The Soaring Stakes of Strikes: Is Ethical Striking Possible in Healthcare?

Abstract: In January of 2023, 7,000 nurses in New York City went on strike. This was the first strike of a new year but far from the first of its kind. ICU nurses participating noted they had become responsible for three to four patients each, double their expected patient responsibilities. They said they were being asked to work 24-hour shifts at times potentially placing patient safety in jeopardy. Since this first strike and the ongoing COVID-19 pandemic, many strikes have cropped up nationwide and globally, all protesting the unjust increase in patient numbers without additional support and stagnant pay. These work expectations have led to a substantial rise in burnout across all levels of healthcare as well as exposed the shortages of healthcare professionals that were present well before the pandemic. This paper aims to evaluate and discuss when and how healthcare strikes are permissible through the lenses of principlism and care ethics, with the added context of studies quantifying the effects of strikes and their alternatives on patient and provider safety and wellbeing. By evaluating strikes through these established frameworks supported by the additional perspective of empirical data, this presentation will conclude that strikes have the potential to be conducted ethically when planned with care and consideration and can be used as a final attempt to help enact changes in working environments.