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2.
J Infect Dev Ctries ; 15(7): 910-12, 2021 07 31.
Article in English | MEDLINE | ID: covidwho-1339634

ABSTRACT

Confirmed new cases of Coronavirus disease 2019 (COVID-19) have accelerated in Sub-Saharan Africa against a backdrop of fragile health systems, a high burden of comorbidities and socioeconomic instability. The context makes the region particularly vulnerable to the virus and its impact. As cases escalate, the need to tailor-make COVID-19-related response strategies to the African context is imperative. This paper aims to discuss key considerations on the public health response to the pandemic and its intersection with ethics and human rights. With this perspective, we bring attention to the conflict between healthcare workers' obligations and patient rights under the unclear policy and regulatory frameworks and the application of restrictive measures in the context of poverty. The indirect effects of the pandemic on already existing health problems are also highlighted. We appeal to the African States to establish appropriate systems which integrate human rights-based approaches to COVID-19 response. These systems should be ethically sound systems and ensure no-one is left behind in terms of testing, access to therapeutics and vaccination, and social protection; based on lessons learned over the past 12 months of the pandemic's presence in SSA, and patterns emerging across the globe.


Subject(s)
COVID-19/psychology , Health Personnel/psychology , Human Rights/ethics , Human Rights/legislation & jurisprudence , Public Health , Africa South of the Sahara/epidemiology , COVID-19/epidemiology , Comorbidity , Delivery of Health Care , Health Policy/legislation & jurisprudence , Humans , Poverty
4.
Front Public Health ; 8: 570243, 2020.
Article in English | MEDLINE | ID: covidwho-1045491

ABSTRACT

Introduction: COVID-19 requires governmental measures to protect healthcare system access for people. In this process, the collision of fundamental rights emerges as a crucial challenge for decision-making. Policy Options and Implications: This policy review analyzes selected articles by the PubMed searcher about extreme measures taken in several countries during precedent pandemics and the current pandemic, and selects hard decisions relating to the exceptional measures taken by judicial departments in Brazil, connecting them to the "collision of fundamental rights and law principles." The collision of rights and principles imposed on decision makers a duty to provide balanced rights, and to adopt the enforcement of some rights prioritization. Ethical concerns were also verified in this field involving rights limitations. During a pandemic, the importance of extreme measures to protect health rights and healthcare systems is instrumental for focused, fast, and correct decision making to avoid loss of life and the collapse of healthcare systems. The main goals of this research are to discuss the implications and guidelines for public health decision making, the indispensable ethical and legal aspects for safeguarding health systems and the lives of people, and the respect of the Justice principle and of fundamental health and dignity rights. We conclude that COVID-19 justifies the prioritization of collective and individual health access rights. Acceptable standards of fundamental rights restrictions are established at the constitutional and international levels and must be enforced by rules and governmental action, to ensure fast and accurate decision making during a pandemic. Freedom rights exercises must be linked to solidarity for the realization of social welfare, for the health rights of all individuals and for health systems to function well during a pandemic. Actionable Recommendations: All individuals are free and equal, therefore social exclusion is prohibited. Institutions must consider social inequalities when discussing public health measures and be guided by ethical standards, by law principles, and rules recognized by constitutional and international law for the benefit of all during a health pandemic. Conclusions: Collective and individual health rights prevail over the collision of rights when facing pandemic occurrences, case by case, in health systems protection, based on the literature, on precedent pandemics and on legitimate Public Health efforts.


Subject(s)
COVID-19 , Health Services Accessibility , Human Rights/ethics , Public Policy , Right to Health , Brazil , Decision Making , Humans , Public Health
5.
Med Health Care Philos ; 24(1): 3-20, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-898085

ABSTRACT

The Covid-19 pandemic creates an unprecedented threatening situation worldwide with an urgent need for critical reflection and new knowledge production, but also a need for imminent action despite prevailing knowledge gaps and multilevel uncertainty. With regard to the role of research ethics in these pandemic times some argue in favor of exceptionalism, others, including the authors of this paper, emphasize the urgent need to remain committed to core ethical principles and fundamental human rights obligations all reflected in research regulations and guidelines carefully crafted over time. In this paper we disentangle some of the arguments put forward in the ongoing debate about Covid-19 human challenge studies (CHIs) and the concomitant role of health-related research ethics in pandemic times. We suggest it might be helpful to think through a lens differentiating between risk, strict uncertainty and ignorance. We provide some examples of lessons learned by harm done in the name of research in the past and discuss the relevance of this legacy in the current situation.


Subject(s)
COVID-19/epidemiology , Ethics, Research , Biomedical Research/ethics , COVID-19/therapy , Compassionate Use Trials/ethics , Human Rights/ethics , Humans , Uncertainty
6.
J Glob Health ; 10(2): 020103, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-895611

ABSTRACT

The COVID-19 pandemic has put health systems, economies and societies under unprecedented strain, calling for innovative approaches. Scotland's government, like those elsewhere, is facing difficult decisions about how to deploy digital technologies and data to help contain, control and manage the disease, while also respecting citizens' rights. This paper explores the ethical challenges presented by these methods, with particular emphasis on mobile apps associated with contact tracing. Drawing on UK and international experiences, it examines issues such as public trust, data privacy and technology design; how changing disease threats and contextual factors can affect the balance between public benefits and risks; and the importance of transparency, accountability and stakeholder participation for the trustworthiness and good-governance of digital systems and strategies. Analysis of recent technology debates, controversial programmes and emerging outcomes in comparable countries implementing contact tracing apps, reveals sociotechnical complexities and unexpected paradoxes that warrant further study and underlines the need for holistic, inclusive and adaptive strategies. The paper also considers the potential role of these apps as Scotland transitions to the 'new normal', outlines challenges and opportunities for public engagement, and poses a set of ethical questions to inform decision-making at multiple levels, from software design to institutional governance.


Subject(s)
Contact Tracing/ethics , Disease Transmission, Infectious/ethics , Human Rights/ethics , Mobile Applications/ethics , Pandemics/ethics , Betacoronavirus , COVID-19 , Contact Tracing/methods , Coronavirus Infections/prevention & control , Disease Transmission, Infectious/prevention & control , Government , Humans , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , SARS-CoV-2 , Scotland/epidemiology , Stakeholder Participation , Technology/ethics
7.
J Infect Dev Ctries ; 14(9): 968-970, 2020 09 30.
Article in English | MEDLINE | ID: covidwho-842091

ABSTRACT

The COVID-19 pandemic has created new challenges on multiple fronts including a few ethical concerns. Timely and appropriate access to health services and the need to protect vulnerable people are some of them. An important aspect to consider, at the global level, is the frailty of health systems in many developing countries and the constant threat of these collapsing due to shortage of resources and medical supply. Special attention should be placed towards protecting the health of care workers who are highly exposed to SARS-CoV-2 infection. Research and clinical trials involving COVID-19 patients and healthy human volunteers must be done in strict adherence to the fundamental principles of bioethics, even if finding a solution is an urgent need. Shared responsibility must be assumed as we collectively face a common problem and ethical conflicts must be resolved using, as reference, the guidelines developed by the World Health Organization and other relevant international and national organizations. This would allow responsible action in the face of the pandemic without harming human rights, the individual and collective well-being.


Subject(s)
Betacoronavirus , Global Health/ethics , Pandemics/ethics , COVID-19 , Clinical Trials as Topic/ethics , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Developing Countries , Health Personnel/ethics , Healthcare Disparities/ethics , Human Rights/ethics , Humans , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , SARS-CoV-2 , Triage/ethics
8.
Int J Law Psychiatry ; 73: 101632, 2020.
Article in English | MEDLINE | ID: covidwho-808407

ABSTRACT

The emergence of the COVID-19 (coronavirus) pandemic in late 2019 and early 2020 presented new and urgent challenges to mental health services and legislators around the world. This special issue of the International Journal of Law and Psychiatry explores mental health law, mental capacity law, and medical and legal ethics in the context of COVID-19. Papers are drawn from India, Australia, the United Kingdom, Ireland, Germany, Portugal, and the United States. Together, these articles demonstrate the complexity of psychiatric and legal issues prompted by COVID-19 in terms of providing mental health care, protecting rights, exercising decision-making capacity, and a range of other topics. While further work is needed in many of these areas, these papers provide a strong framework for addressing key issues and meeting the challenges that COVID-19 and, possibly, other outbreaks are likely to present in the future.


Subject(s)
COVID-19/psychology , Commitment of Mentally Ill , Human Rights , Mental Competency , Mental Disorders/psychology , Mental Health Services , Mental Health , COVID-19/epidemiology , Commitment of Mentally Ill/ethics , Commitment of Mentally Ill/legislation & jurisprudence , Human Rights/ethics , Human Rights/legislation & jurisprudence , Humans , Mental Competency/legislation & jurisprudence , Mental Disorders/epidemiology , Mental Health Services/ethics , Mental Health Services/legislation & jurisprudence , Pandemics , SARS-CoV-2
9.
Cuad Bioet ; 31(102): 167-182, 2020.
Article in Spanish | MEDLINE | ID: covidwho-761283

ABSTRACT

In this paper present, from a bioethical perspective, a reflection on how to reconcile efforts to combat the COVID-19 pandemic with the safeguard of human rights. To do this, I develop three points. First, the regulatory framework that justifies the restriction or suspension of rights in the face of serious threats to public health. Second, the declarations of the international bioethics committees on the way in which human rights should be protected during public health crisis. And third, a review of the main rights threatened both by the public health crisis and by the means adopted to combat it. Before going into each of these points, I offer a preliminary note to clarify certain legal concepts and underline the need to overcome disjunctive approaches in considering human rights.


Subject(s)
Betacoronavirus , Communicable Disease Control/legislation & jurisprudence , Human Rights/ethics , Pandemics/prevention & control , Public Health/ethics , COVID-19 , Communicable Disease Control/methods , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Ethics Committees , European Union , Freedom , Health Resources/ethics , Health Resources/supply & distribution , Health Services Accessibility/ethics , Human Rights/legislation & jurisprudence , Humans , Pandemics/ethics , Pandemics/legislation & jurisprudence , Patient Rights/ethics , Patient Rights/legislation & jurisprudence , Personal Autonomy , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Practice Guidelines as Topic , Public Health/legislation & jurisprudence , Quarantine/ethics , Quarantine/legislation & jurisprudence , Research Subjects , Resource Allocation/ethics , SARS-CoV-2 , Spain , UNESCO
12.
Int J Law Psychiatry ; 73: 101605, 2020.
Article in English | MEDLINE | ID: covidwho-623363

ABSTRACT

The purpose of this paper is to explore the effect of the COVID-19 pandemic on the human rights of persons with mental and cognitive impairments subject to coercive powers in Australia. It sets out the relevant human rights in the Convention on the Rights of Persons with Disabilities which have been engaged by the COVID-19 pandemic and the government's response to it. It examines the effect of emergency legislation on the relaxation of human rights safeguards in mental health laws, with a focus on mental health tribunals (although it is limited by a lack of published decisions and gaps in publicly available information). However, some of the issues created for persons with disabilities during the COVID-19 pandemic are evident in some decisions published by the New South Wales Guardianship Tribunal. The paper critically analyses two guardianship decisions UZX [2020] NSWCATGD 3 (3 April, 2020) and GZK [2020] NSWCATGD 5 (23 April, 2020) and some emergency South Australian legislation COVID-19 Emergency Response Act, 2020 (SA) Schedule 1 to demonstrate the ways in which the human rights of persons with mental and cognitive impairments can be more at risk than those of the general population, even when the general population is itself in "lockdown."


Subject(s)
COVID-19/epidemiology , Coercion , Cognitive Dysfunction , Commitment of Mentally Ill/legislation & jurisprudence , Disabled Persons/legislation & jurisprudence , Human Rights/legislation & jurisprudence , Mental Disorders , Australia/epidemiology , Human Rights/ethics , Humans , Pandemics , SARS-CoV-2
13.
Hastings Cent Rep ; 50(3): 18-21, 2020 May.
Article in English | MEDLINE | ID: covidwho-620803

ABSTRACT

Artificial intelligence surveillance can be used to diagnose individual cases, track the spread of Covid-19, and help provide care. The use of AI for surveillance purposes (such as detecting new Covid-19 cases and gathering data from healthy and ill individuals) in a pandemic raises multiple concerns ranging from privacy to discrimination to access to care. Luckily, there exist several frameworks that can help guide stakeholders, especially physicians but also AI developers and public health officials, as they navigate these treacherous shoals. While these frameworks were not explicitly designed for AI surveillance during a pandemic, they can be adapted to help address concerns regarding privacy, human rights, and due process and equality. In a time where the rapid implementation of all tools available is critical to ending a pandemic, physicians, public health officials, and technology companies should understand the criteria for the ethical implementation of AI surveillance.


Subject(s)
Artificial Intelligence/ethics , Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Population Surveillance/methods , Betacoronavirus , COVID-19 , Human Rights/ethics , Humans , Pandemics , Privacy , Racism/ethics , SARS-CoV-2
15.
J Med Ethics ; 46(7): 451-454, 2020 07.
Article in English | MEDLINE | ID: covidwho-306365

ABSTRACT

The Director-General of the WHO has suggested that China's approach to the COVID-19 crisis could be the standard of care for global epidemics. However, as remarkable as the Chinese strategy might be, it cannot be replicated in other countries and certainly not in Europe. In Europe, there is a distribution of power between the European Union and its member states. In contrast, China's political power is concentrated in the central government. This enables it to take immediate measures that affect the entire country, such as massive quarantines or closing borders. Moreover, the Chinese legal framework includes restrictions on privacy and other human rights that are unknown in Europe. In addition, China has the technological power to easily impose such restrictions. In most European countries, that would be science fiction. These conditions have enabled China to combat epidemics like no other country can. However, the WHO might have been overoptimistic. The Chinese standard of care for treating COVID-19 also raises problematic issues for human rights, and the real consequences of these actions remain to be seen.


Subject(s)
Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Standard of Care/ethics , Standard of Care/standards , Betacoronavirus , COVID-19 , China/epidemiology , Europe/epidemiology , Human Rights/ethics , Human Rights/standards , Humans , Pandemics , Privacy , SARS-CoV-2
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