____________________________________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________________________________ 1 J o u rn a l o f M E D IC A L E T H IC S A N D H IS T O R Y O F M E D IC IN E Letter to editor Volume 13 (Suppl.) Number 29 December 2020 Copyright © 2020 Tehran University of Medical Sciences. This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International license (https://creativecommons.org/licenses/by-nc/4.0/). Non-commercial uses of the work are permitted, provided the original work is properly cited. The significance of shared humanity during the COVID-19 pandemic *Corresponding Author Arpi Manookian School of Nursing and Midwifery, Dr Mirkhani St., Tohid Sq., Tehran, Iran. Postal Code: 1419733171 Tel: (+98) 21 61 05 43 22 Email: ar-manookian@sina.tums.ac.ir Received: 19 Nov 2020 Accepted: 30 Nov 2020 Published: 23 Dec 2020 Citation to this article: Manookian A. The significance of shared humanity during the COVID-19 pandemic. J Med Ethics Hist Med. 2020; 13(Suppl.): 29. Arpi Manookian* Assistant Professor, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran. The COVID-19 pandemic is widely considered to be the most catastrophic crisis that has caused widespread suffering worldwide. A growing body of literature has shown that the COVID-19 pandemic has brought multifaceted health challenges and devastating effects on people's psychological, social and spiritual health. This crisis does not only affect the general population, but is also associated with increased mental and spiritual distress among medical staff including nurses (1). We should all admit that nurses are on the front lines of the COVID-19 pandemic and are therefore facing greater risks than they normally do in their routine practice. They spend more time in close contact with COVID-19 patients and sit by patients’ bedsides instead of spending time with their own families or fulfilling their physical, psychological, and spiritual needs (2). Many concerns have arisen about nurses’ emotional breakdown and also well-being. Nurses struggle with physical and psychological burdens and the burn-out resulting from the COVID-19 pandemic, and most of them continue to be on the front line fighting COVID-19 and providing nursing care (1, 2). Achieving this requires more than simple nursing interventions, but rather the application of "nursing presence" (3). Much work has been carried out on “nursing presence” (3, 4) and “caring capacity” (5). Nursing presence is a critical concept in nursing practice that has been defined as a therapeutic interaction where both the nurse and the patient share common humanity through establishing a deep connection, attentiveness, and compassionate care (3, 4). The significance of shared humanity during the Covid-19 Pandemic 2 J o u rn a l o f M E D IC A L E T H IC S A N D H IS T O R Y O F M E D IC IN E Volume 13 (Suppl.) Number 29 December 2020 Along the same lines, each individual possesses a certain quality called “caring capacity”. It is a unique moral power which elucidates that we deserve respect for our worth and dignity. In this regard, Miller pointed out that “care refers to responding to others’ needs by understanding and adopting their ends as one’s own and making an effort to cultivate and restore their agency” (5). Thus, nursing care is not an obligation but rather a vocation that seeks to serve people and help maintain their dignity through care. In the process of caring for patients, nurses will have the opportunity to contemplate the common needs of all humans, and even concepts such as humanity itself. However, there is still a critical issue related to the key motivational factor that inspires nurses to go beyond their capacity and professional duty and risk their own life and that of their family members to save others. They make the sacrifice to help fight the COVID- 19 pandemic despite the various threats they face. But what inspires nurses to risk their lives and work so hard to protect others in these tough times? Why are they so deeply and intrinsically driven to care for those who need help? This may partly be due to their professional obligations and sense of commitment, but nurses do not seem to be merely bound by their professional duties, particularly during the COVID-19 pandemic. It appears that nurses’ strong motivation is the result of their faith in their intrinsic value as human beings and the inherent worth of their profession. In other words, nurses work so selflessly to maintain their standards in terms of humanity and actualize their perception of themselves as nurses (6). Nurses work so tirelessly to help the patients in these tough times of the COVID-19 pandemic not just because they have to, but because they feel a sort of connection to them. The care process forms a bond between the nurse and the patient that opens a window of humanity for both (7), and this shared humanity seems to be the key factor in overcoming the ethical challenges associated with the COVID-19 crisis. In this regard, Ursula von der Leyen, president of the European Commission, said, “None of us will be safe until everyone is safe” (8). This is a manifestation of our shared humanity, as reflected in a poem by the well-known Persian poet Saadi: The children of humanity are like limbs that share An origin in their creator When one limb passes its days in pain, The other limbs cannot remain”. Indeed, COVID-19 reminds us once again that we are one human community. Finally, the COVID-19 crisis could be considered a time to think deeply about what matters most in our personal and professional life. Given that, the current crisis may offer a moment of enlightenment for nurses and trigger them to reflect on their values, beliefs, and the assumptions underlying their practice. Manookian A. 3 J o u rn a l o f M E D IC A L E T H IC S A N D H IS T O R Y O F M E D IC IN E Volume 13 (Suppl.) Number 29 December 2020 In this regard, in one of my previous studies, the results indicated that the concept of dignified care implies “enlightened practice” (9). Thus, the current crisis of COVID-19 has brought us to realize the significance of humanistic interactions between patients and nurses, our interconnectedness, and also the fact that dignified care may be a new path to enlightenment. In conclusion, the COVID-19 crisis provides us with an opportunity for ethical reflections on the intrinsic values in our profession, our common needs and ends, and also our shared humanity. Furthermore, the current crisis may help us reach personal and professional growth and development by recognizing our interconnectedness, not only during these times, but for years to come. The significance of shared humanity during the Covid-19 Pandemic 4 J o u rn a l o f M E D IC A L E T H IC S A N D H IS T O R Y O F M E D IC IN E Volume 13 (Suppl.) Number 29 December 2020 References 1. Van Bavel JJ, Baicker K, Boggio PS, et al. Using social and behavioral science to support COVID-19 pandemic response. Nat Hum Behav. 2020; 4(5): 460-71. 2. Gallagher A. Learning from Florence Nightingale: a slow ethics approach to nursing during the pandemic. Nurs Inq. 2020; 27(3): e12369. 3. Bozdoğan Yeşilot S, Öz F. Nursing presence: a theoretical overview. Journal of Psychiatric Nursing. 2016; 7(2): 94-9. 4. Finfgeld-Connett D. Meta-synthesis of presence in nursing. J Adv Nurs. 2006; 55(6): 708-14. 5. Miller SC. The ethics of need: agency, dignity and obligation, 1st ed. New York: Routledge; 2013, p.79. 6. Watson J. Nursing's global covenant with humanity–unitary caring science as sacred activism. J Adv Nurs. 2020; 76(2): 699-704. 7. Manookian A, Cheraghi MA, Nikbakht-Nasrabadi A. The mirror of humanity: a hermeneutical perspective in nursing. Nursing Practice Today. 2017; 4(3): 112-4. 8. Ghebreyesus TA, von der Leyen U. World Health Organization: A global pandemic requires a world effort to end it – none of us will be safe until everyone is safe. [cited 2020 December]; available from: https://www.who.int/news-room/commentaries/detail/a-global-pandemic-requires- a-world-effort-to-end-it-none-of-us-will-be-safe-until-everyone-is-safe 9. Cheraghi MA, Manookian A, Nikbakht Nasrabadi A. Patients' lived experiences regarding maintaining dignity. J Med Ethics Hist Med. 2015; 8: 6.