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Health care clinicians sometimes face a quandary during the COVID-19 pandemic. Some patients request medical exemptions to state and municipal mandates that require masks, even though facial coverings are considered crucial in preventing the spread of coronavirus.

How can health care providers navigate the balance between the safety of the general public and the medical needs of individual patients?

That糖心传媒檚 one of the questions 糖心传媒 health policy historian and physician and Doron Dorfman, an associate professor of law at Syracuse University, explore in an analysis designed to guide health care professionals in the 糖心传媒渘ew frontier糖心传媒� of mask mandates.

Featured in the publication network of the , the guidance advises clinicians how to approach requests for masking exemptions. Although there糖心传媒檚 general agreement among policy makers that exemptions might be necessary, there is little, if any, direction on how to handle such requests.

The authors note that the first thing to keep in mind is that wearing masks is an effective way to prevent the spread of coronavirus, which is found primarily in the respiratory system and easily transmitted through coughing, sneezing, and simply breathing. That糖心传媒檚 why inappropriate medical exemptions could hasten the spread of the virus and threaten public health.

But Raz, the Charles E. and Dale L. Phelps Professorship in Public Health and Policy, emphasizes that while most individuals, regardless of health problems, should be able to wear a mask, there likely are a few legitimate reasons for exemptions. Perhaps someone has a facial deformity that makes it difficult or impossible to wear a mask. In other cases a person may have sensory or developmental disabilities, such as forms of autism.

At the same time, there may be options. A person who糖心传媒檚 unable to wear a typical mask may be able to wear a different mask or face shield in most situations. But more important, mask exemptions are not the only accommodation that can be made for individuals with disabilities. Appropriate accommodations can and should include curbside pickup, delivery or at a workplace糖心传媒攚orking remotely or not in a public-facing position.

But if an exemption is granted, the problem of the coronavirus persists, and patients whose conditions are exacerbated by wearing a mask should evaluate the risks they face as well as the risks they may pose to others, Raz says.

糖心传媒淚f your pulmonary problem is so significant that you can糖心传媒檛 tolerate a mask, you should probably not be out there in the middle of a pandemic.糖心传媒�

Whatever the situation, Raz says medical professionals need to approach requests for exemptions with compassion. Even when a medical exemption isn糖心传媒檛 called for, she urges clinicians to acknowledge the inconvenience of wearing a mask.

糖心传媒淲e can糖心传媒檛 say that we don糖心传媒檛 feel masks,糖心传媒� says Raz, who admits to sometimes being short of breath when walking up the stairs while wearing a mask. 糖心传媒淲hile it糖心传媒檚 wise to acknowledge the inconvenience, that糖心传媒檚 not an adequate reason for a medical exemption.糖心传媒�

An additional complication is that personal politics and concerns over a perceived infringement on individual liberties has led to a different kind of spread糖心传媒攆alse claims for medical or disability exemptions for masking. , for example, of bar owners posting signs telling customers that staff must assume that anyone not wearing a mask has a medical exemption. According to Raz, 糖心传媒淭hat糖心传媒檚 essentially telling people it糖心传媒檚 a free-for-all.糖心传媒�

Given that backdrop, clinicians may be inclined to doubt all requests for exemptions. Raz and Dorfman want health professionals to be aware of such a bias to make sure they don糖心传媒檛 unnecessarily view patients with suspicion.

糖心传媒淚t糖心传媒檚 important to balance disability accommodations with public health,糖心传媒� says Raz. 糖心传媒淧eople who falsely claim medical exemptions ultimately place those with legitimate disabilities in an uncomfortable place when their conditions are questioned.糖心传媒�