COVID-19 Pandemic and Public Health Ethics in Japan.

Public health ethics is a discipline dealing with ethical issues relating to public health. As a branch of medical ethics, it also deals with clinical and research ethics. The core issue of public health ethics is to balance the conflict between individual liberty and the public good. Because of the coronavirus disease 2019 (COVID-19) pandemic, deliberation based on public health ethics is required to reduce social disparities and increase community cohesion. This study presents three public health ethics challenges. The first is to introduce an egalitarian liberal approach to public health concerning social and economic issues experienced by vulnerable populations both domestically and globally. I then propose alternative and compensatory public health policies that serve the principles of justice. Second, public health ethics must ensure procedural justice in all public health policy decisions. For example, when deciding to implement public health policies, including restrictions on individual liberties, the decision making process must be open to the public. Third, citizens and students must be educated on public health ethics. The public must be provided with an open forum to deliberate on ethical issues related to public health as well as the appropriate training to do so.

Ethical Issues in Smoking and Prioritization of Vaccines for the Prevention of Communicable Respiratory Tract Infections

While vaccination is an aid, at least temporarily, for all emerging infectious diseases, not just COVID-19, fair distribution is an issue. Vaccine distribution to smokers is one such example. The provision of vaccine preference to smokers is consistent with the maximum life-saving principle and is justified on utilitarian grounds. However, the following five possible objections can be presented: (1) self-responsibility for smoking;(2) support from non-smokers;(3) preference for those who maintain social function;(4) identification of smokers and inducement to smoking behavior;(5) consideration for passive smokers. However, arguments against prioritizing vaccination based on self-responsibility downplay the social factors of smoking. (1) Smokers should be provided with treatment, not punishment. (2) To understand non-smokers and enhance social cohesion, communitarian explanations based on the reciprocity of care should be carefully provided to non-smokers. (3) The principle of maintaining social functioning does not supersede the principle of maximum life-saving. (4) Support for smokers should be based on self-reporting. (5) Severe cases of COVID-19 caused by passive smoking are among the most important cases to avoid. The extensive implementation of testing should actively identify victims of passive smoking. This will be evidence of the damage caused by passive smoking.

Factors of influenza vaccine inoculation and non-inoculation behavior of community-dwelling residents in Japan: Suggestions for vaccine policy and public health ethics after COVID-19.

The aim of this study is to provide basic information that contributes to vaccine inoculation policy after COVID-19. We used the secondary data of the influenza vaccine inoculation behavior survey for community-dwelling adults conducted in 2011, before the COVID-19 pandemic, but after the 2009 novel influenza A (H1N1) pdm 09 pandemic. All factors such as socio-demographic characteristics, health-related behaviors, family environment, physical and social environment, and area of residence were adjusted, and factors related to vaccine inoculation behavior were analyzed. Those living with pregnant women had a significantly higher odds ratio of inoculation; this was self-evident in that those people considered infection to their family. Regarding the social environment, those aged 20-64 years with a significantly higher adjusted odds ratio of inoculation were those with "at least five people with which they interacted in the neighborhood". This result can be interpreted in two ways relating to altruism in Japan. Finally, we indicated the importance of learning from the past, including the case of 2009.

Mask-Wearing during the COVID-19 Pandemic: A Theoretical Analysis from the Perspective of Public Health Ethics

Do we have the right to wear masks during an infectious disease pandemic? If so, what is the underlying philosophical justification for this? During the COVID-19 pandemic, most people wore masks. Should the government be able to intervene to enforce mask wearing? It should be noted that the government's encouragement to wear masks does not mean that people are encouraged to ignore them. In the field of public health ethics, many current debates boil down to establishing a balance between 'individual freedom';and 'the public good';. However, a clear definition of 'the public good';has yet to emerge, which can make this debate difficult. Based on our philosophical analysis, we propose the following as a new right in the field of public health ethics: the 'right to mask for self-protection';. Based on our proposed 'right to mask for self-protection';, we offer a justification for the argument that all people have the right to wear a mask during an infectious disease pandemic or endemic.

Wearable Technology for Monitoring Respiratory Rate and SpO2 of COVID-19 Patients: A Systematic Review.

With the significant numbers of sudden home deaths reported worldwide due to coronavirus disease 2019 (COVID-19), wearable technology has emerged as a method for surveilling this infection. This review explored the indicators of COVID-19 surveillance, such as vitals, respiratory condition, temperature, oxygen saturation (SpO2), and activity levels using wearable devices. Studies published between 31 December 2019, and 8 July 2022, were obtained from PubMed, and grey literature, reference lists, and key journals were also searched. All types of articles with the keywords "COVID-19", "Diagnosis", and "Wearable Devices" were screened. Four reviewers independently screened the articles against the eligibility criteria and extracted the data using a data charting form. A total of 56 articles were on monitoring, of which 28 included SpO2 as a parameter. Although wearable devices are effective in the continuous monitoring of COVID-19 patients, further research on actual patients is necessary to determine the efficiency and effectiveness of wearable technology before policymakers can mandate its use.

Curriculum Proposal for Social Justice Education: A Case Study within High School and College in Japan

During the COVID-19 pandemic, the socially vulnerable were placed in an even more difficult position. High school and college liberal arts education on social justice is needed to address the possible emerging and re-emerging infectious disease pandemics. A desirable educational curriculum to actualize this should include (1) Basic Theory of Ethics and Social Justice-justice and goodness, justice in Ancient Greece, deontology, utilitarianism, and the principle of inequality-, (2) Social Justice Theories-liberal egalitarianism, communitarianism, and social structural approach, (3) Psychology and Behavioral Economics-social intuitionist model, implicit association test, and nudge-, and (4) Advocacy-racism and xenophobia, elderly, disabilities, women, gender and justice-. The curriculum on social justice aims to help students understand the value of social justice, recognize inequality and disparity in society, and acquire the ability to address the widening social gap and inequality. The concept of justice is internationally diverse. Thus, extracting 'social justice';in the context of each country's culture and adding it to the social justice education curriculum is important.

In Whose Best Interest? Parental Hesitancy toward the COVID-19 Vaccine for Children in Japan: A Literature Survey Study

In early February 2022, the Japanese government sent COVID-19 vaccine vouchers to children ages 5–11. Using keywords obtained from the voucher, the frequently asked questions section, and experts, we descriptively analyzed the advantages and disadvantages of vaccination for children and their parents through a web-based literature survey of media articles and government homepage statements in Japan. For children, vaccination helps prevent severe symptoms and may be particularly beneficial for children in low-income families by lowering the rate of suicide and at-home child abuse. For parents, not vaccinating their child allows them to fulfill a more traditional role as a parent (mothers in particular), reduces the gender gap for mothers, and provides greater peace of mind about their child's future fertility. We also examined the governmental vaccination campaigns targeting children from public health perspectives. We argue that the letter accompanying the vaccine voucher should clearly emphasize that further transmission will be prevented, reducing domestic infection. In addition to the biological dimensions of COVID-19 in Japan, we emphasize cultural issues and hope that these can be useful for other countries as they create their own vaccination strategies. Public health in Japan could be promoted if all citizens, regardless of age, acquired fundamental knowledge and skills, the motivation to learn, and the ability to utilize knowledge and skills and think, judge, and express personal ideas.

Solitary death and new lifestyles during and after COVID-19: wearable devices and public health ethics.

BACKGROUND: Solitary death (kodokushi) has recently become recognized as a social issue in Japan. The social isolation of older people leads to death without dignity. With the outbreak of COVID-19, efforts to eliminate solitary death need to be adjusted in line with changes in lifestyle and accompanying changes in social structure. Health monitoring services that utilize wearable devices may contribute to this end. Our goals are to outline how wearable devices might be used to (1) detect emergency situations involving solitary older people and swiftly connect them with medical treatment, to (2) reduce the frequency of deaths that remain undiscovered and (3) to reduce social isolation by promoting social interaction. METHODS: Theoretical and philosophical approaches were adopted to examine ethical issues surrounding the application of wearable devices and cloud-based information processing systems to prevent solitary death in the world with/after COVID-19. MAIN BODY: (1) Technology cannot replace social connections; without social support necessary to foster understanding of the benefits of health management through wearable devices among older adults, such devices may remain unused, or not used properly. (2) Maturity of the technology; systems face the difficult task of detecting and responding to a wide range of health conditions and life-threatening events in time to avert avoidable morbidity and mortality. (3) Autonomy and personhood; promoting the voluntary use of wearable devices that are a part of larger efforts to connect isolated individuals to a community or social services might be effective. Legal force should be avoided if possible. There is some concern that landlords may require an older person to sign a contract agreeing to wear a device. The autonomy of solitary older people should be respected. (4) Governance: policies must be developed to limit access to data from wearables and the purposes for which data can be used. CONCLUSION: If thoughtfully deployed under proper policy constraints, wearable devices offer a way to connect solitary older people to health services and could reduce cases of solitary death while respecting the personhood of the user.

Covid-19, global ethics, and Jihi: A voice from East Asian philosophy.

As the Covid-19 situation has developed rapidly into a pandemic of unprecedented scale, ethicists and philosophers must work to comprehend this tragic historical scene from a macroscopic perspective, striving to create peace in the minds of people worldwide. The Buddhist concept of Jihi is a key idea in East Asian philosophy and implies concern for others. Specifically, it requires its constituents to pray sincerely for the well-being and peace of mind of those who are suffering, regardless of nationality, age, gender, or family origin, and mourn this situation together. Accordingly, Jihi may represent a vital component of global ethics, particularly in situations involving the Covid-19 crisis.

Drug Repurposing for COVID-19: Ethical Considerations and Roadmaps.

While the world rushed to develop treatments for COVID-19, some turned hopefully to drug repurposing (drug repositioning). However, little study has addressed issues of drug repurposing in emergency situations from a broader perspective, taking into account the social and ethical ramifications. When drug repurposing is employed in emergency situations, the fairness of resource distribution becomes an issue that requires careful ethical consideration.This paper examines the drug repurposing in emergency situations focusing on the fairness using Japanese cases. Ethical issues under these circumstances addressed by the authors include: maintaining the evidence level, integrity of clinical research ethics, and voluntary consent by original indication patients. In order to address these issues, they argue that rapid accumulation of ethically and scientifically valid evidence is required, as is obtaining information on resource quantity.

Chronology of COVID-19 Cases on the Diamond Princess Cruise Ship and Ethical Considerations: A Report From Japan.

The Diamond Princess cruise ship has been anchored at the Yokohama port in Japan since February 3, 2020. A total of 691 cases of the coronavirus disease 2019 (COVID-19) infection had been confirmed as of February 23. The government initially assumed that the infection was not spreading aboard and therefore indicated that any persons who either tested negative for the virus or were asymptomatic should immediately disembark. However, on February 5, the government set a 14-day health observation period because of the severity of the infection. Passengers confirmed to be free from infection began disembarking on Day 15 (February 19) of the quarantine. The effectiveness and validity of infection control, justification for the timing of inspections, and even the nature of COVID-19 itself now are all in question. The ethical considerations related to cruise ship infection control include the reasonable justification for isolation, the psychological fragility and quality of life of the isolated passengers and crew members, the procedural justice inherent in a forced quarantine, and the optimization of control measures.The international coordination framework and the global ramifications of such outbreaks should be reevaluated by the international community. Denying a ship's entry based on local politics is incompatible with global justice. Events such as these require an international response and global regulations that seek to reduce disparities.