Care, Dementia, and the Fourth Age in Erica Jong's Later Work.

BACKGROUND AND OBJECTIVES: This article addresses the representations of dementia and caregiving in the fourth age as depicted in Erica Jong's later-life work. It shows how the experience of parental care leads to the discovery of new ways of human interaction and expressions of personhood. RESEARCH DESIGN AND METHODS: Framed within literary-cultural age studies, this article shows how humanities-based inquiry can illuminate important aspects of aging and care of the oldest old, which are significant and revealing, but often hidden under the dark shadow of dementia. RESULTS: Newly discovered ways of communication challenge the notion of the loss of agency as they demonstrate that the body itself has the power of creative and intentional capacities and self-expression. DISCUSSION AND IMPLICATIONS: Care-related narratives offer new insights into aging, dementia, and subjectivity that can help pursue a better analysis of the "deep" old age, strengthen collective solidarity, and manage increasing ageism, especially pronounced during the coronavirus disease 2019 pandemic.

If fetuses are persons, abortion is a public health crisis.

Pro-life advocates commonly argue that fetuses have the moral status of persons, and an accompanying right to life, a view most pro-choice advocates deny. A difficulty for this pro-life position has been Judith Jarvis Thomson's violinist analogy, in which she argues that even if the fetus is a person, abortion is often permissible because a pregnant woman is not obliged to continue to offer her body as life support. Here, we outline the moral theories underlying public health ethics, and examine the COVID-19 pandemic as an example of public health considerations overriding individual rights. We argue that if fetuses are regarded as persons, then abortion is of such prevalence in society that it also constitutes a significant public health crisis. We show that on public health considerations, we are justified in overriding individual rights to bodily autonomy by prohibiting abortion. We conclude that in a society that values public health, abortion can only be tolerated if fetuses are not regarded as persons.

Shame: Ethical Considerations During the Pandemic.

The concept of shame and shaming has been prevalent in the healthcare literature and on social media platforms during the pandemic. There are innumerable ethical implications for the discipline of nursing to consider as the concept of shaming oneself and others is evident in healthcare situations. Shame is an enduring truth found in the humanbecoming ethos of human dignity. This article begins an analysis and discussion of the straight-thinking implications of shame and shaming others while desiring to honor others with human dignity as they traverse the chaotic healthcare system.

Person-Centered Communication Between Health Care Professionals and COVID-19-Infected Older Adults in Acute Care Settings: Findings From Wuhan, China.

OBJECTIVES: The current study aims to explore person-centered communication between health care professionals and COVID-19-infected older patients in acute care settings. METHODS: The current qualitative study explored the communication between professionals and COVID-19-infected older adults in the acute care setting through 2 rounds of interviews with physicians and nurses who provided direct care and treatment for COVID-19-infected older patients in Wuhan, China. We explored the possibilities and significance of facilitating effective communication despite multiple challenges in the pandemic. Conventional content analysis was adopted to analyze the rich data collected from our participants. RESULTS: It is possible and necessary to initiate and sustain person-centered communication despite multiple challenges brought by the pandemic. The achievement of person-centered communication can play significant roles in addressing challenges, building mutual trust, improving quality of care and relationships, and promoting treatment adherence and patients' psychological well-being. DISCUSSION: It is challenging for health care professionals to provide care for COVID-19-infected older adults, especially for those with cognitive and sensory impairment, in acute care settings. Facilitating person-centered communication is a significant strategy in responding to the pandemic crisis and a core element of person-centered care.

Ethical Significance of Being Present With Others During the Pandemic Era.

Human presence with others is vital in the healthcare experience for those who are giving and receiving services, especially during the upheaval unfolding concurrently with a pandemic. The author wishes to explore the notion of telepresence, uniquely defined as a potential living quality priority for those experiencing hospitalization and/or isolation from others. The ethical implications will be undergirded utilizing the humanbecoming enduring truths of reverence, betrayal, awe, and shame.

The impact of caring for dying patients in intensive care units on a physician's personhood: a systematic scoping review.

BACKGROUND: Supporting physicians in Intensive Care Units (ICU)s as they face dying patients at unprecedented levels due to the COVID-19 pandemic is critical. Amidst a dearth of such data and guided by evidence that nurses in ICUs experience personal, professional and existential issues in similar conditions, a systematic scoping review (SSR) is proposed to evaluate prevailing accounts of physicians facing dying patients in ICUs through the lens of Personhood. Such data would enhance understanding and guide the provision of better support for ICU physicians. METHODS: An SSR adopts the Systematic Evidenced Based Approach (SEBA) to map prevailing accounts of caring for dying patients in ICUs. To enhance the transparency and reproducibility of this process, concurrent and independent use of tabulated summaries, thematic analysis and directed content analysis (Split Approach) is adopted. RESULTS: Eight thousand three hundred fifty-eight abstracts were reviewed from four databases, 474 full-text articles were evaluated, 58 articles were included, and the Split Approach revealed six categories/themes centered around the Innate, Individual, Relational and Societal Rings of Personhood, conflicts in providing end of life care and coping mechanisms employed. CONCLUSION: This SSR suggests that caring for dying patients in ICU impacts how physicians view their personhood. To resolve conflicts within individual concepts of personhood, physicians use prioritization, reframing and rely on accessible, personalized support from colleagues to steer coping strategies. An adapted form of the Ring Theory of Personhood is proposed to direct timely personalized, appropriate and holistic support.

[Safe management of COVID-19 dead bodies in sub-Saharan Africa: could families be allowed to bury their dead?] / Gestion sécurisée des dépouilles de personnes décédées de la COVID-19 en Afrique sub-Saharienne: et si on laissait les familles enterrer leurs morts?

Sub-Saharan African countries have been hit by the Coronavirus 2019 pandemic (COVID-19) since March 2020. Besides the resulting health and economic disasters is the psycho-socio-cultural problem related with the management of corpses of people dead from the disease, which might hinder the implementation of the response strategy. In Cameroon for instance, the current corpse management policy is very disputed. In fact, although they were recently made more flexible, the restrictions applied to burials still ban any transfer of dead bodies between cities. In light of the African cultural considerations of dead persons, the disputes observed between the families and the health personnel, the legislation and the available scientific evidence, this article analyses the risks and benefits of allowing families to bury their relatives. It thereafter suggests solutions that reconcile dignity (by allowing families to bury their dead relatives in their homes) and safety (by ensuring a sealed handling and the surveillance by a judiciary police officer). Applying these solutions could improve the population's trust towards the health system, and positively contribute to COVID-19 case prevention, identification and management.

[Ethical reflections on the Measures Taken in Nursing Homes During Pandemic]. / Reflexiones éticas en torno a las Medidas tomadas en las Residencias durante la Pandemia.

The crisis in the health system caused by COVID-19 has left some important humanitarian deficits on how to care for the sick in their last days of life. The humanization of the dying process has been affected in three fundamental aspects, each of which constitutes a medical and ethical duty necessary. In this study, I analyze why dying accompanied, with the possibility of saying goodbye and receiving spiritual assistance, constitutes a specific triad of care and natural obligations that should not be overlooked - even in times of health crisis - if we do not want to see human dignity violated and violated some fundamental rights derived from it.

[Humanize Death in a Time of Sanitary Crisis: Accompanied Die, Farewell and Receive Spiritual Care]. / Humanizar la Muerte en Tiempos de Crisis Sanitaria: Morir Acompañado, Despedirse y Recibir Atención Espiritual.

The crisis in the health system caused by COVID-19 has left some important humanitarian deficits on how to care for the sick in their last days of life. The humanization of the dying process has been affected in three fundamental aspects, each of which constitutes a medical and ethical duty necessary. In this study, I analyze why dying accompanied, with the possibility of saying goodbye and receiving spiritual assistance, constitutes a specific triad of care and natural obligations that should not be overlooked - even in times of health crisis - if we do not want to see human dignity violated and violated some fundamental rights derived from it.