Dear Editor
romoting the principles of professional
practice is an approach to build trust among
individuals concerning the medical profes
sion. Individuals’ trust in nurses plays a cru
cial role in patient care; thus, is of signifi
cant importance. The main cornerstone in nursing care is
the existence of nurses with professional ethics.
Due to the epidemic of Coronavirus Disease ۲۰۱۹
(COVID-۱۹), numerous patients have been hospital
ized in the Intensive Care Unit (ICU) and some have
expired in Iran and around the world. COVID-۱۹ high
lighted various difficult ethical issues encountered by
healthcare providers in caring for patients and families.
Nurses, as frontline healthcare workers, spend most of
their time with patients; therefore, it is essential to ad
dress the ethical concerns they face [۱].
Attention to safety in nurses
In the fight against COVID-۱۹, ensuring the safety
of nurses and other forefront healthcare workers is an
important ethical concern. Nurses have to work under
conditions that pose fundamental and uncertain risks to
their health. Although nurses often voluntarily care for
patients in high-risk situations, deficiencies and inappro
priate conditions (e.g. the lack of protective facilities),
prolonged presence in the wards to compensate for staff
shortages, and patient care threaten their health; accord
ingly, such conditions jeopardize more effective patient
care. Due to these limitations, nurses cannot provide ef
fective care and experience moral distress, psychological
distress, and Post-Traumatic Stress Disorder (PTSD) [۲].
Providing healthcare resources for patients
COVID-۱۹-induced conditions have necessitated
more serious (and ethical) attention to the prioritization
of care and resources in different care units. Making the
right decision about the patient is among the ethical as
pects that nurses encounter in special wards; it imposes
a great moral burden on the healthcare staff. Nurses
must provide care, justice, transparency, and protection
in a way that does not incur legal and conscientious re
sponsibilities.
Patients with COVID-۱۹ are admitted to
hospital wards with different care needs. They require
adequate medical care, beds, ventilators and oxygen
therapy, medicine, and so on. When nurses are unable to
provide effective care due to a large number of hospital
ized patients and the lack of facilities, they face moral
contradictions. Even in the UK, due to a large number
of patients, the situation changed; normally, in the ICU,
the ratio of nurses to patients was ۱: ۱, i.e., altered to
۱: ۶. Consequently, it affected care and caused ethical