Authors:Ian W. Goddard Abstract: The Covid-19 pandemic raises the need for an ethical framework that addresses the unique ethical challenges and questions arising from airborne infectious diseases. For example, are we ever ethically obliged to wear a face mask' If so, why and when' The Respiratory Ethics Framework (REF) herein proposes pathways to answers grounded in ethical norms and the moral principles of non-harm, beneficence and respect for personal autonomy. REF is a personal ethics wherein your ethical duty to increase your respiratory hygiene efforts—such as by donning a mask—is proportional to your estimation of an increase in the likelihood that your respiratory effluent poses a risk of harmful infection to others. REF includes illustrated decision models that instantiate a framework of proportionality between levels of risk, ethical duty and mitigation that shapes risk mitigation across domains. PubDate: Fri, 30 Jun 2023 08:14:03 PDT
Authors:Syed Arsalan Akhter Zaidi et al. Abstract: Epidemics and Pandemics have been plaguing mankind since many centuries, and are a cause of major healthcare expense in modern times. The novel coronavirus pandemic of 2019-2020 spread worldwide faster than many previous pandemics, including EBOLA in 2017. Although personal protective equipment, and social distancing slowed the outbreak, a vaccine is needed to ensure global immunization and to stop this deadly outbreak. Developing a vaccine in times of a public health crisis comes with a lot of ethical considerations, including overlooking proper informed consent, the issue of using placebo in control arm of trials, extended timelines of development of vaccines, randomized placebo control trial of secondary vaccine once the first vaccine is approved, and utilizing vulnerable population for trials. These issues are often overlooked due to the urgency of the situation, and the need of developing a cure/vaccine can lead to potential oversight of many regulations. We discuss some of these issues related to vaccine development in a pandemic situation in this commentary paper. We also discuss some of the arguments supporting a secondary vaccine development such as logistical/economic issue, better efficacy, and the conditions of Equipoise. PubDate: Fri, 30 Jun 2023 08:13:54 PDT
Authors:George A. Gellert Abstract: In an era marked by a ruinous war between a democratic state and a totalitarian regime, political volatility, rightward looking isolationism and nationalism, and heightened competition and disputes between China and the West, it is perhaps difficult to discern why the West should supply China with COVID-19 vaccines and therapeutics, as well as epidemiological assistance in order to mitigate a potentially unrecognized COVID-19 crisis in that nation. This commentary considers three arguments against Western and international indifference to the plight of China as it transitions to COVID-19 endemicity. PubDate: Fri, 30 Jun 2023 08:13:46 PDT
Authors:Andrea Vicini et al. Abstract: Grounded in a presupposition that a single explanatory framework cannot fully account for the expansive learning processes that occur during medical residency, the article examines developing physicians’ reflective writing from three disciplinary lenses. The goal is to understand how the multi-dimensional nature of medical residency translates into assembling educational experiences and constructing meaning that cannot be fully explained through a single discipline. An interdisciplinary research team across medical education, communication, and ethics qualitatively analyzed reflective entries (N=756) completed by family medicine residents (N=33) across an academic year. Results provide evidence for moving toward an integrated thematic explanation across disciplines. The authors suggest that the integration of disciplinary explanations allows for comprehensive understanding of reflection as a cornerstone in the broader formation of the physician. Examples provide evidence for an integrated understanding of a fuller human experience by considering the three thematic explanations as co-occurring, reciprocal processes. PubDate: Mon, 12 Dec 2022 08:42:44 PST
Authors:Noel Otu et al. Abstract: AbstractThis paper reviews the concept of police subculture and examines its role in the management and acceptance of treatment for stress-related injury. In particular, we examine the impact of stigma that attaches to treatment within this subculture. The persistence of the dominant police subculture remains a significant obstacle to officers seeking treatment for stress-related illnesses. The subculture has historically resisted acknowledging the need for treatment in response to the occupational and/or organizational stress-related injury that results from frequent exposure to work-related trauma. Many police administrators are still embedded within and resist changes to the subculture, which results in an atmosphere that is unwelcoming to officers seeking or accepting treatment. This study draws on both qualitative and quantitative studies and modifies labeling theory to determine the sources of stigma involved in the police subculture. The paper reviews the reasons why officers refuse treatment, discusses the issue of stigmatization and labeling, and argues for the need to change police subculture, at least in part by ensuring that administrators support treatment and good health for officers. It is revealed that the stigmatization of officers who seek and receive treatment directly results in others’ refusal/rejection of it. The study recommends that departments address the subcultural processes of labeling and stigmatization associated with stress counseling at the individual, management, and organizational levels to bring about a shift in police subculture and improve the level of occupational health and safety for officers on the force. PubDate: Mon, 12 Dec 2022 08:42:37 PST
Authors:Mary Eleanor R. Wickersham Abstract: Operational and ethical challenges for nursing homes across the United States during the COVID-19 pandemic were daunting, that experience perhaps only a forecast of future epidemics that nursing home administrators and operators may face. This article describes administrator-identified challenges and focuses on how nursing homes might learn from their experiences by increasing flexibility to meet evolving needs, improving quality assurance and disaster planning, using ethics policies and ethical decision-making processes to work through difficult decisions, and leading the way in creating new policies that will make nursing home care safer and more appropriate for patients with ever changing needs. PubDate: Mon, 12 Dec 2022 08:42:30 PST
Authors:Fung Kei Cheng Abstract: The COVID-19 pandemic has devastated public health, economy and social life all over the world, especially wherever a vaccine pass scheme has been implemented. Many countries have begun to relax schedules to return to normal activities. In contrast, Hong Kong continues to tighten the utilisation of a vaccine pass for medical services in order to boost vaccination rates. Such a practice not only significantly challenges ethical and operative concerns but also threatens health equity and social justice for healthcare decision-makers and practitioners, consequently hurting public health and community well-being. This discussion analyses the various arguments, reviews vaccine hesitancy and suggests a holistic approach for solutions (aside from vaccination and medications) to strengthen individual immunity and therefore to deal with this disease more effectively, efficiently and ethically, including personal hygiene and lifestyle. PubDate: Mon, 12 Dec 2022 08:42:23 PST
Authors:V. Ramana Dhara Abstract: This is a fantasy poem about a doctor and his adventures with piracy on the high seas. PubDate: Wed, 03 Aug 2022 11:55:21 PDT
Authors:Lori Maria Walton PhD; DPT, MScPT, MPH(s et al. Abstract: According to the 2021 report from the United Nations High Commissioner for Refugees, 82.4 million people were forcibly displaced because of violence, wars, or persecution and over 26.4 million are currently living with refugee status. Displacement and resettlement trauma are associated with chronic disease onset and poor cognitive, physical, and mental health outcomes for refugee populations. To mitigate some of the deleterious effects of resettlement trauma, we propose a community-based rehabilitation program (CBRP) framework that is culturally sensitive, trauma-informed and focused on the vulnerabilities of women. The purpose of this novel CBRP framework is to address health inequities among a vulnerable refugee population through program development, with a focus on: (1) active participation of the refugee community throughout all levels of program planning; (2) intersectional, gender-focused analysis of power and privilege within the community and host country aimed at reducing barriers and improving access to quality CBRP programs for women; (3) trauma-informed, team-oriented, resilience programming to improve cognitive, physical, and mental health outcomes and prevent chronic disease. This paper will also discuss the need for gender transformative interventions to address specific health inequities related to CBRP feasibility and access, cultural and social influences, acceptability, and related laws and policies.Key Words: Refugee Health, Muslim Women, Community-based Rehabilitation Programs, Physical Activity PubDate: Wed, 03 Aug 2022 11:55:09 PDT
Authors:Gordon Wong et al. Abstract: How to increase the supply of organs donations for transplant is a critical issue in healthcare. Although recently xenotransplantation has received much publicity, it may be years before this becomes clinically viable. The Reciprocity and Priority Allocation (RPA) System currently used in Israel and a few other countries may be a reasonable approach to increase organ donation in the foreseeable future. For this approach to be accepted by the public, a robust analysis on its ethical implications is needed. This paper applies two formal ethics frameworks to analyze the implication of the RPA system. PubDate: Wed, 03 Aug 2022 11:55:00 PDT
Authors:Mark Peacock Abstract: The use of financial incentives in healthcare calls for ethical examination. Michael Sandel's influential work represents such examination and is subject to critical analysis in this paper. Sandel focuses on monetary payments to persuade patients to lose weight, give up smoking etc. but also on the much-discussed case of giving drug addicts money in return for their consent to be sterilized. He offers two separate objections to financial incentives, one based on coercion, the other on corruption. I argue that Sandel's corruption objection to commodification is insufficient to ground the objection he has to financial incentives in healthcare. Whatever strength his corruption objection has comes from his coercion objection. PubDate: Wed, 03 Aug 2022 11:54:53 PDT
Authors:Monica O'Reilly-Jacob et al. Abstract: In the U.S. healthcare system, telehealth is increasingly present and demands ethical assessment. On the one hand, telehealth increases access to healthcare services for some at-risk populations (e.g., people suffering from mental illness and addictions) and in specific contexts (e.g., rural). On the other hand, telehealth widens the digital divide and can lead to overuse of services. Furthermore, because it is still unclear how telehealth influences trust between patients and primary care clinicians, connecting relationship science and human communication research can inform critical reasoning. Finally, healthcare policy is advancing toward the wide adoption of telehealth. Hence, it is urgent to address these ethical issues and invest in further research. PubDate: Wed, 03 Aug 2022 11:54:45 PDT
Authors:Apurva Jain et al. Abstract: Numerous public health hurdles, including pandemics such as COVID-19, have led to concerns about community health practices in relation, necessitating the application of an ethical perspective. International research ethics guidelines are only used in a restricted range of contexts of public health. As a result, a variety of frameworks have been established to assist ethical analysis of public health concerns. In this study, we have used the Nancy Kass framework for analyzing COVID-19 surveillance in Karnataka state of India, which is a six-step approach that can assist public health practitioners in evaluating the ethical consequences of interventions, policy initiatives, services, and so on. In order to supervise the compliance of home quarantine, the government of Karnataka mandated uploading selfies as a digital tracking surveillance measure for the COVID-19 outbreak. However, these measures raised several ethical questions, especially related to an individual’s privacy, confidentiality, autonomy, and liberty. An established state surveillance mechanism with includes enforced measures for data security along with the moral duty of an individual to protect the health of the community can probably balance the principles of ethics. PubDate: Wed, 03 Aug 2022 11:54:36 PDT
Authors:Sheila A. Davis PhD Abstract: Editor's introduction to Volume 18, Number 1 of the Journal of Health Ethics. PubDate: Wed, 03 Aug 2022 11:54:32 PDT
Authors:Kenneth R. Pike et al. Abstract: The proliferation of professional doctorates has reinvigorated debate over the use of the doctoral honorific. Doctorate holders are often addressed as “doctor” in academic contexts, but idiomatic American English associates “doctor” with physicians—licensed clinicians with doctoral degrees in medicine. The possibility of patient confusion has historically justified proscription of the doctoral honorific by others, including nurses, but recently such proscriptions have been withdrawn. An examination of history, language, and ethical reasoning leads us to conclude that, in the context of patient interaction, clinicians should eschew the doctoral honorific entirely. We think it appropriate for professionals to rely on training-pathway titles as part of their professional duty to inform. In particular, we argue that licensed clinicians with doctoral degrees in medicine should embrace the title of “physician.” PubDate: Fri, 17 Dec 2021 08:14:08 PST
Authors:John Stonestreet Abstract: Would patients and families benefit from a Doctor Body Cam' Linked from www.DoctorBodyCam.com, this article explores innovations providing accountability for ethical communication surrounding major healthcare decisions. One of the greatest challenges physicians face is living up to their own ideals, let alone others’ expectations, for high-stakes doctor-patient/family communication, especially at the end of life. From emotional strains to time limitations, a multiplicity of factors obfuscates the pursuit of excellence in this vital endeavor. Evidence suggests that, like nearly every other sector of healthcare and society, African American patients and families are most likely to get the short end of the physician communication stick. Drawing on the current literature, this piece makes a compelling case for the inclusion of third-party specialists to take some of the communication load off of overworked physicians in end-of-life discussions and earlier difficult healthcare issues. A more team-oriented approach to the interdisciplinary art of patient/family-provider health communication surrounding complex issues and treatment decisions may be a win-win for everyone involved. PubDate: Fri, 17 Dec 2021 08:14:01 PST
Authors:Robert Scott Stewart Ph.D. et al. Abstract: In a recent article, C.O. Akpan argues that it is “unnatural for a man to sleep with a man as with a woman, and the idea of marriage in this sense is an abomination” (“The morality of same-sex marriage: How not to globalize a cultural anomie,” Online Journal of Health Ethics, 13(1), 2017, p. 9). Arguments in favor of same sex marriage, he claims, are “driven and motivated by the human right fad” (p. 9) that is inappropriate for African countries.We argue that the specific arguments Akpan employs against the morality of homosexuality and same-sex marriage are flawed. Our paper also presents evidence that human rights are not simply a fad, nor are they of concern and appropriate only to the West. Finally, we examine the case in South Africa, the only African nation to include LGBTQ+ rights in its constitution. In particular, we show that by doing so, South Africa has increased the health and safety not only the LGBTQ+ community, but of the nation’s citizens at large. PubDate: Fri, 17 Dec 2021 08:13:51 PST
Authors:Rodrigo Lopez Barreda Abstract: In the current medical ethics literature, the concept of agency is receiving growing attention. Nevertheless, many of those definitions are narrow in scope. This article intends to provide a deeper understanding of this concept, allowing for its use in clinical practice and public health policies. First, it revises the current concept of agency and some of its shortcomings. Then, the article presents two philosophical accounts of agency, identifying three relevant features, namely time-extended organised planfulness, endorsement of their own actions, and identification with the activity. Lastly, the article depicts how those features may help in the application of agency to the analysis of health issues by means of a number of examples at the individual and collective levels. When analysing health issues, the health status is a key component, but the process that brought about the outcome must be examined; agency informs about this procedural dimension. PubDate: Fri, 17 Dec 2021 08:13:45 PST
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