Intended for healthcare professionals

Observations Ethics Man

Ethics of the on-call rota

BMJ 2017; 356 doi: (Published 04 January 2017) Cite this as: BMJ 2017;356:i6866
  1. Daniel Sokol, medical ethicist and barrister
  1. 12 King’s Bench Walk, London
  1. daniel.sokol{at}

Some criteria for selecting cover for rota gaps are more contentious than others

A colleague is sick. Someone is needed to cover for him tomorrow. There are no locums and no volunteers. Who should be selected?

Few issues generate more passion and cause more heartache to doctors than filling a gap in the on-call rota. Over Christmas it is likely that tears have been shed and friendships lost over who would cover the absent colleague.

So what is the fairest way to choose? There are three uncontroversial criteria.

First, the potential candidates must be available. Candidates who are abroad or too far away to make it back in time cannot be selected. As the philosopher Immanuel Kant wrote, “Ought implies can.” …

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