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Medicine and nursing have long professional traditions of altruism and self-sacrifice, including undertaking not only extreme stress but also personal risk in service of patient care. With exceptions for natural disasters, humanitarian missions, and military service, however, recent concerns about professional “burnout” often have had more to do with mismanagement, exploitation, and generational or technological change than with core clinical circumstances. The COVID-19 pandemic changed that – bringing front and center the close connections between the well-being of health care workers and the well-being of the patients they serve. This chapter begins with the COVID-19 experience of health care workers in New York City and environs during the spring of 2020, examining what happened, why things went wrong, and how it drew attention and generated responses. The chapter then steps back to consider the root causes of health professionals’ physical and psychological vulnerability and moral anguish, such as inequities within the health care system, professional hierarchies, discrimination, safety system failures, and problems with business and regulatory practices. The chapter concludes by offering a range of potential improvements, ranging from ethics and advocacy to corporate governance and labor organization to workplace redesign to legal reform.

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Cambridge University Press


An online version of this work is published at under a Creative Commons Open Access license CC-BY-NC-ND 4.0 which permits re-use, distribution and reproduction in any medium for non-commercial purposes providing appropriate credit to the original work is given. You may not distribute derivative works without permission. To view a copy of this license, visit


I. Glenn Cohen, Abbe R. Gluck, Katherine Kraschel, & Carmel Shachar

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COVID-19 and the Law: Disruption, Impact and Legacy

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