Ethic Series: PDF OnlyEthical Implications of COVID-19 Palliative Care, Public Health, and Long-Term Care FacilitiesParekh de Campos, Amisha PhD, MPH, RN, CHPN; Daniels, Susan MSN, RN, CHPNAuthor Information Amisha Parekh de Campos, PhD, MPH, RN, CHPN, is assistant clinical professor, University of Connecticut School of Nursing, Storrs, and quality and education coordinator, Middlesex Health, Middletown, Connecticut. Susan Daniels MSN, RN, CHPN, is hospice resource nurse, Middlesex Health, Middletown, Connecticut. Address correspondence to Amisha Parekh de Campos, PhD, MPH, RN, CHPN, 21 Pleasant Street, Hospice Homecare, Middletown, CT 06457 ([email protected]). The authors have no conflicts of interest to disclose. This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections. Journal of Hospice & Palliative Nursing: January 6, 2021 - Volume Publish Ahead of Print - Issue - doi: 10.1097/NJH.0000000000000735 Free PAP Metrics Abstract Outbreaks of COVID-19 among nursing homes, assisted living facilities, and other long-term care facilities in the United States have had devastating effects on residents. Restrictions such as banning visitors, sequestering residents, and testing health care staff have been implemented to mitigate the spread of the virus. However, consequences include a decline in mental and physical health, decompensation, and a sense of hopelessness among residents. We present and explore a case study at an assisted living facility addressing the ethical issues in balancing the management of the community versus the resident's right to autonomy and self-determination. A team of palliative care experts was brought into assisted living facilities to manage patients, care for well residents, and provide input in advance care planning and symptom management. The principles of self-determination and autonomy, stewardship, and distributive justice were explored. The use of nursing skills in triage and assessment, principles in public health, and the 8 domains of palliative care provided a comprehensive framework for structuring emergency operations. Palliative interventions and the role of palliative care nurses played an integral part in addressing ethical challenges in the containment of the virus and the deleterious effects of social isolation among the elderly. © 2021 by The Hospice and Palliative Nurses Association.