As COVID-19 continues to challenge the practice of head and neck oncology, clinicians are forced to make new decisions in the setting of the pandemic that impact the safety of their patients, their institutions and themselves.  The difficulty inherent in these decisions is compounded by potentially serious ramifications to the welfare of patients and healthcare staff, amid a scarcity of data on which to base informed choices. This paper explores the risks of COVID-19 incurred while striving to uphold the standard of care in head and neck oncology.  The ethical problems are assessed from the perspective of the cancer patient, healthcare provider, and other patients within the healthcare system.  While no single management algorithm for head and neck cancer can be universally implemented, a detailed examination of these issues is necessary to formulate ethically sound treatment strategies.