During the early stages of the COVID-19 pandemic, many healthcare services unrelated to the virus were temporarily halted. In April 2020, the Department of Health in England directed that these services should be reinstated alongside ongoing pandemic management. This process of “resetting” healthcare created a novel context in which it became crucial to examine how ethical principles informed—and should guide—the incorporation of infection control into everyday clinical practice. This paper draws on findings from the ‘NHS Reset Ethics’ project, which investigated the routine ethical dilemmas faced in restarting maternity and paediatric services across the NHS during the pandemic. Healthcare practitioners and members of the public contributed through interviews and focus groups, with the detailed qualitative methods described in other publications. This article, however, centers on our application of Frith’s symbiotic empirical ethics framework, which allows us to move from empirical observations to the normative proposition that clinical ethics should explicitly recognize the centrality of relationships in healthcare practice. The approach follows a five-step process designed to iteratively develop and refine ethical theory, grounded in a naturalistic understanding of ethics that views theoretical reflection and practical experience as mutually shaping one another. Findings from the Reset project indicated that modifications to working practices introduced ethical tensions for healthcare staff, while infection prevention and control measures often acted as obstacles to both providing and receiving care. For healthcare professionals, delivering care within the context of meaningful, relational interactions emerged as a morally significant aspect of clinical practice. Our study indicates that prioritizing the role of relationships throughout a hospital setting can better support the ethically significant, reciprocal expressions of care among healthcare professionals, patients, and families. We propose two strategies to advance this relational approach. First, clinical ethics practice should shift to explicitly recognize the importance of the networks of relationships—including those with the patient’s care team—that shape patient experience. Second, organizational decision-making should consider the moral value that healthcare professionals place on caring relationships and acknowledge how these relationships can help navigate and resolve ethical challenges.
