Art of Medicine
Nov 2023

Isolation

Zachary G. Jacobs, MD
AMA J Ethics. 2023;25(11):E843-845. doi: 10.1001/amajethics.2023.843.

Abstract

This comic tells the true story of a hospitalist physician learning from a patient how to slow down. It is a commentary on the isolating experience of hospitalization—magnified for patients by infection control precautions and hospital restrictions and for clinicians by long hours away from family and friends, particularly during peaks of the COVID-19 pandemic.

Figure. Isolation, Connection, and Learning to Slow Down

figure1-artm3-2311

Media

Adobe Photoshop.

 

Hospitalization is one of the most isolating experiences imaginable. Separated from home and disconnected from family, friends, and other social support, patients in the hospital are frequently lonely and, in many cases, outright alone. This experience can be further compounded by infection control precautions, which impair socialization and hinder meaningful connection with staff. These compounding effects were exemplified in the early stages of the COVID-19 pandemic, when patients were quarantined behind closed doors and staff minimized time spent in rooms. Many hospitals banned visitation altogether, a decision decried by some as unethical.1

It is clinicians’ duty to support patients suffering from isolation; however, to do so is time-consuming and adds to their stress, especially in the context of infection control precautions and other barriers to efficiency. Personal well-being and duty to family are frequently at odds with beneficence, or the desire to be universally present for patient needs. Ethically, physicians have the right to strike a balance between the duty to care and the duty to self and family2—arguably more than ever during a deadly pandemic3—but even the briefest moments of accompaniment4 can make all the difference in the lives of patients, particularly during times of isolation.

References

  1. McTernan E. Against visitor bans: freedom of association, COVID-19 and the hospital ward. J Med Ethics. 2023;49(4):288-291.
  2. Mercurio MR, Peterec SM. Attending physician work hours: ethical considerations and the last doctor standing. Pediatrics. 2009;124(2):758-762.
  3. McConnell D. Balancing the duty to treat with the duty to family in the context of the COVID-19 pandemic. J Med Ethics. 2020;46(6):360-363.
  4. Jacobson JO. Accompanying patients in the time of COVID-19. JAMA Oncol. 2021;7(7):971-972.

Citation

AMA J Ethics. 2023;25(11):E843-845.

DOI

10.1001/amajethics.2023.843.

Conflict of Interest Disclosure

Author disclosed no conflicts of interest.

The viewpoints expressed in this article are those of the author(s) and do not necessarily reflect the views and policies of the AMA.