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1.
Perihan Elif Ekmekci Müberra Devrim Güner Banu Buruk Begüm Güneş Berna Arda Şefik Görkey 《Developing world bioethics》2023,23(1):23-33
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. 相似文献
2.
Maya Hartig Carley Stephens Aaron Foster Douglas Fontes Michael Kinzel Franklin García-Godoy 《Experimental biology and medicine (Maywood, N.J.)》2021,246(22):2381
Due to the essential role of dentists in stopping the COVID-19 pandemic, the purpose of this review is to help dentists to detect any weaknesses in their disinfection and cross-contamination prevention protocols, and to triage dental treatments to meet the needs of patients during the pandemic. We used PRISMA to identify peer-reviewed publications which supplemented guidance from the center for disease control about infection control and guidelines for dentists. Dentists must triage dental treatments to meet the needs of patients during the pandemic. The ongoing pandemic has changed the practice of dentistry forever, the changes make it more cumbersome, time-consuming, and costly due to the possible pathways of transmission and mitigation steps needed to prevent the spread of COVID-19. Dental chairside rapid tests for SARS-CoV-2 are urgently needed. Until then, dentists need to screen patients for COVID-19 even though 75% of people with COVID-19 have no symptoms. Despite the widespread anxiety and fear of the devastating health effects of COVID-19, only 61% of dentists have implemented a change to their treatment protocols. As an urgent matter of public health, all dentists must identify the additional steps they can take to prevent the spread of COVID-19. The most effective steps to stop the pandemic in dental offices are to; vaccinate all dentists, staff, and patients; triage dental treatments for patients, separate vulnerable patients, separate COVID-19 patients, prevent cross-contamination, disinfect areas touched by patients, maintain social distancing, and change personal protective equipment between patients. 相似文献
3.
The Brazilian Federal Senate created a Parliamentary Inquiry Commission (CPI) to investigate the Bolsonaro government's irregularities in the management of the COVID-19 pandemic. One of the cases that drew attention was the research conducted by Prevent Senior, a private health insurance company, on the early treatment of COVID-19. The article analyzes the scientific validity of the research and the ethical problems related to its implementation. It is based on analysis of Prevent Senior's report of the clinical study, the Brazilian and USA clinical trial registries, the Senate's CPI report, and on the information reported by the media. This case of scientific fraud and political-ideological bias exemplifies how Prevent Senior, using a questionable protocol to enhance its reputation and gain government support, was instrumental in building the “early treatment” narrative for COVID-19, and shows how it served as a basis for a government public policy that promoted the use of ineffective drugs. 相似文献
4.
This perspectives piece focuses on the detrimental cost of ignoring vaccines and refusing vaccination against COVID-19 in the United States. Much of the existing literature regarding the consequences of the unvaccinated emphasizes the impact to population health; however, few academic articles have explored the burden the unvaccinated pose to various sectors of society. This paper analyzes the impact that the unvaccinated have on healthcare systems, the US economy, and global health. Throughout the COVID-19 pandemic, unvaccinated populations were found to have put significant strain on healthcare systems, depleting medical resources and contributing to high rates of healthcare worker shortages. Furthermore, research suggests that between November and December 2021, over 692,000 preventable hospitalizations occurred in unvaccinated individuals, costing the US economy over $13.8 billion. Lastly, it is proposed that the strong international presence of the US, when coupled with high levels of disease transmissibility in the unvaccinated, provides a significant threat to global health. In conclusion, the unvaccinated have caused impacts far beyond that of population health; they have also posed a burden to healthcare systems, the economy, and global public health. 相似文献
5.
2017年12月,《微生物学通报》首次与中国微生物学会兽医微生物学专业委员会合作推出“兽医微生物学主题刊”,集中刊登了兽医微生物学研究领域的病原分离鉴定、诊断方法、分子流行病学及兽用生物制品研发等方面的最新进展及成果。主题刊发表后引起了同行及读者的广泛好评。2019年末,突如其来的新型冠状病毒肺炎疫情给人类的生活、工作与学习带来了巨大影响,也让病毒、变异、核酸检测、疫苗等词汇快速进入大众视野。“同一健康”“公共卫生”“生物安全”在社会层面被广泛认知,兽医微生物学对公共卫生和人类健康的重要作用愈加突显。在这种背景下,时隔五年,《微生物学通报》与兽医微生物学专业委员会再次达成共识,联合推出“兽医微生物学主题刊”第二季,旨在系统梳理我国兽医微生物学研究领域的新理论、新技术与新产品,搭建兽医微生物学科研工作者学术思想与科研成果的交流与展示平台,推进学科发展与繁荣,为健康中国、健康世界贡献智慧与力量。 相似文献
6.
This perspectives piece shares the experience of a trainee during the COVID-19 pandemic as it pertains to initial patient evaluations and the subsequent impact they have on patient outcomes. Specifically highlighting the value of approaching every patient as sick before deeming them as well – this approach to triaging is defined as a “sick bias” throughout the piece. Unfortunately, this initial evaluation can be influenced by explicit and implicit biases of the provider that highlight health inequities within their patient’s care. 相似文献
7.
Kirstin Nackers Amy Becker Katharina Stewart Mark Beamsley William Aughenbaugh Shobhina Chheda 《FASEB BioAdvances》2021,3(3):158-165
The University of Wisconsin Madison School of Medicine and Public Health rapidly adapted its four-year, three-phase medical doctorate clinical curriculum at the onset of the COVID-19 in Spring 2020. Medical students in clinical rotations, our Phase 2 and 3 of the ForWard curriculum, temporarily stopped face to face care of patients, transitioning instead to online learning. For Phase 2 students, this single 12- week interim course included didactic content from all required integrated blocks and the creation of a new content which taught public health principles in the context of historical pandemics. Phase 3 students were rescheduled into online electives, which course directors had offered in the past and agreed to offer again during this time. All Phase 3 students participated in a Public Health Preparedness course after its rapid redesign for online delivery and scaling for an entire class. Phase 2 students returned in July 2020 to abbreviated 8-week integrated blocks that retained approximately 83% of the clinical time students would have received in the intended 12-week integrated blocks. This was possible through the frontloading of teaching sessions to the interim course and creative scheduling of clinical experiences. The 2015 curricular redesign to the integrated curriculum facilitated effective coordination and teamwork that enabled these thoughtful, rapid adjustments to the curriculum. 相似文献
8.
Alex John London 《Bioethics》2019,33(3):326-334
The 2016 CIOMS International ethical guidelines for health‐related research involving humans states that ‘health‐related research should form an integral part of disaster response’ and that, ‘widespread emergency use [of unproven interventions] with inadequate data collection about patient outcomes must therefore be avoided’ (Guideline 20). This position is defended against two lines of criticism that emerged during the 2014 Ebola outbreak. One holds that desperately ill patients have a moral right to try unvalidated medical interventions (UMIs) and that it is therefore unethical to restrict access to UMIs to the clinical trial context. The second holds that clinical trials in contexts of high‐mortality diseases are morally suspect because equipoise does not exist between a standard of care that offers little prospect of clinical benefit and a UMI that might offer some clinical advantage. 相似文献
9.
There are no egalitarians in a pandemic. The scale of the challenge for health systems and public policy means that there is an ineluctable need to prioritize the needs of the many. It is impossible to treat all citizens equally, and a failure to carefully consider the consequences of actions could lead to massive preventable loss of life. In a pandemic there is a strong ethical need to consider how to do most good overall. Utilitarianism is an influential moral theory that states that the right action is the action that is expected to produce the greatest good. It offers clear operationalizable principles. In this paper we provide a summary of how utilitarianism could inform two challenging questions that have been important in the early phase of the pandemic: (a) Triage: which patients should receive access to a ventilator if there is overwhelming demand outstripping supply? (b) Lockdown: how should countries decide when to implement stringent social restrictions, balancing preventing deaths from COVID-19 with causing deaths and reductions in well-being from other causes? Our aim is not to argue that utilitarianism is the only relevant ethical theory, or in favour of a purely utilitarian approach. However, clearly considering which options will do the most good overall will help societies identify and consider the necessary cost of other values. Societies may choose either to embrace or not to embrace the utilitarian course, but with a clear understanding of the values involved and the price they are willing to pay. 相似文献
10.
Increases in international travel and migratory flows have enabled infectious diseases to emerge and spread more rapidly than ever before. Hence, it is increasingly easy for local infectious diseases to become global infectious diseases (GIDs). National governments must be able to react quickly and effectively to GIDs, whether naturally occurring or intentionally instigated by bioterrorism. According to the World Health Organisation, global partnerships are necessary to gather the most up-to-date information and to mobilize resources to tackle GIDs when necessary. Communicable disease control also depends upon national public health laws and policies. The containment of an infectious disease typically involves detection, notification, quarantine and isolation of actual or suspected cases; the protection and monitoring of those not infected; and possibly even treatment. Some measures are clearly contentious and raise conflicts between individual and societal interests. In Europe national policies against infectious diseases are very heterogeneous. Some countries have a more communitarian approach to public health ethics, in which the interests of individual and society are more closely intertwined and interdependent, while others take a more liberal approach and give priority to individual freedoms in communicable disease control. This paper provides an overview of the different policies around communicable disease control that exist across a select number of countries across Europe. It then proposes ethical arguments to be considered in the making of public health laws, mostly concerning their effectiveness for public health protection. 相似文献
11.
Georgina D. Campelia Hilkiah K. Suga John H. Kempen James N. Kirkpatrick Nancy S. Jecker 《Developing world bioethics》2023,23(3):269-276
During the coronavirus disease 2019 (COVID-19) pandemic, bioethical analyses often emphasized population health and societal benefit. Hospital policies frequently focused on reducing risk of transmitting SARS-CoV-2 by restricting visitors; requiring protective equipment; and screening staff, patients and visitors. While restrictions can be burdensome, they are often justified as essential measures to protect the whole population against a virus with high rates of transmission, morbidity and mortality. Yet communities are not monolithic, and the impacts of these restrictions affect different groups differently. An ophthalmological unit outreach program in Ethiopia serves to illustrate. Pre-operative screening policies were designed to protect as many patients as possible but had adverse impacts on underserved communities. As this case study demonstrates, creating hospital policies that truly serve the good of the society may require a more holistic review of impacts on inequitably positioned communities. 相似文献
12.
Given the unprecedented level and duration of mitigation policies during the 2020 COVID-19 pandemic, it is not surprising that the public and the media have raised important questions about the potential for negative mental health consequences of the measures. To answer them, natural variability in policy implementation across US states and over time was analyzed to determine if mitigation policies correlated with Google searches for terms associated with symptoms of depression and anxiety. Findings indicated that restaurant/bar limits and stay-at-home orders correlated with immediate increases in searches for isolation and worry but the effects tapered off two to four weeks after their respective peaks. Moreover, the policies correlated with a reduction in searches for antidepressants and suicide, thus revealing no evidence of increases in severe symptomatology. The policy implications of these findings are discussed. 相似文献
13.
ANGUS DAWSON 《Bioethics》2010,24(5):218-225
In this paper I argue that bioethics is in crisis and that it will not have a future unless it begins to embrace a more Socratic approach to its leading assumptions. The absence of a critical and sceptical spirit has resulted in little more than a dominant ideology. I focus on three key issues. First, that too often bioethics collapses into medical ethics. Second, that medical ethics itself is beset by a lack of self‐reflection that I characterize here as a commitment to three dogmas. Third, I offer a more positive perspective by suggesting how bioethics may benefit from looking towards public health ethics as a new source of inspiration and direction. 相似文献
14.
Chet Trivedy 《American journal of primatology》2020,82(8):e23173
The aim of this article is to explore the impact of coronavirus disease (COVID-19) pandemic on primate-related conservation work. The withdrawal of primatologists and conservation staff from field research can lead to a number of detrimental effects not just on conservation but also on local communities in low- and middle-income countries. Inequalities in access to health and financial insecurities may be drivers for the illegal wildlife trade and the lack of tourism and research activity may allow poachers to work with greater ease. The paper also looks at how conservation organizations and research bodies should modify their field protocols by developing robust occupational health policies that will not only make field work safer but also support local staff as they are likely to face the greatest threats to their physical health, psychological health, and economic loss from COVID-19. By adopting a One Health approach that considers the complex interactions between human and primate health, researchers will be able to find new ways of working not only to protect primates but understand how they adapt to the COVID-19 pandemic. 相似文献
15.
Parker Crutchfield 《Bioethics》2019,33(1):112-121
Some theorists argue that moral bioenhancement ought to be compulsory. I take this argument one step further, arguing that if moral bioenhancement ought to be compulsory, then its administration ought to be covert rather than overt. This is to say that it is morally preferable for compulsory moral bioenhancement to be administered without the recipients knowing that they are receiving the enhancement. My argument for this is that if moral bioenhancement ought to be compulsory, then its administration is a matter of public health, and for this reason should be governed by public health ethics. I argue that the covert administration of a compulsory moral bioenhancement program better conforms to public health ethics than does an overt compulsory program. In particular, a covert compulsory program promotes values such as liberty, utility, equality, and autonomy better than an overt program does. Thus, a covert compulsory moral bioenhancement program is morally preferable to an overt moral bioenhancement program. 相似文献
16.
In this article we articulate a case from moral responsibility to assist Palestinians living in the Occupied Palestinian Territory (OPT). We contextualize this responsibility by focusing on access to healthcare and the provision of vaccines against COVID-19. We specifically present two arguments from responsibility, one that is global or cosmopolitan, and one that is country-specific. For the latter, we focus on Israel. 相似文献
17.
Rieke van der Graaf Indira S. E. van der Zande Johannes J. M. van Delden 《Bioethics》2019,33(3):377-383
As early as 2002, CIOMS stated that pregnant women should be presumed eligible for participation in research. Despite this position and calls of other well‐recognized organizations, the health needs of pregnant women in research remain grossly under‐researched. Although the presumption of eligibility remains unchanged, the revision of the 2002 CIOMS International ethical guidelines for biomedical research involving human subjects involved a substantive rewrite of the guidance on research with pregnant women and related guidelines, such as those on fair inclusion and vulnerability. However, close reading of the guidelines reveals morally relevant different approaches to fair inclusion of pregnant women and other under‐represented groups, such as children and incompetents. Where CIOMS sets out that children and adolescents must be included unless a good scientific reason justifies their exclusion, no such claim of having to justify exclusion appears in the guideline on pregnant women. Instead, CIOMS claims that research relevant to pregnant women’s health needs must be promoted. This paper analyses how and to what extent the guideline on pregnant women differs from other guidance on fair inclusion in the document. Accordingly, the paper evaluates to what extent the current phrasing may contribute to fair inclusion of pregnant women in research. We will conclude that a system change towards a learning health system is essential to break down the status quo of knowledge generation in the field of medication use during pregnancy and argue that the CIOMS guidelines allow for this system change. 相似文献
18.
Alexander Zambrano 《Bioethics》2019,33(6):725-728
In a recent article in this journal, Parker Crutchfield argues that if moral bioenhancement ought to be compulsory, as some authors claim, then it ought to be covert, i.e., performed without the knowledge of the population that is being morally enhanced. Crutchfield argues that since the aim of compulsory moral bioenhancement is to prevent ultimate harm to the population, compulsory moral bioenhancement is best categorized as a public health issue, and should therefore be governed by the norms and values that apply in public health settings. In this article, I argue for two related claims. First, I question the extent to which compulsory moral enhancement should be considered a public health issue that ought to be governed by the norms and values that apply in public health settings. Second, I argue that Crutchfield's argument that covert moral bioenhancement would better respect people's autonomy than an overt program overlooks two important autonomy‐based reasons that, in fact, favor an overt moral enhancement program over a covert one. 相似文献
19.
Parasitic diseases constitute the most common infections among the poorest billion people, entailing high mortality rates and leading to long-term infirmities and poverty. Although the setting-up of public health programs implies many ethical consequences, the range of specific questions in parasitology that can be attributed to bioethics remains, to a large extent, unexplored. From the present analysis, it emerged three main issues which characterize ethical stakes in parasitology: accounting the complexity of the field of intervention, putting the principle of justice into practice and managing the changing context of research. From the research angle, medical parasitology-mycology, as other biological disciplines, is undergoing tensions derived from biological reductionism. Thanks to its links with the history and philosophy of the sciences, bioethics can help to clarify them and to explain the growing hold that technologies have over scientific thinking. On the whole, researchers as well as clinicians are called on to assume a specific responsibility, proportional to their competence and their place in the making of scientific, health, economic and social decisions. 相似文献
20.
The alarming levels of spread and severity of COVID-19 have dominated global attention. In this time of crisis, there is an urgent need for studies identifying the linkages between the pandemic and social welfare. To help policymakers respond to the situation better, we investigate how the severity of the COVID-19 pandemic can condition people's psychological well-being. Employing the latest weekly panel data within an individual fixed effects framework, we uncover the damaging consequences of the COVID-19 severity, as measured by mortality rate, on the incidences of daily anxiety, worry, displeasure, and depression in the United States. Our work underlines the importance of public spending on mental health, both during and after the pandemic. 相似文献