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1.
Gaceta Medica de Caracas ; 130(3):643-658, 2022.
Article in Spanish | Scopus | ID: covidwho-2101065

ABSTRACT

The arrival of the pandemic caused by COVID-19, causing almost six million deaths around the world, took practically all the health systems of both developed and underdeveloped countries by surprise, including Venezuela. Virtual medical consultations, a way of practicing telemedicine, have a great impact with the arrival of this new coronavirus since it has become an ally to guarantee health care, reduce the collapse of hospitals, optimize the use of protective equipment personnel, and reduce the risk of infection for both healthcare personnel and patients themselves. However, in countries like Venezuela where there is no biolegal framework that regulates its practice, it could cause a series of repercussions and bioethical dilemmas. © 2022 Academia Nacional de Medicina. All rights reserved.

2.
Frontiers in Communication ; 7, 2022.
Article in English | Web of Science | ID: covidwho-2099110

ABSTRACT

COVID-19 remains a pressing global health disaster, and pregnant women and their unborn child/ren continue to be extremely at risk. In the Philippines, a developing country in Southeast Asia, pregnant women were generally excluded from initial vaccination drives to avoid adverse effects in their offspring, amidst findings from animal studies and post-trial monitoring on the vaccines' safety. In August 2021, the Philippine Obstetrical and Gynecological Society (POGS) and the Department of Health (DOH) released guidelines for the vaccination of pregnant women due to the eventual increase in their mortality during outbreaks of the Delta variant. This perspective presents various forms of scientific communication on COVID-19 vaccination to Filipino pregnant women and forwards recommendations to improve communication in various settings. First, we present three modalities on how information on COVID-19 vaccination is disseminated to pregnant women in the Philippines and discuss their potential impacts on knowledge promotion and actual vaccination uptake, taking into account the Filipino cultural value of "pakikipagkapwa". These include government and doctor-led initiatives, social media posts and comments, and experiences of one of the authors in vaccination drives in rural and remote communities. Findings are used to develop the BAKUNANAYS guidelines, comprised of 10 recommendations for healthcare workers, health agencies, and doctors vaccinating pregnant women in the Philippines and other developing countries, especially those with a similar socio-economic profile and cultural values.

3.
Acta Colombiana de Cuidado Intensivo ; 22:S79-S92, 2022.
Article in English, Spanish | Scopus | ID: covidwho-2094945

ABSTRACT

Throughout the history of humanity, there have been epidemics and pandemics, which have generated a climate of uncertainty, and fears that affect health, social and economic matters. The reports issued by international institutions during the COVID-19 pandemic in relation to health, bioethics and the economy, show a very weak link between them, which is highlighted by the vulnerability of fundamental rights in exceptional times and health and life emergencies. Society's disobedience and indiscipline has resulted in greater infections and deaths, which have impacted the safety and well-being of the population. The development of a vaccine may improve this uncertainty and fears of society. Clinical bioethics from ethical principles and patients’ rights should extend knowledge and participation to human rights, universal principles, and actions of society. The COVID-19 pandemic has shown that the existing bioethical frameworks were not designed for a pandemic and this has been noticed. The holistic vision of bioethics integrates social, cultural, environmental, political, and economic issues with life, health, and people in a global and social way, and integrates citizens’ duties and community rights. © 2021 Asociación Colombiana de Medicina Crítica y Cuidado lntensivo

4.
Acta Colombiana de Cuidado Intensivo ; 21(3):212-220, 2021.
Article in English, Spanish | Scopus | ID: covidwho-2094935

ABSTRACT

Introduction: Health institutions may be faced with an overflow in medical care and a decrease in resources in times of the COVID-19 pandemic. If so, they will have to make decisions based on the principle of distributive justice to benefit those who need it most and thus generate the greatest social good. Objective: To analyse the moral, bioethical, and scientific aspects in the decisions made in the context of scarce resources due to the COVID-19 pandemic. Methodology: An analysis and reflection was carried out on the moral, bioethical, and scientific aspects, based on ethical concepts reported in the medical literature, and issued during the COVID-19 pandemic. Results: For the analysis and reflection, three aspects were taken into account: 1. The moral basis of the decision (moral action, ethical dilemma and conflict of interest, and moral theories). 2. The bioethical basis of the decision (medical profession, hospital ethics committees, clinical ethics, principles of bioethics). 3. The scientific basis for the decision (triage in the pandemic with its priorities, other triage scales). Statistics: Due to the type of reflection study, no statistical measures were used. Conclusion: Moral sensitivity, bioethical reasoning, and scientific knowledge are essential when making decisions in times of the allocation of scarce resources. They will always be accompanying the decision of distributive justice, as regards the respect for the dignity and rights of patients to health and dignified death. © 2020 Asociación Colombiana de Medicina Crítica y Cuidado lntensivo

5.
Chinese Medical Ethics ; 35(9):978-985, 2022.
Article in Chinese | Scopus | ID: covidwho-2090894

ABSTRACT

COVID-19 poses a major threat to safety and health of human life. Vaccination has become an important means to resist and prevent COVID-19. Under the background of limited global supply of COVID-19 vaccine and its initial application, it is extremely necessary to discuss its ethical principles. Based on the bioethics theory and in accordance with relevant laws and regulations on vaccine use in China, this paper put forward the ethical principles of COVID-19 vaccine use, including safety principle, respect principle, fairness and justice principle, optimization principle and humanitarianism principle, which provided reference for scientifically formulating COVID-19 vaccination strategy and forming a group immune barrier to effectively control the epidemic situation in COVID-19. © 2022, Editorial department of Chinese Medical Ethics. All rights reserved.

6.
Engaging Science Technology and Society ; 8(2):176-180, 2022.
Article in English | Web of Science | ID: covidwho-2072285

ABSTRACT

The challenges of research in ethics and technology require attentive listening. Geoffrey Charles Bowker, began to give attention to the theme over twenty years ago. What ensues is a contemporary commentary on the ethics of emerging technologies with extracts from an audio interview (by Zoom) between Elen Nas and Bowker, which took place during the early part of the Covid-19 pandemic. The main question of this open dialogue is regarding the use of technologies such as AI to ask-what has changed with the problems identified now and in the past in relation to ethical computing? To paraphrase Bowker-it is impossible to think of new technologies that would not change human values then and now.

7.
Jahr ; 13(1):143-161, 2022.
Article in Bosnian | Scopus | ID: covidwho-2067495

ABSTRACT

Although it does not seem so at first glance, the COVID-19 pandemic did not make any fundamental changes, both in terms of the socio-economic framework of our actions and in terms of moral action. The reason for this lies primarily in the neglect of the utopian approach, which turned out to be necessary for looking at the socio-economic relations in the sphere of morality. Bioethics can provide a framework for such an in-depth moral questioning. I start this paper with the presentation of the attitude toward the pandemic, which remains within the parameters the inalterability of the world dogma. I then briefly ponder the notion of utopia and the concept of ‘degrowth’, the latter being an exemplary utopian approach to the human relationship toward the environment. Since the destructive attitude toward nature is the main cause of pandemic outbreaks, and both issues are of interest to bioethics, the latter should consider the attitude towards pandemics in a utopian way, primarily because the human destructiveness towards life stems primarily from the current socio-economic system. A characteristic of non-utopian thinking is that it neglects the reasons for the occurrence of certain moral conflicts, thus enabling it to be constantly perpetuated. As I try to show in the last part of the paper, the pluri-perspective methodology of integrative bioethics provides the tools to thwart this perpetuation. © 2022 University of Rijeka, Faculty of Medicine. All rights reserved.

8.
Glob Bioeth ; 33(1): 41-44, 2022.
Article in English | MEDLINE | ID: covidwho-1669086

ABSTRACT

The Covid-19 pandemic is associated with an increase in ethics publications and an upsurge of interest in global bioethics. This commentary argues that global bioethics is broader than international bioethics, as defined by Macklin, because the nature of moral problems is determined by processes and practices of globalization, and because a broader theoretical perspective is required. Such perspective acknowledges the connectedness and relationality of human beings, as assumed in the care-based feminist bioethics defended by Tong. The commentary finally claims that a rights-based approach is not opposed to but reinforces a care-based global bioethics.

9.
The Hastings Center Report ; 52(5):44-45, 2022.
Article in English | ProQuest Central | ID: covidwho-2059409

ABSTRACT

How do policy‐makers call shots on major decisions—such as putting a country into lockdown to mitigate the risk of Covid‐19—when they don't have all the scientific facts about how the virus spreads? And to which moral values do they appeal when weighing the health and economic risks involved? David B. Resnik addresses such questions in his book Precautionary Reasoning in Environmental and Public Health Policy (Springer, 2021), which provides a fresh perspective on the precautionary principle. The precautionary principle captures the common intuition “better safe than sorry” but is also a contentious facet of precautionary reasoning. Resnik's novel approach to the precautionary principle and detailed discussion of moral values makes this book an excellent read for anyone interested in policy‐making, philosophy, or public health.

10.
Hastings Cent Rep ; 52(5): 8-14, 2022 09.
Article in English | MEDLINE | ID: covidwho-2059408

ABSTRACT

For much of 2021, allocating the scarce supply of Covid-19 vaccines was the world's most pressing bioethical challenge, and similar challenges may recur for novel therapies and future vaccines. In the United States, the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices (ACIP) identified three fundamental ethical principles to guide the process: maximize benefits, promote justice, and mitigate health inequities. We argue that critical components of the recommended protocol were internally inconsistent with these principles. Specifically, the ACIP violated its principles by recommending overly broad health care worker priority in phase 1a, using being at least seventy-five years of age as the only criterion to identify individuals at high risk of death from Covid-19 during phase 1b, failing to recommend place-based vaccine distribution, and implicitly endorsing first-come, first-served allocation. More rigorous empirical work and the development of a complete ethical framework that recognizes trade-offs between principles may have prevented these mistakes and saved lives.


Subject(s)
Bioethics , COVID-19 , Vaccines , Advisory Committees , COVID-19/prevention & control , COVID-19 Vaccines , Humans , United States/epidemiology , Vaccination
11.
Hastings Cent Rep ; 52(5): 6-7, 2022 09.
Article in English | MEDLINE | ID: covidwho-2059407

ABSTRACT

One Health (OH) as a biomedical and social movement calls to reorient public health approaches toward more holistic, nonanthropocentric approaches that do not exclude the interests of animals and ecosystems. OH thus urges reexamination, from both scientific and moral perspectives, of the practice of culling pet, farm, or wild animals in the face of a zoonosis. Pandemics such as Covid and monkeypox highlight the need for more rigorous analysis of the justifications traditionally provided to back these culling practices. Such analyses should then ground reasonable OH policies and legislation that consider the rights of humans, animals, and the environment. Bill S.861, "Advancing Emergency Preparedness through One Health Act of 2021," which was introduced in the U.S. Congress, is a step in the right direction.


Subject(s)
COVID-19 , One Health , Animal Culling , Animals , Ecosystem , Health Policy , Humans , Zoonoses/prevention & control
12.
Hastings Cent Rep ; 52(5): 2, 2022 09.
Article in English | MEDLINE | ID: covidwho-2059406

ABSTRACT

Two articles in the September-October 2022 issue of the Hastings Center Report discuss health-related reasons that people might have to actively bring their lives to an end. In one, Brent Kious considers the situation of a person who, because of illness, becomes a burden on loved ones. A person in such a situation might prefer to die, and Kious argues that, while there is no obligation to hasten one's death, the choice to do so could sometimes be reasonable. In a second article, Henri Wijsbek and Thomas Nys discuss a case in the Netherlands in which a woman with severe dementia was euthanized at a point when her advance euthanasia directive did not align with what she said, when asked, about death. Wijsbek and Nys defend the authority of her advance directive against a range of objections. In a third article, Henry Silverman and Patrick Odonkor, physicians at the University of Maryland Medical Center, where the first pig-to-human heart transplantation was performed in early 2022, develop recommendations for clinical trials of porcine heart transplantation. And an essay in the issue criticizes the allocation recommendations developed for Covid-19 vaccines by the U.S. Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices.


Subject(s)
COVID-19 , Dementia , Physicians , Advance Directives , Animals , COVID-19 Vaccines , Female , Humans , Swine
13.
Espacio Abierto ; 31(3):1, 2022.
Article in English | ProQuest Central | ID: covidwho-2058128

ABSTRACT

El personalismo político es un fenómeno sociopolítico que se ha instalado en países donde sus actores principales son figuras carismáticas y de liderazgo sui generis. Con la aparición del COVID-19 y las afectaciones que trajo consigo, éstos tomaron determinados tipos de decisiones y designios no congruentes ni adecuados con la coyuntura crítica generada. Al analizar los casos particulares del presidente Jair Bolsonaro de Brasil y el primer ministro británico Boris Johnson, se observaron conductas y acciones individualistas contrarias a los derechos humanos fundamentales [p.e. derecho a la vida] así como la transgresión de principios éticos y bioéticos. Este artículo analizará políticamente las gestiones y gobernanzas de estos dos líderes políticos considerando sus rasgos personalistas así como el uso del sentido común para afrontar la pandemia. También se consideraron los principios bioéticos de no maleficencia, beneficencia, respeto por la vida humana y el de responsabilidad individual y social, lo que permite abordar sus arbitrios irracionales y sus designios discrecionales. Considerando que estos dos países aún transitan por esta crisis de sanitaria, serios problemas macroeconómicos, honda crisis social y psíquica que ha condenado hasta el respeto por la vida de sus habitantes, se considera la forma como este cuadro general plantea incertidumbre en el futuro político de estas figuras públicas.Alternate :Political personalism is a sociopolitical phenomenon that has been installed in countries where its main actors are charismatic and sui generis leadership figures. With the appearance of COVID-19 and the effects that it brought with it, they made certain types of decisions and designs that were not consistent or adequate with the critical situation generated. When analyzing the particular cases of President Jair Bolsonaro of Brazil and British Prime Minister Boris Johnson, individualistic behaviors and actions contrary to fundamental human rights were observed [e.g. right to life] as well as the transgression of ethical and bioethical principles. This article will politically analyze the efforts and governance of these two political leaders considering their personal traits as well as the use of common sense to face the pandemic. The bioethical principles of non-maleficence, beneficence, respect for human life and that of individual and social responsibility were also considered, which allows addressing their irrational will and discretionary designs. Considering that these two countries are still going through this health crisis, serious macroeconomic problems, deep social and psychic crisis that has condemned even the respect for the life of its inhabitants, it is considered how this general picture raises uncertainty in the political future of these public figures.

14.
Jahr ; 13(1):125-141, 2022.
Article in English | Scopus | ID: covidwho-2056768

ABSTRACT

The COVID-19 pandemic has put every contemporary society in front of various challenges. While those are often reflected and explained through economic, political or medical lenses, it seems that thorough ethical and bioethical insights are too rarely exposed and made explicit. This article tries to contribute to the neglected sphere of interconnection and interrelatedness of basic moral values and general, primarily public health, challenges. Moreover, it will be argued that by deeply disrespectful behaviour of chief institutions and inappropriate communication to the overall community (citizens) the value of elementary trust and respectfulness has been eroded, betrayed, and consequently brings to the plethora of economic, political, medical, and other challenges and troubles. The key argument is that the effectiveness of the public health measures is primarily rooted in stable and publicly communicated basic values, such as life and health, but the stability and communication of those values lays mostly in moral values such as trust, respect, fairness etc. One of the most important lessons this pandemic could give the humanity is the almost self-evident, but often forgotten insight, that moral values are the necessary glue of all values needed for functional society (and generally functional global community on Earth). The examples will be taken from the Croatian example of social, political, and institutional confrontation to the COVID-19 pandemic. © 2022 University of Rijeka, Faculty of Medicine. All rights reserved.

15.
Jangwa Pana ; 21(3), 2022.
Article in Spanish | ProQuest Central | ID: covidwho-2056764

ABSTRACT

This article of reflection is an invitation to think critically about one of the main forms of expression and institutionalization of bioethics in Latin America: the so-called Research Ethics Committees. Starting from experiences during the Covid-19 pandemic in Argentina and based on the environmental, social, political and economic particularities of our region, the main objective of the work is to uncover and expose an ethical fracture in the way in which the health problems and the well-being of the communities and individuals of our territories are addressed. A characterization of the ethical fracture is provided, together with some of its problems and a set of ideas that can be incorporated by the Research Ethics Committees to overcome it.Alternate :El presente artículo de reflexión es una invitación a pensar de forma crítica una de las principales modalidades de expresión e institucionalización de la bioética en América Latina: los denominados Comités de Ética en Investigación. Partiendo de experiencias transitadas durante la pandemia de la Covid-19 en Argentina y en función de las particularidades ambientales, sociales, políticas y económicas que exhibe la región, el objetivo fundamental del trabajo consiste en desocultar y exponer una fractura ética en el modo en que se abordan las problemáticas que afectan la salud y el bienestar de las comunidades e individuos de nuestros territorios. Luego de brindar una caracterización de la fractura ética, se exhiben algunos de sus problemas y se ofrece un conjunto de ideas que pueden ser incorporadas por los Comités de Ética en Investigación para subsanarla.

16.
Pediatria Integral ; 26(5):317.e1-317.e7, 2022.
Article in Spanish | Scopus | ID: covidwho-2046224

ABSTRACT

Human relationships are changing dramatically and this affects professional relationships directly. Health relationships between professionals and patients are not exempt from these changes. Among the factors that have contributed to this is the recognition of minorities and the rights that accompany them, new social values (health as an object of consumption), the resurgence of ethical and moral principles, administrative regulations related to efficiency, the relationships between professional colleagues, the ups and downs of the economy or unforeseeable circumstances, such as the COVID-19 pandemic, etc. The legal capacity of the adolescent to act with respect to medical treatment, that is, if minors can authorize or reject it by themselves, constitutes, from an ethical-legal perspective, a particularly complex issue. And this is so because the adolescent is a subject who is precisely in the final phase of the transition between being a minor and becoming of legal health age, that is, between a limited capacity to act and a full capacity to act, comparable to that of the elderly. © 2022, Ediciones Ergon SA. All rights reserved.

17.
BMC Public Health ; 22(1): 1747, 2022 09 15.
Article in English | MEDLINE | ID: covidwho-2029703

ABSTRACT

BACKGROUND: Workplace programmes to test staff for asymptomatic COVID-19 infection have become common, but raise a number of ethical challenges. In this article, we report the findings of a consultation that informed the development of an ethical framework for organisational decision-making about such programmes. METHODS: We conducted a mixed-method consultation - a survey and semi-structured interviews during November-December 2020 in a UK case study organisation that had introduced asymptomatic testing for all staff working on-site in its buildings. Analysis of closed-ended survey data was conducted descriptively. An analysis approach based on the Framework Method was used for the open-ended survey responses and interview data. The analyses were then integrated to facilitate systematic analysis across themes. Inferences were based on the integrated findings and combined with other inputs (literature review, ethical analysis, legal and public health guidance, expert discussions) to develop an ethical framework. RESULTS: The consultation involved 61 staff members from the case study organisation (50 survey respondents and 11 interview participants). There was strong support for the asymptomatic testing programme: 90% of the survey respondents viewed it as helpful or very helpful. Open-ended survey responses and interviews gave insight into participants' concerns, including those relating to goal drift, risk of false negatives, and potential negative impacts for household members and people whose roles lacked contractual and financial stability. Integration of the consultation findings and the other inputs identified the importance of a whole-system approach with appropriate support for the key control measure of isolation following positive tests. The need to build trust in the testing programme, for example through effective communication from leaders, was also emphasised. CONCLUSIONS: The consultation, together with other inputs, informed an ethical framework intended to support employers. The framework may support organisational decision-making in areas ranging from design and operation of the programme through to choices about participation. The framework is likely to benefit from further consultation and refinement in new settings.


Subject(s)
COVID-19 , Workplace , COVID-19/diagnosis , COVID-19 Testing , Decision Making, Organizational , Humans , Public Health
18.
J Eval Clin Pract ; 2022 Sep 15.
Article in English | MEDLINE | ID: covidwho-2029369

ABSTRACT

BACKGROUND: Using a specific bioethical theory (=global bioethics) and method (=a posteriori), we try here to identify and evaluate the bio-ethical issues raised by the COVID-19 pandemic, and possible solutions, to improve the management of cancer patients at the hospital in future pandemics, before the emergence of vaccines or scientifically validated treatments. MATERIALS & METHODS: Our work is based primarily on the clinical experience of three oncologists from the oncology department of Foch Hospital in France, who were on the frontline during the first wave of the epidemic. We compared their perceptions with published findings, to complete or nuance their views. RESULTS: Three bio-ethical issues were identified, and possible solutions to these problems were evaluated: (1) scientific evidence versus lack of time → the creation of emergency multidisciplinary team meetings (MTM); (2) healthcare equality versus lack of resources → the development of telemedicine; (3) individual liberties versus risk of contamination → role of cancer patients' associations, psychologists and bioethicists. CONCLUSION: We consider the creation of an emergency MTM, in particular, in addition to a true ethics committee with real competence in bioethics, to be a first solution that would be easy to implement in hospitals in many countries.

19.
Philosophies ; 7(4):77, 2022.
Article in English | ProQuest Central | ID: covidwho-2024005

ABSTRACT

Solidarity within bioethics is increasingly being recognized as an important means of improving health for all. Its contribution seems particularly relevant when there are injustices or inequalities in health and different individuals or groups are disadvantaged. But the current context of ecological collapse, characterized mainly by a loss of biodiversity and ecosystem decline, affects global health in a different way to other factors. This scenario creates new challenges, risks and problems that require new insights from a bioethical perspective. I, therefore, propose an argument in favor of ecological solidarity. The aim of this article is to re-define this concept, outlining which causes should incite action through ecological solidarity and who should be the main recipient of it. To this end, I discuss what the background for practicing ecological solidarity might be: an intrinsically altruistic motivation to attempt to be a better person or a forced response to a political obligation. Finally, by way of example, I argue for rewilding as an effective, practical strategy through which ecological solidarity can be applied in the belief that building ecological solidarity supports a number of key interdependencies and ensures ethical care for the health of the planet.

20.
Rev. bioét. (Impr.) ; 29(2): 242-250, abr.-jun. 2021.
Article in Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-2022160

ABSTRACT

Resumo "Ageísmo" é o preconceito ou discriminação contra a pessoa idosa, seja por meio da estigmatização ou de práticas discriminatórias da sociedade e de suas instituições. No atual contexto da pandemia de covid-19, a postura ageísta da sociedade ocidental e, consequentemente, dos protocolos para distribuição de recursos em saúde tem sido fortemente evidenciada, trazendo consigo prejuízo importante à assistência a essa população. Este ensaio teórico discute manifestações e consequências do ageísmo em políticas de distribuição de recursos na pandemia, pensando as implicações bioéticas desse tipo de discriminação no que se refere aos princípios da justiça e da dignidade humana.


Abstract Ageism is the prejudice or discrimination of older adults, whether through stigmatization or discriminatory practices by society and its institutions. The current covid-19 pandemic context has shown Western society's ageist stance and, consequently, of its protocols on the distribution of health resources, leading to severe negative repercussions to the care of this population. This theoretical essay discusses the manifestations and consequences of ageism in the context of health resource distribution policies during the pandemic, considering the bioethical implications involved in this type of discrimination when considering the principles of justice and human dignity.


Resumen El "edadismo" se refiere al prejuicio y discriminación a las personas mayores, ya sea por estigmatización o prácticas discriminatorias por parte de la sociedad y sus instituciones. En el contexto actual de la pandemia de covid-19, se ha evidenciado fuertemente la postura edadista de la sociedad occidental y, en consecuencia, de los protocolos que involucran la distribución de los recursos en salud, trayendo consigo un daño importante a la atención en salud de esta población. Este ensayo teórico discute las manifestaciones y consecuencias del edadismo en el contexto de las políticas de distribución de recursos en salud en la pandemia, considerando las implicaciones éticas de esa discriminación respecto a los principios de justicia y dignidad humana.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Bioethics , Aged , Ageism , COVID-19 , Health Policy
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