Hard Choices in the Pandemic and Guidelines: Ethical and Juridical Remarks on Medical Responsibility and Liability

2021 ◽  
pp. 411-438
Author(s):  
Antonio Da Re ◽  
Andrea Nicolussi
2020 ◽  
Vol 40 (1) ◽  
Author(s):  
Farzana Gounder

The burden of preventable diseases is increasing in the South Pacific Island Countries and Territories. In Fiji, significant media attention and national finances are spent on public dissemination of the modifiable risk factors of chronic illnesses. However, little is known about lay societal perceptions of chronic illnesses and of people living with these illnesses. This preliminary study takes an area-situated approach to lay knowledge and examines Suva residents’ moral evaluations associated with socially significant health concerns in Fiji. Using the case studies of HIV, cancer, and diabetes, the research employs content analysis to examine 144 Suva residents’ Letters to the Editor, published between 2000 and 2019 in The Fiji Times. The findings indicate that letter writers on chronic illnesses are power sensitive, interested in governmental responsibility, and aware of the role of stigma in creating inequitable health outcomes. The study’s findings locate chronic illness as not only a medical responsibility but also a social justice and human rights concern that requires a multisectoral approach, with community-tailored responses at the heart of all discussions. The lay-societal recognition of the three illnesses as being socially relevant suggests grassroots support for policies directed towards structural reforms for the prevention and management of these illnesses.


Author(s):  
Erwin Deutsch ◽  
Hans-Ludwig Schreiber

BMJ ◽  
2009 ◽  
Vol 338 (jun09 1) ◽  
pp. b2329-b2329
Author(s):  
C. Lees

2020 ◽  
Vol 12 (15) ◽  
pp. 5984 ◽  
Author(s):  
Viktor Glantz ◽  
Phatthranit Phattharapornjaroen ◽  
Eric Carlström ◽  
Amir Khorram-Manesh

Surge capacity is the ability to manage the increased influx of critically ill or injured patients during a sudden onset crisis. During such an event, all ordinary resources are activated and used in a systematic, structured, and planned way to cope with the situation. There are, however, occasions where conventional healthcare means are insufficient, and additional resources must be summoned. In such an event, the activation of existing capabilities within community resources can increase regional surge capacity in a flexible manner. These additional resources together represent the concept of Flexible Surge Capacity. This study aims to investigate the possibility of establishing a Flexible Surge Capacity response system to emergencies by examining the main components of surge capacity (Staff, Stuff, Structure, System) within facilities of interest present in the Western Region of Sweden. Through a mixed-method and use of (A) questionnaires and (B) semi-structured key-informant interviews, data was collected from potential alternative care facilities to determine capacities and capabilities and barriers and limitations as well as interest to be included in a flexible surge capacity response system. Both interest and ability were found in the investigated primary healthcare centers, veterinary and dental clinics, schools, and sports and hotel facilities to participate in such a system, either by receiving resources and/or drills and exercises. Barriers limiting the potential participation in this response system consisted of a varying lack of space, beds, healthcare materials, and competencies along with a need for clear organizational structure and medical responsibility. These results indicate that the concept of flexible surge capacity is a feasible approach to emergency management. Educational initiatives, drills and exercises, layperson empowerment, organizational and legal changes and sufficient funding are needed to realize the concept.


2020 ◽  
pp. bmjnph-2020-000129
Author(s):  
Joseph Williams ◽  
Carol Williams

IntroductionDaily vitamin D supplements are recommended for elderly care home residents; however, they are rarely given and vitamin D deficiency in care homes is widespread. This study aimed to understand the determinants of current practice and perceived responsibility for the vitamin D status of residents.MethodsThirteen semi-structured interviews were conducted with key informants in two areas of Southern England including care home managers, general practitioners (GPs) and public health professionals. Interviews were audio recorded and transcribed verbatim.ResultsInductive thematic analysis identified four themes: framing of vitamin D supplements as medicines; professional and sector boundaries whereby GPs are perceived as responsible for the vitamin D status of residents and care home managers felt unable to administer over-the-counter vitamin tablets; low awareness of national guidance; and ethical and practical issues. This results in vitamin D supplements requiring prescription by medical professionals and few residents receiving them.ConclusionThe medical framing of vitamin D supplements in care homes is a practical barrier to implementation of longstanding nutrition guidelines. A paradigm shift is needed so that vitamin D is understood as a protective nutrient as well as a medicine, and a public health as well as a medical responsibility. Vitamin D is important for musculoskeletal health. Possible links with COVID-19 are still being investigated. The pandemic has drawn attention to conditions in care homes and there is an opportunity to revise current guidance on vitamin D supplementation which will have lasting benefit for this vulnerable group.


BMJ ◽  
1954 ◽  
Vol 2 (4882) ◽  
pp. 290-291

BMJ ◽  
1928 ◽  
Vol 1 (3516) ◽  
pp. 921-922
Author(s):  
S. E. White

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