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1.
Open Philosophy ; 5(1):636-649, 2022.
Article in English | Web of Science | ID: covidwho-2070805

ABSTRACT

COVID-19 unemployed millions of Americans, many of whom already lacked the financial ability to withstand an economic crisis. Mid-quarantine, politicians began to grapple on what protections for renters would stay in place as the assistance bills came to an end. The COVID-19 rent crisis raised significant moral questions to the American populace - namely, that of the State's responsibility to care for its citizens. This article examines rent strikes in the context of care ethics. Care ethics contends that our actions have moral weight. What we do matters. Rent strikes sit at the intersection of political practice and care ethics. This article contends that rent strikes provided care when the State did not, and that this lack of care highlights the need for solidarity.

2.
J Law Biosci ; 9(2): lsac026, 2022.
Article in English | MEDLINE | ID: covidwho-2051478

ABSTRACT

With the limited initial availability of COVID-19 vaccines in the first months of 2021, decision-makers had to determine the order in which different groups were prioritized. Our aim was to find out what normative approaches to the allocation of scarce preventive resources were embedded in the national COVID-19 vaccination schedules. We systematically reviewed and compared prioritization regulations in 27 members of the European Union, the United Kingdom, and Israel. We differentiated between two types of priority categories: groups that have increased infection fatality rate (IFR) compared to the average for the general population and groups chosen because their members experience increased risk of being infected (ROI). Our findings show a clear trend: all researched schedules prioritized criteria referring to IFR (being over 65 years old and coexisting health conditions) over the ROI criteria (eg occupation and housing conditions). This is surprising since, in the context of treatment, it is common and justifiable to adopt different allocation principles (eg introducing a saving more life-year approach or prioritizing younger patients). We discuss how utilitarian, prioritarian, and egalitarian principles can be applied to interpret normative differences between the allocation of curative and preventive interventions.

3.
Nurs Ethics ; 29(5): 1096-1106, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1993251

ABSTRACT

Since the beginning of the pandemic spread of the Coronavirus, societies have been reminded that the impact of Covid-19 and public health measures of infection containment reflect known gradients of inequality. Measures focusing only the (acknowledged) frontstage of the pandemic and neglecting its (unacknowledged) backstage-understood as those framework conditions indispensable for societies to thrive-have worsened the impact of social determinants of health on the most vulnerable, as shown by the deleterious effects of prolonged social isolation of residents of nursing homes. To reflect this phenomenon ethically, a framework is proposed which is inspired by the feminist philosopher Margret Little. At its core stands the assumption that caring for people and moral ends allows us to identify what is morally salient. This epistemological stance allows a critical look at the alleged dilemmas invoked to enforce brute, long-lasting policies of closing nursing homes in many places-especially in the light of their dubious effectiveness in preventing viral spread and the severe physical and psychological consequences for those affected. If moral salience is only fully perceived through the closeness of the caring relationship, the human suffering resulting from these policies reveals the utter inadequacy of the dilemma rhetoric used to justify them. This insight is illustrated by the personal experience of the author: He describes his role as an essential care partner of his mother living in a nursing home and forced into the role of a "visitor" who witnessed a constant deterioration of care. Based on an epistemological understanding of caring for making reliable moral judgments, potentially exclusionary effects of distinguishing essential from non-essential groups in care will be addressed together with the need to overcome strict boundaries between front- and backstage. Such efforts will strengthen the moral community of persons needing care, professional care givers and essential care partners.


Subject(s)
COVID-19 , Pandemics , Caregivers/psychology , Humans , Male , Morals , Nursing Homes
4.
Asian Social Work and Policy Review ; 2022.
Article in English | Scopus | ID: covidwho-1992732

ABSTRACT

Housekeeping and sanitary workers are crucial for the functional efficiency and hygiene of healthcare facilities. In India, women from oppressed castes and backward classes are predominantly recruited in these occupations. The work, regarded as “polluting,” is stigmatized, devalued, and lies at the historical and sociocultural intersections of caste, class, and gender. In the context of the COVID-19 pandemic, this paper utilizes the concepts of “feminization of labor” and “care ethics” to read caste into an intersectional theoretical analysis of the organization of marginalized women's labor in such essential, yet invisibilized healthcare work. An exploratory narrative review of literature focusing exclusively on marginalized healthcare housekeepers and sanitation workers in India is undertaken and supplemented with a critical analysis of labor laws and policies to trace the sustained reproduction of the caste-based sexual division of labor in these occupations. I propose that their exploitative terms and conditions are sustained by what I refer to as the “feminine caste contract” – a complex sociopolitical and legal arrangement of precarious, casteist, and gendered work conditions. Recognizing the exploitation inherent in this contract, recommendations are made for social work education and practice to play a key role in restructuring marginalized women's labor in essential care work. © 2022 John Wiley & Sons Australia, Ltd.

5.
Erdkunde ; 76(3), 2022.
Article in English | Scopus | ID: covidwho-1987422

ABSTRACT

After COVID-19 was characterised as a pandemic in spring 2020, care and care work became very dominant topics in public discourse in Western Europe. Against this backdrop, the paper turns to the underlying social structures and conditions of caring relations and aims to go before and beyond the pandemic. The serious occasion of the COVID-19 pandemic and its unjust social effects will be taken as a starting point to engage with social theory to discuss pre-existing uneven ‘geographies of caring relations’ in capitalist societies, which pandemic-related measures are built on. For this, the paper draws on Joan Tronto’s extended thoughts on critical feminist care ethics, emphasising her notion of caring-with as the possibility to trust in caring relations based on interdependencies and solidarity, and argues for explicitly linking caring relations to questions of social justice. This framework stresses the foundations of social injustice and shifts the perspective from individual caring subjects and places (‘who and where’) to unjust social structures (‘how’). Moreover, it challenges dominant biopolitics and care economies by way of an insourcing of caring relationships. By conceiving care as part of social theory and not only social analyses, care ethics provide a normative framework for geography and beyond to imagine and practise social change. © 2022, Erdkunde. All rights reserved.

6.
Arts Psychother ; 80: 101920, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-1935942

ABSTRACT

In this article, we aim to illustrate how inclusive research can be situated as a form of care work. We do this through addressing tensions and possibilities arising in an ongoing arts-based community-research project - DiStory, Then and Now. We discuss the design of the project along with critical, philosophical, and ethical foundations that drive decision-making and shifts in methodology in response to COVID-19 pandemic restrictions. We argue that understanding inclusive research as care work is vital, particularly in pandemic times where complex socio-political contexts threaten the social survival of individuals and communities that have traditionally been excluded from knowledge creation projects. Our efforts to counter epistemic violence through practices of care are critically considered alongside tensions emerging in connection with physical contact restrictions combined with technology barriers experienced by many of our group members.

7.
Advancing Global Bioethics ; 18:125-164, 2022.
Article in English | Scopus | ID: covidwho-1872279

ABSTRACT

This chapter examines the ethical challenges of treating and caring for Covid patients. Healthcare professionals are at risks to be infected by SARS-CoV-2, and in all countries illness and death has affected them as well as their families. The ethical discussion focuses on whether professionals have a duty to treat and to care, when there is substantial personal risk, particularly when sufficient protective equipment is not available. Ethical issues also exist for patients. They can experience various kinds of harm as a result of having contracted an infectious disease, and as the result of being in isolation during treatment in the healthcare facility. Patients with other diseases are harmed because modalities of treatment and care are cancelled or postponed since priority is given to Covid patients. A further ethical concern relates to the difficulty to maintain ordinary standards of care in conditions of emergency. Specific attention is subsequently given to ethical questions of research. The only way to improve the treatment of Covid patients is sustained research to test and develop medication. Intensive public debate has emerged on the subject of triage. If resources, especially in intensive care, are limited, which patients will be selected for treatment, and which criteria are ethically justified? The last paragraph of this chapter will focus on end-of-life care, and the need to provide palliative care to seriously ill Covid patients. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

8.
ACME ; 21(1):65-80, 2022.
Article in English | Scopus | ID: covidwho-1738234

ABSTRACT

In 2020, the novel coronavirus (COVID-19) disrupted life around the globe. In the United States, governors issued state of emergency orders and mandated shelter-in-place and social distancing measures. While these measures are important, they ignore the nuances of risk for vulnerable groups, such as older adults. Moreover, social distancing measures made more visible the reality that many patients in care homes often die in isolation. In this commentary, we argue that a rethinking of later-life care is necessary and to understand this need, that critical geographers should expand on how we evaluate care. Here we start from a space of radical care ethics to examine the emotional experience of place and the role it should play in how we think about later-life care. Reflecting on state-mandated social distancing, we show that the current system of geriatric care in the United States does not promote dignified living for older adults and how older adults’ complex emotions are ignored in current later-life care. We conclude by recommending that the emotional experiences of place must be taken into consideration for scholars examining place-based later-life care of older adults. © 2022,ACME. All Rights Reserved.

9.
Nurs Ethics ; 29(4): 833-843, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1731442

ABSTRACT

BACKGROUND: The first COVID-19 wave started in February 2020 in France. The influx of patients requiring emergency care and high-level technicity led healthcare professionals to fear saturation of available care. In that context, the multidisciplinary Ethics-Support Cell (EST) was created to help medical teams consider the decisions that could potentially be sources of ethical dilemmas. OBJECTIVES: The primary objective was to prospectively collect information on requests for EST assistance from 23 March to 9 May 2020. The secondary aim was to describe the Cell's functions during that period. RESEARCH DESIGN: This observational, real-time study of requests for Cell consultations concerned ethical dilemmas arising during a public health crisis. The EST created a grid to collect relevant information (clinical, patient's/designated representative's preferences and ethical principles strained by the situation), thereby assuring that each EST asked the same questions, in the same order. PARTICIPANTS AND RESEARCH CONTEXT: Only our university hospital's clinicians could request EST intervention. ETHICAL CONSIDERATIONS: The hospital Research Ethics Committee approved this study (no. CER-2020-107). The patient, his/her family, or designated representative was informed of this ethics consultation and most met with EST members, which enabled them to express their preferences and/or opposition. FINDINGS/RESULTS: 33 requests (patients' mean age: 80.8 years; 29 had COVID-19: 24 with dyspnea, 30 with comorbidities). 17 Emergency Department solicitations concerned ICU admission, without reference to resource constraints; others addressed therapeutic proportionality dilemmas. DISCUSSION: Intervention-request motives concerned limited resources and treatment intensity. Management revolved around three axes: the treatment option most appropriate for the patient, the feasibility of implementation, and dignified care for the patient. CONCLUSIONS: COVID-19 crisis forced hospitals to envisage prioritization of ICU access. Established decision-making criteria and protocols do not enable healthcare professionals to escape ethical dilemmas. That acknowledgement highlights ethical risks, enhances the added-value of nursing and encourages all players to be vigilant to pursue collective deliberations to achieve clear and transparent decisions.


Subject(s)
COVID-19 , Ethics Consultation , Aged, 80 and over , Ethics Committees, Clinical , Female , Health Personnel , Humans , Male , Morals
10.
Postdigital Science and Education ; 2021.
Article in English | Scopus | ID: covidwho-1705802

ABSTRACT

Critics of artificial intelligence have suggested that the principles of fairness, accountability and transparency (FATE) have been used for ‘ethics washing’, in order to appease industrial interests. In this article, we develop this relational and context-dependent analysis, arguing that ethics should not be understood as values or design decisions, but as socio-technical achievements, enacted in the practices of students, teachers and corporations. We propose that the ethics of using AI in education are political, involving the distribution of power, privilege and resources. To illustrate this, we trace the controversies that followed from an incident in which a student was misclassified as a cheat by an online proctoring platform during the Covid-19 lockdown, analysing this incident to reveal the socio-technical arrangements of academic integrity. We then show how Joan Tronto’s work on the ethics of care can help think about the politics of these socio-technical arrangements — that is, about historically constituted power relations and the delegation of responsibilities within these institutions. The paper concludes by setting the immediate need for restorative justice against the slower temporality of systemic failure, and inviting speculation that could create new relationships between universities, students, businesses, algorithms and the idea of academic integrity. © 2021, The Author(s).

11.
Int J Environ Res Public Health ; 19(4)2022 02 13.
Article in English | MEDLINE | ID: covidwho-1690239

ABSTRACT

Due to its major impact on Dutch care homes for older people, the COVID-19 pandemic has presented care staff with unprecedented challenges. Studies investigating the experiences of care staff during the COVID-19 pandemic have shown its negative impact on their wellbeing. We aimed to supplement this knowledge by taking a narrative approach. We drew upon 424 personal narratives written by care staff during their work in a Dutch care home during the COVID-19 pandemic. Firstly, our results show that care staff have a relational-moral approach to good care. Residents' wellbeing is their main focus, which they try to achieve through personal relationships within the triad of care staff-resident-significant others (SOs). Secondly, our results indicate that caregivers experience the COVID-19 mitigation measures as obstructions to relational-moral good care, as they limit residents' wellbeing, damage the triadic care staff-residents-SOs relationship and leave no room for dialogue about good care. Thirdly, the results show that care staff experiences internal conflict when enforcing the mitigation measures, as the measures contrast with their relational-moral approach to care. We conclude that decisions about mitigation measures should be the result of a dialogic process on multiple levels so that a desired balance between practical good care and relational-moral good care can be determined.


Subject(s)
COVID-19 , Aged , COVID-19/epidemiology , Humans , Narration , Nursing Homes , Pandemics , SARS-CoV-2
12.
Urvio-Revista Latinoamericana De Estudios De Seguridad ; - (31):43-61, 2021.
Article in Spanish | Web of Science | ID: covidwho-1573003

ABSTRACT

Security in Latin America has traditionally been addressed from a state-centric and notable realistic perspective, underlining the threats to the state, from an external actor or from internal destabilization. This paper aims to highlight the suitability of incorporating Feminist Security Studies and Care Ethics in security analysis in order to redefine threats and what "feeling safe" implies, especially in the scenario generated by the COVID-19 pandemic. To this end, the gaps and silences in mainstream theories in the diagnoses on the worsening of the security challenges in the first semester of the pandemic are evidenced. Also, the nuances and perceptions of security included in the Care Ethics approach are highlighted. It is concluded that the conceptual broadening that the Care Ethics approach entails is relevant to analyze -academically and politically- the security threats in Latin America.

13.
Prospects (Paris) ; 51(1-3): 233-245, 2021.
Article in English | MEDLINE | ID: covidwho-1525565

ABSTRACT

This text is a simultaneously personal and political commentary on those who inhabit the border between worlds, such as those now at war in a viral assemblage. Starting from a general intention of shifting curricular responses away from instrumental and technical solutions toward cultivating the ability to act and think in times of uncertainty, the argument developed here is that the need to respond to the Covid-19 crisis involves repositioning curriculum and responsibility as caring for the Earth. The article creates a dialogue between cosmoecological alliances of different onto-epistemological practices and formulations that expand the ethics of care for other-than-humans. The central issue is to defend reimagining the relationship between curriculum and subjectivity within interdependent stories on the planet. We do this in order to develop a sort of vaccine to prevent curricular imagination from becoming captive to the geometric coordinates of the economization of life.

14.
Hastings Cent Rep ; 51(4): 7-8, 2021 07.
Article in English | MEDLINE | ID: covidwho-1306646

ABSTRACT

One of the biggest policy interventions during the last year of the COVID-19 pandemic was the Coronavirus Aid, Relief, and Economic Securities Act, instituting a novel form of economic relief similar to a universal basic income. The economic impact payments, colloquially known as "stimulus checks," were distributed based on the socioeconomic status of American citizens and legal residents and provided much-needed financial aid. However, the distribution of these payments paid little attention to other important factors that might determine the economic security of said individuals, such as race and gender. This article calls for policy-makers to pay particular attention to how structural inequity and discrimination based on identity could affect the efficacy of proposed policies and demonstrate an ethic of care informed by an understanding of intersectionality.


Subject(s)
COVID-19/economics , COVID-19/epidemiology , Cost of Illness , Economics, Behavioral/statistics & numerical data , Healthcare Financing/ethics , Health Behavior/ethics , Health Services Accessibility/economics , Humans , United Nations , United States
15.
J Pain Symptom Manage ; 64(3): e159-e164, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-1233502

ABSTRACT

In this compelling personal narrative describing a case from the front lines of the COVID-19 pandemic, a palliative care physician harnesses the creative powers and strengths of the interdisciplinary team to provide compassionate care to a critically ill patient and his family. The author describes the process of identifying a surrogate decision maker from among the patient's many adult children-several of whom were estranged from him and each other-and facilitating weighty decisions about his end-of-life care. Over the course of this journey, the author grapples with her inner biases and struggles with the emotional trauma associated with bearing witness to extraordinary suffering and social isolation imposed by COVID-19. Not only does the ethics of care approach embodied here lead to the creation of enduring vibrant works of art for this patient and others, but it also affirms a guiding principle of palliative care in which interdisciplinary collaboration is marshalled in the service of cultivating relationships, upholding responsibilities, and intensifying empathy among persons tied together by a common narrative.

16.
J Health Psychol ; 27(8): 1971-1990, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1211678

ABSTRACT

Moral distress is a negative emotional response that occurs when physicians know the morally correct action but are prevented from taking it because of internal or external constraints. Moral distress undermines a physician's ethical integrity, leading to anger, poor job satisfaction, reduced quality of care and burnout. Scarce literature exists on the ethical aspects of moral distress in medicine. We conducted an ethical analysis of moral distress as experienced by physicians and analysed it from the literature using two predominant ethical theories: principlism and care ethics. Finally, we consider the emergence of moral distress in medicine during the COVID-19 pandemic.


Subject(s)
Attitude of Health Personnel , COVID-19 , Ethical Analysis , Humans , Morals , Pandemics , Stress, Psychological/psychology , Surveys and Questionnaires
17.
Perspect Med Educ ; 10(4): 238-244, 2021 08.
Article in English | MEDLINE | ID: covidwho-1141531

ABSTRACT

In this article the authors review the current-day definition of professionalism through the lens of the two ongoing pandemics: COVID-19 and racism. The pandemics have led to contemporary practice-related questions, such as: does professionalism entail that health care providers (HCP) be compelled to treat patients without PPE or if patients refuse to wear masks? And what role do HCP play in society when confronted with glaring health disparities and police brutality? The authors propose using care ethics as a theory to view professionalism, as it takes into account broadly encompassing relationships between HCP and society, history and context. Professionalism viewed through a care ethics lens would require professionalism definitions to be expanded to allow for interventions, i.e., not just refrain from doing harm but actively interfere or take action if wrong is being witnessed. Principles related to the primacy of patient welfare need to be re-addressed to prevent systematic self-sacrifice which results in harm to HCP and burnout. Mature care should be a characteristic of professionalism ensuring that HCP care for the sick but be practically wise, highlighting the importance of balancing too little and too much care for self and others. Professionalism needs to be viewed as a bi-directional relational exchange, with society demonstrating solidarity with those providing care. Additionally, given the scale of health disparities, simply stating that HCP need to work towards social justice oversimplifies the problem. Professionalism needs to encompass incorporating critical action and critical pedagogy into health care training and the health care profession to demonstrate solidarity with those impacted by racism.


Subject(s)
COVID-19 , Ethics, Medical , Pandemics , Physicians/ethics , Professionalism , Racism , Social Justice , Burnout, Professional , Delivery of Health Care/ethics , Education, Medical , Health Personnel , Healthcare Disparities , Humans , Physician-Patient Relations/ethics , SARS-CoV-2 , Social Discrimination , Violence
18.
Ethik Med ; 33(1): 51-70, 2021.
Article in German | MEDLINE | ID: covidwho-1059832

ABSTRACT

DEFINITION OF THE PROBLEM: The COVID-19 pandemic poses a considerable challenge to the capacity and functionality of intensive care. This concerns not only resources but, above all, the physical and psychological boundaries of nursing professionals. The question of how care for others and self-care of nurses in intensive care units are related to each other in the context of the COVID-19 pandemic has not been addressed in public and scientific discourse so far. ARGUMENTS: The present contribution reflects this relationship with reference to the Code of Ethics of the International Council of Nurses, particularly considering principlism and the Care Ethics according to Joan Tronto. As a result, it shows a corridor of ethically justifiable care with several borders, above all: (1) self-care must not be given up completely for the benefit of care for others, and (2) a categorical subordination of care for others to self-care is ethically not justifiable. CONCLUSION: The article makes an important contribution to a differentiated ethical consideration of the rights and responsibilities of intensive care nurses as moral actors within the pandemic in Germany. It, thus, provides a first starting point for a broad social and political discourse which is urgently needed not only during but also after the pandemic in order to improve the situation of intensive care nurses and those who are cared for.

19.
Soc Sci Med ; 272: 113707, 2021 03.
Article in English | MEDLINE | ID: covidwho-1036187

ABSTRACT

2020 in the United States was marked by two converging crises-the COVID-19 pandemic and the large-scale uprisings in support of Black lives. These crises were met with both a counterproductive and inadequate response from the federal government. We examine these converging crises at the individual, social, and political scales. The biological realities of COVID-19 impact different populations in widely varied ways-the poor, the elderly, Black, Indigenous, and people of color, and those living with comorbidities get sick and die at the highest rates. Social distancing guidelines shifted millions of people to work-from-home and millions more lost their jobs, even as care laborers, preponderantly women, Black, Indigenous, and people of color, were asked to put their and their loved ones' lives on the line for the continuation of all of our lives. These biological, social, and economic crises have been punctuated by civil unrest, as millions took to the streets for racial justice, noting the unequal impacts of the pandemic. These converging crises have laid bare decades of neoliberal and neoconservative policies and ideologies, undergirded as they have been by racial capitalism, for their fundamental uncaringness. In this paper, we argue that this pandemic not only made a wider population more acutely aware of the necessity and importance of the need to care and for caring labors, but also that we stand at the precipice of potentiality--of producing a more caring society. To frame our argument, we draw on Nancy Scheper-Hughes and Margaret Lock's (1987) framework of three bodies-individual, social, and political-to unpack the multi-scalar entanglements in the differential impacts of COVID-19, questions of care, and their articulation in the current political-economic context.


Subject(s)
COVID-19 , Pandemics , Social Determinants of Health , Social Justice , African Americans , COVID-19/economics , COVID-19/mortality , COVID-19/prevention & control , Capitalism , Employment , Federal Government , Female , Humans , Physical Distancing , Social Determinants of Health/economics , United States
20.
Camb Q Healthc Ethics ; 30(1): 69-72, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-997747

ABSTRACT

Ethical issues raised by the outbreak of COVID-19 have predominantly been addressed through a public health ethics lens. This article proposes that the rising COVID-19 fatalities and the World Health Organization's failure to include palliative care as part of its guidance on how to maintain essential health services during the pandemic have exposed palliative care as an underlying global crisis. It therefore calls for a different ethical framework that includes a care ethics perspective and thereby addresses the ways in which the pandemic has triggered new difficulties in ensuring the delivery of appropriate end-of-life care for the dying. The article analyses the structural weaknesses of palliative care accentuated by the pandemic and proposes solutions that could set in motion lasting changes in the way it is delivered beyond COVID-19.


Subject(s)
COVID-19 , Palliative Care/ethics , Humans , Pandemics , SARS-CoV-2 , Terminal Care
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