Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 106
Hastings Cent Rep ; 52(5): 8-14, 2022 09.
Article in English | MEDLINE | ID: covidwho-2059408


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.

Bioethics , COVID-19 , Vaccines , Advisory Committees , COVID-19/prevention & control , COVID-19 Vaccines , Humans , United States/epidemiology , Vaccination
Monash Bioeth Rev ; 40(1): 1-16, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-2048673


The global response to the recent coronavirus pandemic has revealed an ethical crisis in public health. This article analyses key pandemic public health policies in light of widely accepted ethical principles: the need for evidence, the least restrictive/harmful alternative, proportionality, equity, reciprocity, due legal process, and transparency. Many policies would be considered unacceptable according to pre-pandemic norms of public health ethics. There are thus significant opportunities to develop more ethical responses to future pandemics. This paper serves as the introduction to this Special Issue of Monash Bioethics Review and provides background for the other articles in this collection.

Bioethics , Coronavirus Infections , Coronavirus Infections/epidemiology , Humans , Pandemics/prevention & control , Public Health
Rev. bioét. (Impr.) ; 29(2): 242-250, abr.-jun. 2021.
Article in Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-2022160


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.

Humans , Male , Female , Aged , Aged, 80 and over , Bioethics , Aged , Ageism , COVID-19 , Health Policy
Perspect Biol Med ; 65(3): 426-441, 2022.
Article in English | MEDLINE | ID: covidwho-2021457


Over the last 80 years, a series of critical events has led to reconsideration of the basic premises of medical ethics. One of these events was the recognition of horrific medical experiments performed by German medical scientists in World War II concentration camps, resulting in intensified emphasis on a consent requirement, later understood as grounded in the bioethical principle of respect for autonomy, as well as on the moral accountability of the experimenter. Another important event that is forcing a reconsideration of respect for autonomy in medicine and health care is the COVID-19 pandemic. But this time the matter pulls in a different direction, from respect for autonomy to social responsibility, represented in problems as disparate as the wearing of masks, vaccination requirements, and equity in vaccine access and distribution. How can modern bioethics, in part a creature of the response to Nazi crimes, accommodate the intensified sensitivity about public health needs that has accompanied the shock of the pandemic? The responses of European medical ethics to the Nazi era provide tools for bioethics as it faces the challenge now at hand. This article uses historical context from postwar Europe to argue that, in light of the pandemic experience, respect for autonomy must systematically incorporate a commitment to social responsibility.

Bioethics , COVID-19 , COVID-19/epidemiology , Ethics, Medical , Humans , Pandemics , Social Responsibility
BMC Med Ethics ; 23(1): 88, 2022 08 28.
Article in English | MEDLINE | ID: covidwho-2021280


BACKGROUND: At the start of 2021, oncologists lacked the necessary scientific knowledge to adapt their clinical practices optimally when faced with cancer patients refusing or reluctant to be vaccinated against COVID-19, despite the marked vulnerability of these patients to severe, and even fatal forms of this new viral infectious disease. Oncologists at Foch Hospital were confronted with this phenomenon, which was observed worldwide, in both the general population and the population of cancer patients. METHODS: Between April and November 2021, the Ethics and Oncology Departments of Foch Hospital decided to investigate this subject, through an empirical and interdisciplinary study in bioethics. Our scientific objective was to try to identify and resolve the principal bio-ethical issues, with a view to improving clinical practices in oncology during future major pandemics of this kind, from a highly specific bio-ethical standpoint (= quality of life/survival). We used a mainly qualitative methodological approach based on questionnaires and interviews. RESULTS: In April 2021, 29 cancer patients refused or were reluctant to be vaccinated (5.6%; 29/522). Seventeen of these patients said that making vaccination mandatory would have helped them to accept vaccination. In October 2021, only 10 cancer patients continued to maintain their refusal (1.9%; 10/522). One of the main reasons for the decrease in refusals was probably the introduction of the "pass sanitaire" (health pass) in July 2021, which rendered vaccination indispensable for many activities. However, even this was not sufficient to convince these 10 cancer patients. CONCLUSION: We identified a key bio-ethical issue, which we then tried to resolve: vaccination policy. We characterized a major tension between "the recommendation of anti-COVID-19 vaccination" (a new clinical practice) and "free will" (a moral value), and the duty to "protect each other" (a moral standard). Mandatory vaccination, at least in France, could resolve this tension, with positive effects on quality of life (i.e. happiness), or survival, in cancer patients initially refusing or reluctant to be vaccinated, but only if collective and individual scales are clearly distinguished.

Bioethics , COVID-19 , Neoplasms , Humans , Interdisciplinary Studies , Policy , Quality of Life , Vaccination
Theor Med Bioeth ; 43(4): 209-220, 2022 08.
Article in English | MEDLINE | ID: covidwho-2000040


Robert Veatch's The Foundations of Justice: Why the Retarded and the Rest of Us Have Claims to Equality (1986) delves into deep questions of justice through the case of a child with disabilities. I describe what is basically right about this vision, as well as what is problematic from the standpoint of contemporary disability bioethics. From there, I dive into the notion of vulnerability that is at play in his work. He describes disability as necessarily a condition of weakness, lesser-than existence, and neediness. When disability is viewed in this way as an inherently vulnerable state of being, the essential sociopolitical dimensions of disability receive inadequate attention, which, in turn, makes it impossible to identify injustices correctly. I connect these points to concrete challenges faced by disability communities during the COVID-19 pandemic, which have raised profound questions about the just use of scarce critical care resources. Any case drawn from the pandemic is a very different kind of case than that of the child in Veatch's book, but a commonality is the question of who should get what limited resources when needs and urgency vary.

Bioethics , COVID-19 , Disabled Persons , Male , Child , Humans , Pandemics , Social Justice
Rev Gaucha Enferm ; 43: e20210137, 2022.
Article in English, Portuguese | MEDLINE | ID: covidwho-1993598


OBJECTIVE: To reflect about vaccine hesitancy from ethical and bioethical perspectives. METHODOLOGY: Reflective study through the analysis of bibliographic research carried out from December 2020 to May 2021 in the data banks SciELO, PubMed, Direção Geral da Saúde, and Ordem dos Enfermeiros. RESULTS: Vaccination aims at collective protection. The effects desirable in the individual do not have the same ethical value in the collective, leading to cost-benefit imbalances. The insufficiency of principlist Bioethics leads us to use other moral values, such as responsibility, solidarity, and social justice, to reflect on problems related to vaccination. CONCLUSION: In ethics there are no perfect solutions, and they depend on the context. Group immunity is one of the most discussed issues in a pandemic. Equitable distribution and the principle of justice are reflected daily in the nursing profession.

Bioethics , COVID-19 , COVID-19/epidemiology , COVID-19/prevention & control , Humans , Morals , Pandemics/prevention & control , Vaccination , Vaccination Refusal
Rev. bioét. (Impr.) ; 30(2): 434-443, abr.-jun. 2022. tab, graf
Article in Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-1951700


Resumo Este estudo busca relacionar as questões bioéticas acerca da quarentena como ferramenta de mitigação da pandemia de covid-19 na sociedade. Trata-se de revisão integrativa da literatura, seguindo os critérios da Preferred Reporting Items for Systematic Reviews and Meta-Analyses nas etapas pertinentes. A busca foi realizada nas bases de dados Biblioteca Virtual em Saúde, PubMed e SciELO, procurando textos publicados entre 2019 e 2020, em inglês, espanhol e português. Dentre os artigos identificados, sete foram selecionados para compor este trabalho, sendo dois dos Estados Unidos, dois da Espanha, um da Finlândia, um da Austrália e um de Bangladesh. Os estudos ressaltam que, apesar de a quarentena e o isolamento serem as únicas estratégias conhecidas até o momento, é necessário desenvolver políticas que levem em consideração os princípios bioéticos, focando, por exemplo, populações em situação de vulnerabilidade social, que necessitam de suporte para estabelecer tal medida.

Abstract This study seeks to relate the bioethical questions about the quarantine as a mitigation tool of the COVID-19 pandemic in society. It is an integrative review, following criteria of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses at the pertinent phases. The search was carried out in the databases Biblioteca Virtual em Saúde, PubMed and SciELO, searching texts published between 2019 and 2020, in English, Spanish and Portuguese. Among the identified articles, seven were selected to be part of this work, of those, two are from the United States, two from Spain, one from Finland, one from Australia, and one from Bangladesh. The studies show that, despite the quarantine and the distancing being the only strategies known up to this moment, developing politics that consider bioethical principles, focusing on, for example, socially vulnerable populations, who need support to establish this measure, is necessary.

Resumen Este estudio pretende relacionar las cuestiones bioéticas sobre la cuarentena como herramienta de mitigación para la pandemia del Covid-19. Esta es una revisión integradora de la literatura basada en los criterios del Preferred Reporting Items for Systematic Reviews and Meta-Analyses en las etapas correspondientes. Se realizó en las bases de datos Biblioteca Virtual en Salud, PubMed y SciELO una búsqueda de artículos publicados entre 2019 y 2020, en inglés, español y portugués. Entre los artículos identificados, se seleccionaron siete: dos de Estados Unidos, dos de España, uno de Finlandia, uno de Australia y uno de Bangladesh. Los estudios destacan que, aunque la cuarentena y el aislamiento son las únicas estrategias conocidas hasta el momento, es necesario desarrollar políticas que tengan en cuenta los principios bioéticos, centrándose, por ejemplo, en las poblaciones en situación de vulnerabilidad social, que necesitan apoyo para cumplir tal medida.

Bioethics , Quarantine , Pandemics , COVID-19
Rev. bioét. (Impr.) ; 30(2): 391-404, abr.-jun. 2022. tab
Article in Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-1951699


Resumo O enfrentamento da covid-19 suscitou uma série de problemas na área da saúde, em razão do aumento da demanda de cuidados intensivos. Para solucionar a crise causada pela escassez de recursos de alta complexidade, a tomada de decisão tem se norteado por escores prognósticos, porém esse processo inclui uma dimensão moral, ainda que esta seja menos evidente. Mediante revisão integrativa, este artigo buscou refletir sobre a razoabilidade da utilização de indicadores de gravidade para definir a alocação de recursos escassos na saúde. Observou-se que o trabalho realizado em situações de escassez de recursos provoca sobrecarga moral, convergindo para busca por soluções padronizadas e objetivas, como a utilização de escores prognósticos. Conclui-se que seu uso isolado e indiscriminado não é eticamente aceitável e merece avaliação cautelosa, mesmo em situações emergenciais, como a da covid-19.

Abstract Facing COVID-19 caused many problems in the healthcare field, due to the rise in the intensive care demand. To solve this crisis, caused by the scarcity of resources of high complexity, decision-making has been guided by prognostic scores; however, this process includes a moral dimension, although less evident. With na integrative review, this article sought to reflect on the reasonability of using severity indicators to define the allocation of the scarce resources in healthcare. We observed that the work carried out on resource scarcity situations causes moral overload, converging to the search for standard and objective solutions, such as the use of prognostic scores. We conclude that their isolated and indiscriminate use is not ethically acceptable and deserves cautious evaluation, even in emergency situations, such as COVID-19.

Resumen La lucha contra el Covid-19 implicó una serie de problemas en el área de la salud, debido al aumento de la demanda de cuidados intensivos. Para solucionar la crisis provocada por la escasez de recursos de alta complejidad, la toma de decisiones estuvo orientada por puntuaciones pronósticas, pero este proceso incluye una dimensión moral aún menos evidente. A partir de una revisión integradora, este artículo buscó reflexionar sobre la razonabilidad de utilizar indicadores de gravedad para definir la asignación de recursos escasos en salud. El trabajo realizado en situaciones de escasez de recursos genera sobrecarga moral, llevando a la búsqueda de soluciones estandarizadas y objetivas, como el uso de puntuaciones de pronóstico. Se concluye que su uso aislado e indiscriminado no es éticamente aceptable y merece una cuidadosa evaluación, incluso en situaciones de emergencia, como la del Covid-19.

Bioethics , Health Care Rationing , APACHE , Ethics , Organ Dysfunction Scores , COVID-19 , Intensive Care Units
Rev. bioét. (Impr.) ; 30(2): 318-324, abr.-jun. 2022.
Article in Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-1951697


Resumo Este estudo busca refletir acerca do cuidado intercultural quanto ao modo de agir no processo de enfermagem ante as diferentes culturas. Trata-se de estudo teórico de abordagem reflexiva baseado na experiência do acadêmico na construção de seu portfólio, realizado no ano de 2020 por meio de reflexões pautadas em portfólio acadêmico do quinto semestre de um curso de enfermagem do Sul do Brasil. Após análise do material produzido e das reflexões anotadas no diário do portfólio, emergiram as seguintes categorias: cuidado intercultural em disciplinas de enfermagem e interculturalidade e pandemia. Assim, após reflexão e discussão sobre o cuidado de enfermagem, abordar-se-ão a interculturalidade diante das disciplinas cursadas, as experiências da trajetória acadêmica nesse período e, por fim, os impactos da pandemia de covid-19 no processo de cuidado das pessoas do ponto de vista da interculturalidade. Essa temática torna-se importante por suscitar uma reflexão sobre a relação enfermeiro-paciente.

Abstract This study seeks to reflect on intercultural care regarding the how to act in the nursing process in the face of different cultures. This is a theoretical study with reflexive approach based on the experience of the academic in building their portfolio carried out in 2020 by means of reflections based on academic portfolios of the fifth semester of a nursing program in the South region of Brazil. After analysis of the produced material and of the noted reflections in the portfolio diary, the following categories emerged: intercultural care in nursing courses and interculturality in the pandemic. Thus, after reflection and discussion on nursing care, we will focus on interculturality in the face of the courses taken, the experiences of the academic trajectory in this period, and, finally, the impacts of the COVID-19 pandemic in the process of care for people from the point of view of interculturality. This thematic becomes important for bringing up a reflection on the nurse-patient relation.

Resumen Este estudio reflexiona sobre el cuidado intercultural en la forma de actuar de la enfermería ante las diferentes culturas. Se trata de un estudio teórico, de tipo reflexivo, sobre la experiencia de académicos en la construcción de su portafolio, que cursaban el quinto semestre de enfermería en el sur de Brasil, en el periodo de 2020. Tras realizados el análisis de datos y las reflexiones anotadas en el diario de portafolio, surgieron las siguientes categorías: cuidado intercultural en las materias de enfermería e interculturalidad y pandemia. Luego de la reflexión y discusión sobre el cuidado de enfermería, se aborda la interculturalidad en las materias cursadas, las vivencias de la trayectoria académica en este periodo, y los impactos de la pandemia del Covid-19 sobre el proceso de cuidado de las personas desde el punto de vista de la interculturalidad. Este tema es importante para suscitar una reflexión sobre la relación enfermero-paciente.

Bioethics , Education, Nursing , Ethics , Cultural Competency , Nurse-Patient Relations , Nursing Care
Rev. bioét. (Impr.) ; 30(2): 258-271, abr.-jun. 2022. graf
Article in Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-1951696


Resumo O papel da bioética na promoção de espaços educativos e deliberativos representa uma demanda para viabilizar a inclusão social de grupos vulneráveis. Neste escopo, e com intuito de validar método de aplicação da deliberação em ambientes virtuais, realizou-se a terceira versão da ação "O caminho do diálogo", que promoveu, entre idosos, discussão acerca do impacto da pandemia de covid-19 nos processos de inclusão e, entre acadêmicos de bioética, debate sobre fragilidades, valores éticos, crenças e potencialidades da inclusão da proteção animal, veganismo, crise hídrica, saúde mental, deficiências múltiplas, refugiados, moradores em situação de rua, violência contra mulheres, sexualidade e gênero e educação digital. Este artigo relata a experiência dessa intervenção e discute a bioética no contexto da deliberação, com intenção não de trabalhar formalmente conceitos de bioética, mas de introduzir a perspectiva bioética pelo diálogo interdisciplinar como meio de identificar vulnerabilidades e debater soluções para promover a inclusão.

Abstract The role of bioethics in promoting educative and deliberative spaces represents a demand to make the social inclusion of vulnerable groups viable. In this scope, and aiming to validate the method of applying deliberation in virtual environments, we carried out the third version of the " O caminho do diálogo " (The path of dialogue) action, which promoted, among older adults, a discussion about the impact of the COVID-19 pandemic in the inclusion processes and, among bioethics academics, a debate on fragilities, ethical values, beliefs and potentialities of inclusion of animal protection, veganism, water crisis, mental health, multiple disabilities, refugees, homeless people, violence against women, sexuality and gender, and digital education. This article reports this interventions experience and discusses bioethics in the context of deliberation, intending not to formally work bioethics concepts, but to introduce the bioethical perspective by using interdisciplinary dialogue as a means of identifying vulnerabilities and debating solutions to promote inclusion.

Resumen El papel de la bioética al promover espacios educativos y deliberativos representa una demanda de inclusión social de grupos vulnerables. Para validar el método de aplicación de deliberación en entornos virtuales, se realizó la tercera edición de la acción "El camino del diálogo", que levantó, entre los mayores, la discusión sobre el impacto de la pandemia del Covid-19 en los procesos de inclusión y, entre académicos de bioética, un debate sobre las debilidades, valores éticos, creencias y potencialidades de la inclusión de la protección animal, veganismo, crisis hídrica, salud mental, múltiples discapacidades, refugiados, personas sin hogar, violencia contra la mujer, sexualidad y género, y educación digital. Se describe aquí esta intervención y se discute la bioética de la deliberación, con la intención no de trabajar formalmente conceptos de bioética, sino de introducir la perspectiva bioética mediante el diálogo interdisciplinario como mecanismo de identificación de vulnerabilidades y debate de soluciones inclusivas.

Risk Groups , Bioethics , User-Computer Interface , Aged , Education , Social Inclusion
Eur J Emerg Med ; 28(2): 90-91, 2021 04 01.
Article in English | MEDLINE | ID: covidwho-1937776
Neurol India ; 70(3): 845-848, 2022.
Article in English | MEDLINE | ID: covidwho-1934352


Vulnerable moments, panic, and uncertainties are the hallmarks of pandemic outbreaks. Medicolegal challenges add further injury to the public health chaos. Although containing the pandemic is of prime concern, medicolegal and ethical uncertainties further complicate ideal standards of medical care. Constraints in the provision of medical care, resource limitations, infectivity risks, burgeoning costs, and pandemic control laws, create extremely precarious medicolegal situations. Ethics and medical negligence laws may, at times, be trampled upon by the overwhelming urgencies of the pandemic. Hence, we attempt to review basic ethical and medicolegal principles that are put to test by pandemic urgencies. We aim to study these vulnerable medicolegal moments in neurosurgeons'/neurologists' clinical and research practices during the COVID-19 times from our own practice and contemporary literature on COVID practices, medicolegal sciences, and pandemic healthcare directives. We also review supportive measures and safeguards to brace these vulnerable moments effectively. We compile medicolegally sound and ideal practice parameters, including the basic principles for a restructured informed surgical consent ensuring a medicolegally and ethically sound practice. Several ethical and medicolegal exigencies are part of medical practice during a pandemic. Special care should be taken to avoid violations of medicolegal and ethical proprieties during the urgencies of medical care and research. Restructuring of contracts like the informed consent would also count as an ideal practice modification in a pandemic.

Bioethics , COVID-19 , Neurologists , Neurosurgeons , Humans , Informed Consent , Malpractice , Pandemics/prevention & control
Int J Environ Res Public Health ; 19(14)2022 07 08.
Article in English | MEDLINE | ID: covidwho-1928558


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.

Bioethics , COVID-19 , COVID-19/epidemiology , Humans , Morals , Pandemics , Public Health
Bioethics ; 36(5): 482-485, 2022 06.
Article in English | MEDLINE | ID: covidwho-1861213
Rev. bioét. (Impr.) ; 30(1): 19-26, jan.-mar. 2022.
Article in Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-1833845


Resumo Este artigo objetiva refletir acerca dos dilemas éticos enfrentados pelos profissionais de saúde, pacientes e familiares durante a pandemia da covid-19. A pandemia irrompeu questões éticas na saúde, ocasionadas pela falta de recursos materiais, humanos e o medo do desconhecido. Pacientes e familiares também foram afetados pelo distanciamento na internação e no luto. Profissionais da saúde depararam com dilemas éticos que suscitam questões sobre o dever de assistir o paciente e a garantia da segurança pessoal, lidando com o desafio de agir com ética em meio à sobrecarga e à insegurança do contexto. A família e os pacientes enfrentam um cenário de adaptação do cuidar em saúde com a carência de tecnologias que permitam acolhimento diante da necessidade de distanciamento, inclusive no processo dos rituais de despedida dos finados. Assim, investimentos em saúde podem impulsionar mudanças no cuidado, em observância da justiça social e do respeito à dignidade humana.

Abstract This article aims to reflect on the ethical dilemmas faced by health professionals, patients and family members during the COVID-19 pandemic. The pandemic raised ethical issues in health caused by the lack of material and human resources and the fear of the unknown. Patients and family members were also affected by social distancing in hospitalization and mourning. Health profissionals faced ethical dilemmas that raise questions about the duty to assist patients and the guarantee of personal safety, dealing with the challenge of acting ethically amid work overload and insecurity of the context. The family and patients face a scenario of adaptation of health care with the lack of technologies that allow feelings of care in the face of the need for distancing, including in the process of farewell rituals of the late. Investments in health can thus drive changes in care, in compliance with social justice and respect for human dignity.

Resumen Este artículo reflexionó sobre los dilemas éticos que enfrentan los profesionales de la salud, los pacientes y familiares durante la pandemia del covid-19. La pandemia hizo estallar cuestiones éticas en salud, provocadas por la falta de recursos materiales y humanos, y el miedo a lo desconocido. Los pacientes y sus familias fueron afectados por el distanciamiento en la hospitalización y el duelo. Los profesionales de la salud afrontaron dilemas éticos en cuanto al deber de asistir al paciente y la garantía de seguridad personal, y el desafío de actuar éticamente durante la sobrecarga e inseguridad en ese contexto. Los pacientes y sus familias enfrentan una adaptación de la atención a la falta de tecnología para acogerles ante el distanciamiento, incluso en el proceso de despedida al difunto. Las inversiones en salud pueden promover cambios en la atención en observancia de la justicia social y el respeto a la dignidad humana.

Patients , Bioethics , Bereavement , Family , Mental Health , Health Personnel , Coronavirus Infections , Fear , Pandemics , Physical Distancing , COVID-19
Hastings Cent Rep ; 52 Suppl 1: S63-S65, 2022 03.
Article in English | MEDLINE | ID: covidwho-1802227


In this essay, a Black scholar of the cultural histories of Black women's reproductive lives launches a discussion of generations of racism, health inequities, and violence against Black bodies by looking at Black poet and essayist Dionne Brand's critique of the notion of returning to "the normal" after the Covid-19 pandemic. To what, the essay asks, is everyone so eager to return? The intergenerational wait for Black people's moment of racial reckoning is its own unique biomedical warfare, which cannot end with the end of a pandemic. This warfare undercuts Black people's daily health with anxiety and depression, altering the very chromosomes passed down to their children. To health care providers, bioethicists, and those who practice antiracist health work the author poses these questions: How will you confront anti-Black racism within every formulation of "treatment"-diagnosis, care, medication distribution, physical therapy? How long will the violence against Black lives be dissolved into talking points about our bodies? How can one listen, ethically, to Black people? These, she asserts, are questions of practice, of politics, and of care.

Bioethics , COVID-19 , Racism , African Americans , Child , Female , Humans , Pandemics
Camb Q Healthc Ethics ; 31(2): 177-184, 2022 04.
Article in English | MEDLINE | ID: covidwho-1730228


Robert Baker and Rosamond Rhodes each argue against the universality "common morality," the approach to ethics that comprises four fundamental principles and their application in various settings. Baker contends that common morality cannot account for cultural diversity in the world and claims that a human rights approach is superior in the context of global health. Rhodes maintains that bioethics is not reducible to common morality because medical professionals have special privileges and responsibilities that people lack in everyday life. Baker fails to demonstrate how the human rights approach to global ethics is more sensitive to culture than the use of bioethics principles that comprise common morality. Rhodes has a narrow interpretation of "common morality," which when understood more broadly, accounts for the special privileges and obligation of medical professionals.

Bioethics , Morals , Cultural Diversity , Human Rights , Humans
Camb Q Healthc Ethics ; 31(2): 161-163, 2022 04.
Article in English | MEDLINE | ID: covidwho-1730227
Bioethics ; 36(3): 305-312, 2022 03.
Article in English | MEDLINE | ID: covidwho-1705809


Our paper interrogates the ethics of digital pandemic surveillance from Indigenous perspectives. The COVID-19 pandemic has shown that Indigenous peoples are among the communities most negatively affected by pandemic infectious disease spread. Similarly to other racialized subpopulations, Indigenous people have faced strikingly high mortality rates from COVID-19 owing to structural marginalization and related comorbidities, and these high rates have been exacerbated by past and present colonial dominance. At the same time, digital pandemic surveillance technologies, which have been promoted as effective tools for mitigating a pandemic, carry risks for Indigenous subpopulations that warrant an urgent and thorough investigation. Building on decolonial scholarship and debates about Indigenous data sovereignty, we argue that should Indigenous communities wish to implement digital pandemic surveillance, then they must have ownership over these technologies, including agency over their own health data, how data are collected and stored, and who will have access to the data. Ideally, these tools should be designed by Indigenous peoples themselves to ensure compatibility with Indigenous cultures, ethics and languages and the protection of Indigenous lives, health and wellbeing.

Bioethics , COVID-19 , COVID-19/epidemiology , Humans , Indigenous Peoples , Pandemics , Technology