Throughout the centuries, societies have looked to the caring professions in times of health crisis, and in
response, healthcare workers can boast a long history of serving their patients regardless of the hazards. In
recent times, the culture of duty to serve has become eroded by an increasing emphasis on self-determination
and a transactional approach within the healthcare worker (HCW)/patient relationship. We examine the tension
between duty to serve and personal autonomy, and place the four traditional medical ethical principles of
beneficence, non-maleficence, justice and autonomy within a layered framework that takes account of societal
context and values. These issues are teased out in a hypothetical discourse between two moral philosophers
Socrates and Plato, who use a process of reflective equilibrium to resolve the following question: Should
healthcare organisations ethically be able to compel healthcare workers to serve during a pandemic, regardless
of unavoidable personal risk?
