no conflicts of interest relevant to this article. Dr. Leis reports receiving remuneration for expert testimony as requested by hospitals of the Ontario Hospital Association, Ministry of the Attorney General, and Seneca College.

Figures

Figure 1.
Figure 1.
The Ethical Infection Prevention and Control (EIPAC) framework.
See this image and copyright information in PMC

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