Editorial introduction: Bioethics, COVID-19, and racial, economic, and social inequity in US health care

Mark Medley, a member of the editorial board of Review & Expositor, and my friend since 1993 when we first met as graduate students at the University of Notre Dame, contacted me a year ago to invite me to edit this issue focusing on bioethics and health care, with attention given to the implications of the COVID-19 pandemic and the racial, economic, and social inequities in the US health care system. That is a mouthful for a topic, but I was pleased to accept the invitation. Indeed, I am delighted to share with readers the following essays contributed to this thematic issue by a cohort of conscientious and punctual academicians and scholarly practitioners. That is not to say, of course, that I take delight in the problems these eight articles and three expository essays address. God forbid. After all, for all the good the health care system and medicine accomplish in the United States, it seems that just as many problems are associated with it.1 Moreover, during the last 3 years, the COVID-19 pandemic has unmasked and exacerbated profound weaknesses already present within US health care, such as equitable access to, and just allocation of, health care. The mandatory lockdowns, the masking policies, and the vaccines to mitigate the spread of COVID-19 and its variants also have raised deep-seated questions and generated intense disagreement and debate. Because some of the essays that follow narrate the origin and spread of COVID-19, I will not rehearse that narrative here. Suffice it to say that politicians and government officials, health care professionals and providers, clergy and chaplains, employers and employees, colleges and universities, ethicists, and theologians all seemed caught off guard and ill-prepared to respond to this new global threat to people and communities, especially vulnerable people, including the elderly, children, the poor, persons of color, and the immunocompromised. Even the health care professionals found themselves stretched and stressed beyond their physical, mental, moral, and spiritual limits. My spouse is an ICU registered nurse, and her experiences with COVID-19 patients and their loved ones often felt overwhelming; yet she somehow persisted in providing the best care she could for them.