scholarly journals Drug Repurposing for COVID-19: Ethical Considerations and Roadmaps

2020 ◽  
Vol 30 (1) ◽  
pp. 51-58 ◽  
Author(s):  
HIROYASU INO ◽  
EISUKE NAKAZAWA ◽  
AKIRA AKABAYASHI

AbstractWhile 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.

1988 ◽  
Vol 69 (10) ◽  
pp. 603-610 ◽  
Author(s):  
Ann P. Conrad

The author presents and discusses the findings of a research study on ethical issues identified by clinical social workers at all phases of the social work process. Results indicate the need for ethical skills in the role-coping repertoire of practitioners and suggest content for training in ethical problem solving.


2014 ◽  
Vol 22 (5) ◽  
pp. 548-560 ◽  
Author(s):  
Maria F Jiménez-Herrera ◽  
Christer Axelsson

Background: Decision-making and assessment in emergency situations are complex and result many times in ethical conflicts between different healthcare professionals. Aim: To analyse and describe situations that can generate ethical conflict among nurses working in emergency situations. Methods: Qualitative analysis. A total of 16 emergency nurses took part in interviews and a focus group. Ethical considerations: Organisational approval by the University Hospital, and informed consent and confidentiality were ensured before conducting the research. Result/conclusion: Two categories emerged: one in ‘ethical issues’ and one in ‘emotions and feelings in caring’. The four ethical subcategories are presented: Autonomy, the first sub category: first, the nurse’s ability to practise care on an emergency ward and, second, to support the patient and/or relatives in terms of care and medical treatment. The conflicts arise when the nurse ends up in the middle between the patient and the physician responsible for the diagnosis and treatment from a nature scientific perspective. Reification of injured body: patient was often reified and fragmented, becoming just a leg or arm. Different factors contributed in this perspective. Pain: pain relief was often inadequate but more effectively treated in the emergency medical services than at the emergency department. The nurses highlighted the phenomenon of suffering because they felt that pain was only an object, forgetting the patients’ care need, like separating mind from body. Death: the nurses felt that the emergency services are only prepared to save lives and not to take care of the needs of patients with ‘end-of-life’ care. Another issue was the lack of ethical guidelines during a cardiac arrest. Resuscitation often continues without asking about the patient’s ‘previous wishes’ in terms of resuscitation or not. In these situations, the nurses describe an ethical conflict with the physician in performing their role as the patient’s advocate. The nurses express feelings of distress, suffering, anger and helplessness.


2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Charles Tembo ◽  
Allan Maganga ◽  
Peterson Dewah

 This article presents various points of view regarding the treatment of sunken fontanelle by various communities as ignited by the controversial practice of kutara(a practice that involves the father of a child sliding his penis from the lower part of the left and right cheeks to the top of the head, as well as from the lower part of the face to the top of the head, and from the lower back part of the head to the top). The story of Alick Macheso’s use of his manhood to treat nhova (sunken fontanelle) opened a Pandora’s box. The story not only attracted the attention of critics from diverse cultural and ethical backgrounds, but revealed multi-ethnic positions. That is, reactions were steeped in a multiplicity of intellectual, religious and even cultural grounding. Reactions ranged from accusations of backwardness and absurdity, through to medical and Christian orientations toward the treatment of nhova. The overarching idea is that there is a general tendency to dismiss the age-old practice of kutara,coupled with an uncritical celebration of certain positions. The debate that ensued following publication of the story seemed to revolve around ethical considerations. The school of thought that dismisses kutara with disdain regards it as unethical and unimaginable in the present-day world—it is redolent with insinuations of absurdity on the part of those that live and celebrate it. We contend that the raging debate that followed the publication of the story can best be conceptualised within the context of African ethics. We note that kutara has relevance to the spirituality, ethical values, privacy, and protection of children’s rights, among other ethical issues. It is hoped that the article will stir further debate and encourage more research among information practitioners, scholars and researchers into the ethical issues surrounding the treatment of sunken fontanelle in various African communities. It argues for an Afrocentric conceptualisation of phenomena in order to contribute to debates on the renaissance of African cultures, and stresses that it is imperative to harness the life-furthering age-old traditions in African ontological existence.


2019 ◽  
Vol 26 (28) ◽  
pp. 5340-5362 ◽  
Author(s):  
Xin Chen ◽  
Giuseppe Gumina ◽  
Kristopher G. Virga

:As a long-term degenerative disorder of the central nervous system that mostly affects older people, Parkinson’s disease is a growing health threat to our ever-aging population. Despite remarkable advances in our understanding of this disease, all therapeutics currently available only act to improve symptoms but cannot stop the disease progression. Therefore, it is essential that more effective drug discovery methods and approaches are developed, validated, and used for the discovery of disease-modifying treatments for Parkinson’s disease. Drug repurposing, also known as drug repositioning, or the process of finding new uses for existing or abandoned pharmaceuticals, has been recognized as a cost-effective and timeefficient way to develop new drugs, being equally promising as de novo drug discovery in the field of neurodegeneration and, more specifically for Parkinson’s disease. The availability of several established libraries of clinical drugs and fast evolvement in disease biology, genomics and bioinformatics has stimulated the momentums of both in silico and activity-based drug repurposing. With the successful clinical introduction of several repurposed drugs for Parkinson’s disease, drug repurposing has now become a robust alternative approach to the discovery and development of novel drugs for this disease. In this review, recent advances in drug repurposing for Parkinson’s disease will be discussed.


2018 ◽  
Vol 18 (13) ◽  
pp. 1110-1122 ◽  
Author(s):  
Juan F. Morales ◽  
Lucas N. Alberca ◽  
Sara Chuguransky ◽  
Mauricio E. Di Ianni ◽  
Alan Talevi ◽  
...  

Much interest has been paid in the last decade on molecular predictors of promiscuity, including molecular weight, log P, molecular complexity, acidity constant and molecular topology, with correlations between promiscuity and those descriptors seemingly being context-dependent. It has been observed that certain therapeutic categories (e.g. mood disorders therapies) display a tendency to include multi-target agents (i.e. selective non-selectivity). Numerous QSAR models based on topological descriptors suggest that the topology of a given drug could be used to infer its therapeutic applications. Here, we have used descriptive statistics to explore the distribution of molecular topology descriptors and other promiscuity predictors across different therapeutic categories. Working with the publicly available ChEMBL database and 14 molecular descriptors, both hierarchical and non-hierchical clustering methods were applied to the descriptors mean values of the therapeutic categories after the refinement of the database (770 drugs grouped into 34 therapeutic categories). On the other hand, another publicly available database (repoDB) was used to retrieve cases of clinically-approved drug repositioning examples that could be classified into the therapeutic categories considered by the aforementioned clusters (111 cases), and the correspondence between the two studies was evaluated. Interestingly, a 3- cluster hierarchical clustering scheme based on only 14 molecular descriptors linked to promiscuity seem to explain up to 82.9% of approved cases of drug repurposing retrieved of repoDB. Therapeutic categories seem to display distinctive molecular patterns, which could be used as a basis for drug screening and drug design campaigns, and to unveil drug repurposing opportunities between particular therapeutic categories.


Author(s):  
Angèle Flora Mendy

By examining policies of recruiting non-EU/EEA health workers and how ethical considerations are taken into account when employing non-EU/EEA nurses in the United Kingdom, France, and Switzerland, this chapter intends to show that the use of the so-called ‘ethical’ argument to convince national public opinion of the relevance of restrictive recruitment policies is recent (since the 1990s). The analysis highlights the fact that in addition to the institutional legacies, qualification and skills—through the process of their recognition—play an important role in the opening or restriction of the labour market to health professionals from the Global South. The legacy of the past also largely determines the place offered to non-EU/EEA health professionals in the different health systems of host countries.


2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Alex McKeown ◽  
Miranda Mourby ◽  
Paul Harrison ◽  
Sophie Walker ◽  
Mark Sheehan ◽  
...  

AbstractData platforms represent a new paradigm for carrying out health research. In the platform model, datasets are pooled for remote access and analysis, so novel insights for developing better stratified and/or personalised medicine approaches can be derived from their integration. If the integration of diverse datasets enables development of more accurate risk indicators, prognostic factors, or better treatments and interventions, this obviates the need for the sharing and reuse of data; and a platform-based approach is an appropriate model for facilitating this. Platform-based approaches thus require new thinking about consent. Here we defend an approach to meeting this challenge within the data platform model, grounded in: the notion of ‘reasonable expectations’ for the reuse of data; Waldron’s account of ‘integrity’ as a heuristic for managing disagreement about the ethical permissibility of the approach; and the element of the social contract that emphasises the importance of public engagement in embedding new norms of research consistent with changing technological realities. While a social contract approach may sound appealing, however, it is incoherent in the context at hand. We defend a way forward guided by that part of the social contract which requires public approval for the proposal and argue that we have moral reasons to endorse a wider presumption of data reuse. However, we show that the relationship in question is not recognisably contractual and that the social contract approach is therefore misleading in this context. We conclude stating four requirements on which the legitimacy of our proposal rests.


Genes ◽  
2020 ◽  
Vol 12 (1) ◽  
pp. 25
Author(s):  
He-Gang Chen ◽  
Xiong-Hui Zhou

Drug repurposing/repositioning, which aims to find novel indications for existing drugs, contributes to reducing the time and cost for drug development. For the recent decade, gene expression profiles of drug stimulating samples have been successfully used in drug repurposing. However, most of the existing methods neglect the gene modules and the interactions among the modules, although the cross-talks among pathways are common in drug response. It is essential to develop a method that utilizes the cross-talks information to predict the reliable candidate associations. In this study, we developed MNBDR (Module Network Based Drug Repositioning), a novel method that based on module network to screen drugs. It integrated protein–protein interactions and gene expression profile of human, to predict drug candidates for diseases. Specifically, the MNBDR mined dense modules through protein–protein interaction (PPI) network and constructed a module network to reveal cross-talks among modules. Then, together with the module network, based on existing gene expression data set of drug stimulation samples and disease samples, we used random walk algorithms to capture essential modules in disease development and proposed a new indicator to screen potential drugs for a given disease. Results showed MNBDR could provide better performance than popular methods. Moreover, functional analysis of the essential modules in the network indicated our method could reveal biological mechanism in drug response.


2021 ◽  
Vol 10 (2) ◽  
pp. 36
Author(s):  
Michael Weinhardt

While big data (BD) has been around for a while now, the social sciences have been comparatively cautious in its adoption for research purposes. This article briefly discusses the scope and variety of BD, and its research potential and ethical implications for the social sciences and sociology, which derive from these characteristics. For example, BD allows for the analysis of actual (online) behavior and the analysis of networks on a grand scale. The sheer volume and variety of data allow for the detection of rare patterns and behaviors that would otherwise go unnoticed. However, there are also a range of ethical issues of BD that need consideration. These entail, amongst others, the imperative for documentation and dissemination of methods, data, and results, the problems of anonymization and re-identification, and the questions surrounding the ability of stakeholders in big data research and institutionalized bodies to handle ethical issues. There are also grave risks involved in the (mis)use of BD, as it holds great value for companies, criminals, and state actors alike. The article concludes that BD holds great potential for the social sciences, but that there are still a range of practical and ethical issues that need addressing.


2020 ◽  
Vol 11 (05) ◽  
pp. 755-763
Author(s):  
Shibani Kanungo ◽  
Jayne Barr ◽  
Parker Crutchfield ◽  
Casey Fealko ◽  
Neelkamal Soares

Abstract Background Advances in technology and access to expanded genetic testing have resulted in more children and adolescents receiving genetic testing for diagnostic and prognostic purposes. With increased adoption of the electronic health record (EHR), genetic testing is increasingly resulted in the EHR. However, this leads to challenges in both storage and disclosure of genetic results, particularly when parental results are combined with child genetic results. Privacy and Ethical Considerations Accidental disclosure and erroneous documentation of genetic results can occur due to the nature of their presentation in the EHR and documentation processes by clinicians. Genetic information is both sensitive and identifying, and requires a considered approach to both timing and extent of disclosure to families and access to clinicians. Methods This article uses an interdisciplinary approach to explore ethical issues surrounding privacy, confidentiality of genetic data, and access to genetic results by health care providers and family members, and provides suggestions in a stakeholder format for best practices on this topic for clinicians and informaticians. Suggestions are made for clinicians on documenting and accessing genetic information in the EHR, and on collaborating with genetics specialists and disclosure of genetic results to families. Additional considerations for families including ethics around results of adolescents and special scenarios for blended families and foster minors are also provided. Finally, administrators and informaticians are provided best practices on both institutional processes and EHR architecture, including security and access control, with emphasis on the minimum necessary paradigm and parent/patient engagement and control of the use and disclosure of data. Conclusion The authors hope that these best practices energize specialty societies to craft practice guidelines on genetic information management in the EHR with interdisciplinary input that addresses all stakeholder needs.


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