In response to the COVID-19 pandemic, surgeons are being forced to shift from patient-centered ethics to public health ethics. This shift will inevitably cause moral distress for surgeons as they are forced to alter elective surgical schedules and shift to other aspects of patient care. However, as we look toward a period of even greater stresses on the medical systems in the US and elsewhere in the near future, we should not lose track of the changes in our ethical assumptions and how these affect our ability to care for our patients.