ABSTRACT
This essay argues for the importance of formalizing public engagement efforts around bioethics as something we might call "bioethics communication," and it outlines the Johns Hopkins Berman Institute of Bioethics' plans for engaging in this effort. Because science is complex and difficult to explain to nonexperts, the field of science communication has arisen to meet this need. The field involves both a practice and a subject of empirical research. Like science, bioethics is also complex and difficult to explain, which is why the world needs bioethics communication. The authors are engaged in a brand-new effort to establish the sort of public bioethics efforts that would constitute bioethics communication, through a program which they call the Dracopoulos-Bloomberg iDeas Lab. The authors invite colleagues to experiment and learn with them as they invest in the development of bioethics communicators and their products.
Subject(s)
Bioethics , Humans , Empirical Research , Communication , Academies and Institutes , LearningABSTRACT
The question about how to resume typical orthopaedic care during a pandemic, such as coronavirus disease 2019, should be framed not only as a logistic or safety question but also as an ethical question. The current published guidelines from surgical societies do not explicitly address ethical dilemmas, such as why public health ethics requires a cessation of nonemergency surgery or how to fairly allocate limited resources for delayed surgical care. We propose ethical guidance for the resumption of care on the basis of public health ethics with a focus on clinical equipoise, triage tiers, and flexibility. We then provide orthopaedic surgery examples to guide physicians in the ethical resumption of care.
Subject(s)
COVID-19 , Orthopedic Procedures/ethics , Public Health Administration/ethics , Adolescent , Aged , Arthroplasty, Replacement, Hip , Arthroplasty, Replacement, Knee , COVID-19/epidemiology , Clavicle/injuries , Clavicle/surgery , Clinical Decision-Making , Female , Femoral Neoplasms/surgery , Fractures, Bone/surgery , Giant Cell Tumors/surgery , Humans , Male , Middle Aged , Orthopedics , Pandemics , Practice Guidelines as Topic , Rotator Cuff Injuries/surgery , SARS-CoV-2 , Therapeutic Equipoise , TriageSubject(s)
COVID-19/prevention & control , Low Back Pain/therapy , Pain Management/ethics , Pandemics/ethics , Phantom Limb/therapy , Radiculopathy/therapy , Aged , COVID-19/epidemiology , Female , Humans , Injections, Epidural/ethics , Low Back Pain/diagnosis , Male , Nerve Block/ethics , Pain Management/methods , Phantom Limb/diagnosis , Radiculopathy/diagnosisABSTRACT
The Coronavirus disease 2019 pandemic has been an unprecedented challenge to healthcare systems and clinicians around the globe. As the virus has spread, critical questions arose about how to best deliver health care in emergency situations where material and personnel resources become scarce. Clinicians who excel at caring for the individual patient at the bedside are now being reoriented into a system where they are being asked to see the collective public as their responsibility. As such, the clinical ethics that clinicians are accustomed to practicing are being modified by a framework of public health ethics defined by the presence of a global pandemic. There are many unknowns about Coronavirus disease 2019, which makes it difficult to provide consistent recommendations and guidelines that uniformly apply to all situations. This lack of consensus leads to the clinicians' confusion and distress. Real-life dilemmas about how to allocate resources and provide care in hotspot cities make explicit the need for careful ethical analysis, but the need runs far deeper than that; even when not trading some lives against others, the responsibilities of both individual clinicians and the broader healthcare system are changing in the face of this crisis.