Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 105
Filter
1.
Hastings Cent Rep ; 50(2): 2, 2020 03.
Article in English | MEDLINE | ID: covidwho-2074979

ABSTRACT

In early March 2020, the March-April Hastings Center Report was very nearly assembled and contained nothing about Covid-19, which was still just beginning to make itself publicly known in the United States. Two weeks later, the editorial line-up was undergoing a remix, and essays that lay out sweeping agendas for the response to the worldwide crisis were in preparation. The central theme in the agenda that Lawrence O. Gostin and colleagues develop is that the pandemic requires a sharp break from usual ethical norms yet simultaneously demands a return to core ethical commitments. A similar theme is sounded by Mildred Z. Solomon and colleagues in a commentary calling for federal actions to keep the health care system functioning. Other essays in the issue take up an assortment of topical issues-including international patient dumping-that were simmering along prior to the pandemic, and the two articles take up foundational questions about the nature of moral reasoning.


Subject(s)
Coronavirus Infections , Pneumonia, Viral , Betacoronavirus , COVID-19 , Humans , Pandemics , SARS-CoV-2 , United States
2.
J Bioeth Inq ; 2022 Sep 19.
Article in English | MEDLINE | ID: covidwho-2035272

ABSTRACT

Digital COVID certificates are a novel public health policy to tackle the COVID-19 pandemic. These immunity certificates aim to incentivize vaccination and to deny international travel or access to essential spaces to those who are unable to prove that they are not infectious. In this article, we start by describing immunity certificates and highlighting their differences from vaccination certificates. Then, we focus on the ethical, legal, and social issues involved in their use, namely autonomy and consent, data protection, equity, and international mobility from a global fairness perspective. The main conclusion of our analysis is that digital COVID certificates are only acceptable if they meet certain conditions: that they should not process personal data beyond what is strictly necessary for the aimed goals, that equal access to them should be guaranteed, and that they should not restrict people's autonomy to access places where contagion is unlikely. We conclude that, if such conditions are guaranteed, digital COVID certificates could contribute to mitigating some of the most severe socioeconomic consequences of the pandemic.

3.
Med Health Care Philos ; 25(4): 655-669, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2007201

ABSTRACT

Moralization is a social-psychological process through which morally neutral issues take on moral significance. Often linked to health and disease, moralization may sometimes lead to good outcomes; yet moralization is often detrimental to individuals and to society as a whole. It is therefore important to be able to identify when moralization is inappropriate. In this paper, we offer a systematic normative approach to the evaluation of moralization. We introduce and develop the concept of 'mismoralization', which is when moralization is metaethically unjustified. In order to identify mismoralization, we argue that one must engage in metaethical analysis of moralization processes while paying close attention to the relevant facts. We briefly discuss one historical example (tuberculosis) and two contemporary cases related to COVID-19 (infection and vaccination status) that we contend to have been mismoralized in public health. We propose a remedy of de-moralization that begins by identifying mismoralization and that proceeds by neutralizing inapt moral content. De-moralization calls for epistemic and moral humility. It should lead us to pull away from our tendency to moralize-as individuals and as social groups-whenever and wherever moralization is unjustified.


Subject(s)
COVID-19 , Public Health , Humans , COVID-19/epidemiology , Morals
4.
Chinese Medical Ethics ; 35(3):250-254, 2022.
Article in Chinese | Scopus | ID: covidwho-1988513

ABSTRACT

The global spread of COVID-19 indicates that cultivating public health awareness and constructing the concept of human health community has become an urgent need and a long-term plan in the current social situation. In the post-epidemic period, only by adhering to the concept of human health community, strengthening the cooperation among individuals, families, communities, institutions, urban and rural areas, countries and so on, weaving closely and consolidating the “net bottom” of grass-roots prevention and control from point to area, and establishing the mechanism of group prevention, group control and joint prevention and control, can we thoroughly curb the spread of the epidemic in the world. Under the development concept and value orientation of human health community, the individual is not only a booster of public health, but also a component of public health, and also a beneficiary of public health. The realization of public health is inseparable from the practice of each individual. Under the guidance of the concept of human health community and the awareness of individual health first responsibility, all citizens need to shape health promotion behaviors that fit the individual’s own situation, promote the health maintenance atmosphere consciously followed by the whole society, create a healthy ecological environment accessible to everyone, and let all citizens share the good results of public health management, so as to achieve the good vision of human health community. © 2022, Editorial department of Chinese Medical Ethics. All rights reserved.

5.
Asia Pacific Journal of Health Management ; 17(2):8, 2022.
Article in English | Web of Science | ID: covidwho-1979883

ABSTRACT

COVID-19 brought havoc in the world with its high infectivity and virulence. Many countries were caught unprepared in public health capacity and socio-economic parameters. In this trying time, public health ethics remain an unanswered question on many fronts of treatment and control of novel coronavirus. The objective of the paper is to analyse the significant ethical challenges faced during the COVID-19 pandemic. The pre-defined thematic areas based on critical issues are identified to understand the ethical concerns of prevention and control of COVID-19. Secondary sources of literature have been consulted, and pieces of evidence gathered to strengthen the arguments. The article also provides a recommendation on ethical measures for the preservation of human dignity and ethical practices. The human rights aspects of regulations during the pandemic of the coronavirus are discussed to understand various nuances of justice and liberty.

6.
Bioethics ; 36(8): 883-890, 2022 10.
Article in English | MEDLINE | ID: covidwho-1978423

ABSTRACT

This article provides a systematic analysis of the proposal to use Covid-19 vaccination status as a criterion for admission of patients with Covid-19 to intensive care units (ICUs) under conditions of resource scarcity. The general consensus is that it is inappropriate to use vaccination status as a criterion because doing so would be unjust; many health systems, including the UK National Health Service, are based on the principle of equality of access to care. However, the analysis reveals that there are several unique features of Covid vaccination status in the context of a pandemic that make this issue disanalogous to cases (such as lung cancer caused by smoking) discussed previously. First, there is equality in access to care at the point of vaccination; the unvaccinated refuse the offer of preventive care when they decline vaccination, weakening their claim to ongoing care if they become ill (this is qualitatively different from 'poor lifestyle choices' such as smoking). Second, the decision of one person to refuse vaccination substantially increases the risk that they will become seriously ill and need ICU care; the person who chooses not to get vaccinated thus potentially increases the pressure on intensive care bed provision, as well as increasing the risk that he or she will infect others who in turn might end up needing ICU care. Third, justice cuts both ways, and giving unvaccinated patients equal priority may itself be unjust when other patients have reduced their risk of ending up on the ICU by getting vaccinated.


Subject(s)
COVID-19 , Triage , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/therapeutic use , Female , Humans , Intensive Care Units , State Medicine , Vaccination
7.
J Prev Med Hyg ; 63(1): E104-E108, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1955106

ABSTRACT

Using the case of the vaccine against smallpox as an example, this article explores how the attitude and the politics of the Vatican State towards vaccination changed between the 18th and 19th century. Despite some notable exceptions, the Catholic Church became progressively involved in supporting vaccination in Italy, exerting its temporal and spiritual authority to develop healthcare policies and to convince a population that still considered the vaccine as potentially harmful. The brief historical overview on vaccine and vaccination shows that during the XIX century the Catholic church and in particular, the political decision of the Pope, engaged temporal and spiritual power, high authority and persuasive influence to encourage the population, more than anyone the hesitant people, to get vaccine against smallpox. Although with the due differences determined by the path of time and by the scientific, educational and social advances of modern-day, this view from the past can provide us, with actual COVID pandemic, a reason of deep thinking and also how to face the present COVID-19 pandemic and to prepare for forcoming future. Actually, it shows us how the terrible smallpox epidemic was handled and finally overcome, thanks to vaccination.


Subject(s)
COVID-19 , Smallpox , COVID-19/prevention & control , Catholicism/history , Humans , Italy , Pandemics/prevention & control , Public Health , Smallpox/history , Smallpox/prevention & control , Vaccination
8.
Int J Environ Res Public Health ; 19(14)2022 07 08.
Article in English | MEDLINE | ID: covidwho-1928558

ABSTRACT

Even though various countries' overall policy for dealing with the pandemic was not particularly innovative, the pandemic was perceived as a unique crisis. "COVID exceptionalism" has seemed to create "a new normal" that we all need to "learn to live with". The main change in perspective, while not new for public health experts, is that health exists within a social and political context. While public health ethics has turned out to be an important discipline, there is a long way to its wider acceptance. Entering the "new normal" calls for a wider embrace of public health approaches to ethics. The renewed emphasis on understanding health as a social concept encompasses central normative implications in relation to dealing with COVID-19 and in relation to dealing with other global crises, chiefly climate change. We argue that entering the era of "the new normal" in healthcare requires a nuanced understanding of the relationship between the individual and society and demands the formulation of a new system of bioethics focused on the concept of solidarity as a central value in public health. Such a concept should refer to the fact that in the "new normal", risks require new social and political formations of standing together in confronting risks that cross national, cultural, and identity borders. Forming and expanding solidarity in health and healthcare, we argue, is the main normative challenge for public health today.


Subject(s)
Bioethics , COVID-19 , COVID-19/epidemiology , Humans , Morals , Pandemics , Public Health
9.
Pakistan Journal of Medical Sciences Quarterly ; 38(4):1056, 2022.
Article in English | ProQuest Central | ID: covidwho-1918918

ABSTRACT

The COVID-19 pandemic has highlighted the vulnerability of countries worldwide and their abilities to cope with the fast-paced demands of the research and medical community. A key to promoting ethical decision-making frameworks is by calibrating the sustainability at regional, national, and global levels to incorporate coordinated reforms. We performed a sustained ethical analysis and critically reviewed evidence addressing country-level responses to practices during the COVID-19 pandemic using PubMed (MEDLINE), Scopus, and CINAHL. The World Health Organization's ethical framework proposed for the entire population during the pandemic was applied to thematically delineate findings under equality, best outcomes (utility), prioritizing the worst off, and prioritizing those tasked with helping others. The findings demarcate ethical concerns about the validity of drug and vaccine trials in developing and developed countries, hints of unjust healthcare organizational policies, lack of equal allocation of pertinent resources, miscalculated allocation of resources to essential workers and stratified populations.

10.
J Bioeth Inq ; 19(2): 301-314, 2022 06.
Article in English | MEDLINE | ID: covidwho-1906500

ABSTRACT

Meat is a multi-billion-dollar industry that relies on people performing risky physical work inside meat-processing facilities over long shifts in close proximity. These workers are socially disempowered, and many are members of groups beset by historic and ongoing structural discrimination. The combination of working conditions and worker characteristics facilitate the spread of SARS-CoV-2, the virus that causes COVID-19. Workers have been expected to put their health and lives at risk during the pandemic because of government and industry pressures to keep this "essential industry" producing. Numerous interventions can significantly reduce the risks to workers and their communities; however, the industry's implementation has been sporadic and inconsistent. With a focus on the U.S. context, this paper offers an ethical framework for infection prevention and control recommendations grounded in public health values of health and safety, interdependence and solidarity, and health equity and justice, with particular attention to considerations of reciprocity, equitable burden sharing, harm reduction, and health promotion. Meat-processing workers are owed an approach that protects their health relative to the risks of harms to them, their families, and their communities. Sacrifices from businesses benefitting financially from essential industry status are ethically warranted and should acknowledge the risks assumed by workers in the context of existing structural inequities.


Subject(s)
COVID-19 , COVID-19/epidemiology , COVID-19/prevention & control , Humans , Meat , Pandemics/prevention & control , Public Health , SARS-CoV-2 , United States/epidemiology
11.
Hastings Cent Rep ; 52(3): 4-5, 2022 May.
Article in English | MEDLINE | ID: covidwho-1905851

ABSTRACT

Kensey Dishman was unvaccinated when she contracted Covid-19 at thirteen years old. She also had asthma and is now dead. Her divorced parents disagreed about whether Kensey should be vaccinated, and her father suggested that it was Kensey's own choice to refuse vaccination. This situation is as complicated as it is tragic, and it raises a number of legal and ethical issues regarding medical decision-making for minors, parental rights, vaccination mandates, and individual freedom versus government interests in protecting minors as well as public health. This commentary explores these issues and highlights potential sources of liability for those involved in Kensey's treatment decisions given her high-risk for complications from Covid-19.


Subject(s)
COVID-19 , Adolescent , Clinical Decision-Making , Female , Humans , Minors , Public Health , Vaccination
12.
SSRN; 2021.
Preprint in English | SSRN | ID: ppcovidwho-339149

ABSTRACT

During the COVID-19 pandemic, the discipline of public ethics has struggled to find a consensus on how best to conceptualise the challenges. The transactional nature of clinical ethics is too limited to capture the range of ethically relevant concerns. Although public health ethics is broader, it fails to provide a convincing framework for the deeply political implications of the response to the pandemic. They go beyond health issues and raise questions of justice. We consider the demands of fairness for all, corrective justice for past structural wrongs, and utopian approaches that draw on our ideas about the ideal society. The lack of an agreed framework for ethical analysis is exacerbated by dwindling faith in expertise and a degradation of trust in media sources to present reliable, accurate information. These matters have undermined the quality of public reason. Although both the USA and UK had well-established anticipatory governance for pandemic influenza, it was not followed when COVID-19 took hold. The pandemic has exposed the weaknesses of our collective thinking, our readiness to discuss the issues rationally and effectively, and our ability to act effectively in the public good. Rebuilding effective public ethics in its wake will present a monumental challenge.

13.
Vaccines (Basel) ; 10(6)2022 May 26.
Article in English | MEDLINE | ID: covidwho-1869859

ABSTRACT

(1) Background: By summer 2021, overseas France turned COVID-19 vaccine and immunity certificates into passports to open travel bubbles. Subsequently, its territories set French records for both COVID-19 and 6-month excess all-cause mortality. (2) Methods: Official time series were collected to compare time correlations between air traffic and COVID-19 transmission and mortality in overseas France, before and after the implementation of immunity passports. (3) Results: Air traffic initially had a reversed relationship with COVID-19, which transitioned into a leader-follower relationship with the introduction of immunity passports. Essentially, air traffic increased 16 days before COVID-19 cases increased (r = 0.61) and 26 days before deaths increased (r = 0.31) in Martinique, 26 days (r = 0.72) and 40 days (r = 0.82) before in Guadeloupe, and 29 days (r = 0.60) and 31 days (r = 0.41) before in Réunion upon introduction of immunity passports. Moreover, air traffic became as correlated as community transmission to COVID-19 mortality in Guadeloupe. (4) Conclusions: Since the introduction of immunity passports, air traffic has been pacesetting COVID-19 within one month for transmission, and within an additional two weeks for mortality in overseas France. Responding to WHO's call for real-world evidence, this study suggests that COVID-19 passports are not commensurate with health system goals.

14.
J Med Ethics ; 2022 May 20.
Article in English | MEDLINE | ID: covidwho-1861650

ABSTRACT

Despite their clearly demonstrated safety and effectiveness, approved vaccines against COVID-19 are commonly mistrusted. Nations should find and implement effective ways to boost vaccine confidence. But the implications for ethical vaccine development are less straightforward than some have assumed. Opponents of COVID-19 vaccine challenge trials, in particular, made speculative or empirically implausible warnings on this matter, some of which, if applied consistently, would have ruled out most COVID-19 vaccine trials and many non-pharmaceutical responses.

15.
Front Med (Lausanne) ; 9: 824791, 2022.
Article in English | MEDLINE | ID: covidwho-1785359

ABSTRACT

In this paper, we focus on a novel bioethical approach concerning the ethical implications of the Social Determinants of Health (SDs) in the time of COVID-19, offering a fresh interpretation of our agency and responsibility in the current pandemic era. Our interpretation is grounded on the idea that our health basically depends on factors that go beyond our organism. In this sense, we stress the radical importance of circumstances to ethically assess an action, in the current pandemic context. Moreover, due the centrality of the SDs in our bioethical assessments-that implies that our health does not exclusively depend on our choices, behaviors, and lifestyle-we can affirm that we are not entirely responsible for our wellness or diseases. As health depends on economic, social, cultural, and environmental factors, we argue that the analysis of personal responsibility facing personal health status should receive further consideration. In this sense, following the "social connection model," we stress the importance of the concept of "shared responsibility" in collective decisions: if we make many decisions collectively, we are also collectively responsible of these decisions. Furthermore, to responsibly tackle the social inequalities that are the underlying cause of disparities in health outcomes, we propose two main strategies based on the Capability Approach: 1. empowering the individuals, especially the most vulnerable ones; and 2. designing preventive policies and interventions that provides an opportunity to address the disparities moving forward. This will help us going beyond the "individualistic medical ethics paradigm" and integrating our concept of health with social factors (e.g., the SDs), based on a more relational and interdependent anthropological thought.

16.
J Med Ethics ; 2022 Apr 01.
Article in English | MEDLINE | ID: covidwho-1774979

ABSTRACT

The SARS-CoV-2 (COVID-19) pandemic continues to expose underlying inequities in healthcare for black, indigenous and Latinx communities in the USA. The gaps in equitable care for communities of colour transcend the diagnosis, treatment and vaccinations related to COVID-19. We are experiencing a continued gap across racial and socioeconomic lines for those who suffer prolonged effects of COVID-19, also known as 'Long COVID-19'. What we know about the treatment for Long COVID-19 so far is that it is complex, requires a multidisciplinary approach and there is still much research needed to fully understand the effects. In this paper, we discuss pragmatic considerations for including affected communities, relevant stakeholders, and leaders from communities of colour in the planning and implementation of Long COVID-19 research.

17.
R I Med J (2013) ; 105(3):9-12, 2022.
Article in English | PubMed | ID: covidwho-1762367

ABSTRACT

Public health policy often involves a trade-off between promoting population health and protecting the interests of identifiable individuals. This paper analyses this trade-off as it arises in the context of decisions about the vaccination of children against Covid-19, where vaccination may be in the interests of society as a whole, as a means to stopping transmission, but not in the interests of individual children. The paper argues that the UK's Joint Committee on Vaccination and Immunisation resolved this tension by appeal to a version of a non-maleficence principle. It argues that, while this principle can be a useful guide to some public health policy decision-making, it is inappropriate in the case of vaccination.

18.
J Law Biosci ; 9(1): lsab036, 2022.
Article in English | MEDLINE | ID: covidwho-1752127

ABSTRACT

In early 2021, cases of rare adverse events were observed in individuals who had received the Astra Zeneca COVID-19 vaccine. Countries around the world differed radically in their policy responses to these observations. In this paper, we outline the ethical justification for different policy approaches for managing the emerging risks of novel vaccines in a pandemic. We begin by detailing the precautionary approach that some countries adopted, and distinguishing ethical questions regarding the management of known and unknown risks. We go on to outline the harms of adopting a highly precautionary approach in a pandemic context, and explain why an appropriate policy approach should accommodate the benefits as well as the risks of vaccination. In the final section, we outline three policy approaches that can accommodate the different benefits of vaccination, whilst taking into account the harms of precaution. Whilst we do not set out to defend one particular policy approach, we explain how different moral theories lend different degrees of support to each of these different approaches. Our analysis elucidates how fundamental value conflicts in public health ethics played out on the global stage of vaccine policy.

19.
J Med Ethics ; 46(11): 722-723, 2020 11.
Article in English | MEDLINE | ID: covidwho-1723854

ABSTRACT

In their recent article, 'Why lockdown of the elderly is not ageist and why levelling down equality is wrong', Savulescu and Cameron argue for selective isolation of the elderly as an alternative to general lockdown. An important part of their argument is the claim that the latter amounts to 'levelling down equality' and that this is 'unethical' or even 'morally repugnant'. This response argues that they fail to justify either part of this claim: the claim that levelling down is always morally wrong is subject to challenges that Savulescu and Cameron do not consider; and a policy of maintaining general lockdown does not constitute levelling down, as it provides absolute benefits to those who would be worse off under selective isolation.


Subject(s)
Ageism , Aged , Humans
20.
Dev World Bioeth ; 2022 Feb 12.
Article in English | MEDLINE | ID: covidwho-1685265

ABSTRACT

The particular dynamics of public health emergencies urge scientists and Ethics Committee (EC) members to change and adapt their operating procedures to function effectively. Despite having previous pandemic experiences, ethics committees were unprepared to adapt to COVID-19 pandemic challenges. This survey aims to learn and thoroughly discuss the most salient issues for ECs during the COVID-19 pandemic. The results indicate that the main problems faced by ECs were lack of/insufficient regulations, lack of data/experience/knowledge, sloppy review, poor research design, and poor adaptation to quarantine measures. Coping with factors that threaten the autonomy and independence of ECs, the ethical dilemma regarding maximizing common good versus protecting the rights and well-being of study participants, comprehending the change in the context of vulnerable populations, and redefining the role of ECs to strengthen trust in science and vaccine confidence were outstanding issues.

SELECTION OF CITATIONS
SEARCH DETAIL