scholarly journals Examining ‘immunity passports’ from an ethics perspective – ten reasons why they are bad idea

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
N Kofler ◽  
F Baylis
Keyword(s):  
Public Health ◽  
Healthcare Workers ◽  
Biological Data ◽  
Free Access ◽  
False Negatives ◽  
Code Tracking ◽  
Gender Minorities ◽  
Damage Limitation ◽  
Documentation Systems ◽  
And Gender

Abstract The two panelists will elaborate on 'four practical problems and six ethical objections', which add up to one very bad idea, i.e., the 'immunity passport'. Such an idea is equal to restricting movement on the basis of biology threatens freedom, fairness and public health. Lessons from previous pandemics will be examined in the context of current measures being deployed, assessing practical and ethical aspects. For example, false negatives in people with few antibodies leading to immune individuals being incorrectly labelled as not immune or not having access to testing to demonstrate immunity. Additionally, the case of healthcare workers will be examined considering feasibility of testing, but also in terms of discrimination and stigma. Another aspect to be explored in detail is monitoring and how it erodes privacy, with the main aim of immunity passport controlling movement. Documentation systems are already presenting a serious risk to privacy, with China announcing the QR-code tracking systems is likely to stay in place after the pandemic ends. Access issues to testing can contribute to further discrimination, whereas labelling people on their basis of their COVID19 status would create a new measure of dividing the society to 'immunoprivileged and immonodeprived' people. A labelling particularly disconcerting in the absence of a free, universally available vaccine. Furthermore, Social and financial inequities would be amplified, whereas divisions between nations could be fueled. Already people with HIV are subjected to restrictions on entering, living and working in certain countries with laws that impinge on the rights of those from sexual and gender minorities. Governments should instead invest on pandemic damage limitation - test, trace and isolate, and apps that empower individuals to make safe choices about their own movements should be prioritized. Also, the development, production and global distribution of a vaccine for SARS-CoV-is key. Universal, timely, free access to a vaccination becomes possible could allow for ethical recording of vaccination status in the context of certain activities. Threats to freedom, fairness and public health are inherent to any platform that is designed to segregate society on the basis of biological data. All policies and practices must be guided by a commitment to social justice.

scholarly journals Reply to Comment on Hardacker, C.T.; Baccellieri, A.; Mueller, E.R.; Brubaker, L.; Hutchins, G.; Zhang, J.L.Y.; Hebert-Beirne, J. Bladder Health Experiences, Perceptions and Knowledge of Sexual and Gender Minorities. Int. J. Environ. Res. Public Health 2019, 16, 3170

2020 ◽  
Vol 17 (7) ◽  
pp. 2458
Author(s):  
Cecilia T. Hardacker ◽  
Anna Baccellieri ◽  
Elizabeth R. Mueller ◽  
Linda Brubaker ◽  
Georgia Hutchins ◽  
...  
Keyword(s):  
Public Health ◽  
Sexual And Gender Minorities ◽  
Gender Minorities ◽  
Health Experiences ◽  
And Gender

We appreciate your comments and concerns about our manuscript in IJERPH on Bladder Health Experiences, Perceptions and Knowledge of Sexual and Gender Minorities [...]

Sexual and Gender Minorities, Public Health, and Ethics

2019 ◽  
pp. 231-244
Author(s):  
Tonya Littlejohn ◽  
Tonia Poteat ◽  
Chris Beyrer
Keyword(s):  
Public Health ◽  
Public Health Surveillance ◽  
Health Surveillance ◽  
Health Needs ◽  
Health Issues ◽  
Sexual And Gender Minorities ◽  
Ethical Challenges ◽  
Gender Minorities ◽  
The Social ◽  
And Gender

Sexual and gender minorities (LGBT persons) are more visible and mobilized than ever. In some countries, that visibility and activism have contributed to the advancement of sexual and gender rights. Nevertheless, and despite those gains, stigma, discrimination, and criminalization of these populations persist and have impeded efforts to address their public health needs. As a result, sexual and gender minorities continue to experience a range of health disparities, and overall face a disproportionately high burden of mental health issues, HIV/AIDS, and other illnesses. This chapter explores core ethical challenges and debates that impact health promotion and prevention efforts with sexual and gender minorities, with a focus on issues arising in public health surveillance and interventions, and on understanding the social and political context that impacts the lived reality of sexual and gender minorities.

scholarly journals Comment on Hardacker, C.T.; Baccellieri, A.; Mueller, E.R.; Brubaker, L.; Hutchins, G.; Zhang, J.L.Y.; Hebert-Beirne, J. Bladder Health Experiences, Perceptions and Knowledge of Sexual and Gender Minorities. Int. J. Environ. Res. Public Health 2019, 16, 3170

2020 ◽  
Vol 17 (7) ◽  
pp. 2310
Author(s):  
Joshua S. Jue ◽  
Mahmoud Alameddine
Keyword(s):  
Public Health ◽  
Minority Status ◽  
Sexual And Gender Minorities ◽  
Gender Minorities ◽  
Health Experiences ◽  
Males And Females ◽  
Sexual And Gender Minority ◽  
And Gender ◽  
And Function ◽  
The Impact

Our knowledge of voiding is derived from studies comprised of cisgender males and females, with relatively little known about the impact of sexual and gender minority status on voiding perceptions, symptoms, and function [...]

An Overview of Ethics Issues for Public Health in Particular Populations

2019 ◽  
pp. 173-180
Author(s):  
Ruth Gaare Bernheim ◽  
Elizabeth Fenton
Keyword(s):  
Public Health ◽  
Ethical Issues ◽  
Health Needs ◽  
Ethical Challenges ◽  
Persons With Disabilities ◽  
Gender Minorities ◽  
Fundamental Goal ◽  
Aging Populations ◽  
Different Populations ◽  
And Gender

Improving the health of populations is a fundamental goal of public health. An essential step to achieve this goal is addressing the varying health needs and stressors experienced by different populations and subgroups within a population, along with the significant ethical issues of health equity raised by disparities in health among these groups. This chapter provides an overview of the section of The Oxford Handbook of Public Health Ethics dedicated to examining the public health needs and related ethical issues of a number of subpopulations that generally experience or are exposed to health stressors. Those stressors may include historic injustices, discrimination and stigmatization, and unique social or physical needs, limitations, or vulnerabilities. The chapters in this section consider aging populations, children and adolescents, persons with mental illness, persons with disabilities, sexual and gender minorities, and immigrants and refugees. Examining public health practices and strategies through the lens of each of these particular populations helps to illustrate the ethical challenges of improving population health equitably.

An eHealth Intervention for Promoting COVID-19 Knowledge and Protective Behaviors and Reducing Pandemic Distress among Sexual and Gender Minorities: Protocol for a Randomized Controlled Trial (#SafeHandsSafeHearts) (Preprint)

2021 ◽  
Author(s):  
Peter Adam Newman ◽  
Venkatesan Chakrapani ◽  
Charmaine Williams ◽  
Notisha Massaquoi ◽  
Suchon Tepjan ◽  
...  
Keyword(s):  
Public Health ◽  
Controlled Trial ◽  
Sexual And Gender Minorities ◽  
Protective Behaviors ◽  
Exit Interviews ◽  
Randomized Controlled ◽  
Gender Minorities ◽  
And Gender ◽  
Ehealth Intervention ◽  
Lgbt Populations

BACKGROUND Existing data on COVID-19 disparities among vulnerable populations portend excess risk for lesbian, gay, bisexual, transgender (LGBT) and other persons outside of heteronormative and cisgender identities (i.e., LGBT+). Owing to adverse social determinants of health, including pervasive HIV and sexual stigma, harassment, violence, barriers in access to healthcare, and existing health and mental health disparities, sexual and gender minorities in India and Thailand are at disproportionate risk for SARS-CoV-2 infection and severe disease. Despite global health disparities among LGBT+ populations, there is a lack of coordinated, community-engaged interventions to address the expectable excess burden of COVID-19 and public health-recommended protective measures. OBJECTIVE We will conduct a randomized controlled trial (RCT) to evaluate the effectiveness of a brief, peer-delivered eHealth intervention to increase COVID-19 knowledge and public health-recommended protective behaviors and reduce psychological distress among LGBT+ people residing in Bangkok, Thailand, and Mumbai, India. Subsequent to the RCT, we will conduct exit interviews with purposively sampled subgroups, including those with no intervention effect. METHODS SafeHandsSafeHearts is a 2-site, parallel waitlist-controlled RCT to test the efficacy of a 3-session, peer counselor-delivered eHealth intervention based on motivational interviewing and psychoeducation. The study methods, online infrastructure and content were pilot tested with LGBT+ individuals in Toronto, Canada before adaptation and roll-out in the other contexts. The primary outcomes are COVID-19 knowledge (index based on U.S. CDC items), protective behaviors (index based on WHO and U.S. CDC guidelines), depression (PHQ-2) and anxiety (GAD-2). Secondary outcomes include loneliness, COVID-19 stress, and intended care-seeking. We will enroll N = 310 participants in each city, age 18 years and older, one-third cisgender gay, bisexual and other men who have sex with men, one-third cisgender lesbian, bisexual and other women who have sex with women, and one-third transfeminine, transmasculine and gender nonbinary people. Participants will be equally stratified in the immediate intervention and waitlist control group. Participants are mainly recruited from online social media accounts of community-based partner organizations. They can access the intervention on a computer, tablet, or mobile phone. SafeHandsSafeHearts has 3 sessions delivered weekly over three successive weeks. Exit interviews will be conducted online with 3 subgroups (n = 12 per group; N = 36 in each city) of purposively selected participants, to be informed by RCT outcomes and focal populations of concern. RESULTS The RCT was funded in 2020. The study protocol was registered with ClinicalTrials.gov (NCT04870723). The trials started recruitment as of August 1, 2021, and all RCT data collection will likely be completed by December 31, 2021. CONCLUSIONS The SafeHandsSafeHearts RCT will provide evidence about the effectiveness of a brief, peer-delivered e-Health intervention developed for LGBT+ populations amid the COVID-19 pandemic. If the intervention proves effective, it will provide a basis for future scale-up in India and Thailand, and other low- and middle-income countries. CLINICALTRIAL NIH U.S. National Library of Medicine, ClinicalTrials.gov: NCT04870723; https://clinicaltrials.gov/ct2/show/NCT04870723

The Erasure of Intersex, Transgender, Nonbinary, and Agender Experiences by Misusing Sex and Gender in Health Research

2021 ◽  
Author(s):  
Tessalyn Morrison ◽  
Alexis Dinno ◽  
Taurica Salmon
Keyword(s):  
Public Health ◽  
Health Research ◽  
Public Health Research ◽  
Research Quality ◽  
Sex And Gender ◽  
Minority Communities ◽  
Biological Sex ◽  
Gender Minorities ◽  
Health Experiences ◽  
And Gender

Abstract Sex and gender conflation continues to perpetuate the invisibility of sex and gender minorities and obscure information about the ways that biological sex and gender affect health. The misuse of sex and gender terms and the sex and gender binaries can yield inaccurate results, but more importantly, contributes to the erasure of intersex, transgender, nonbinary, and agender health experiences. This article discusses ways in which public health researchers can use sex and gender terms correctly, and center the health experiences of intersex, transgender, nonbinary, and agender individuals. This includes promoting sensitivity in approaching minority communities, improving survey questions, and collaborating with sex and gender minority communities to improve research quality and participant experiences. Improving our standards for the quality of sex and gender term usage and centering sex and gender minorities in public health research are imperative to addressing the health inequalities faced by sex and gender minorities.

Anxiety Disorders among Sexual and Gender Minority Populations

2020 ◽  
pp. 45-57
Author(s):  
Brandon J. Weiss ◽  
Bethany Owens Raymond
Keyword(s):  
Anxiety Disorders ◽  
Minority Stress ◽  
Minority Status ◽  
Sexual And Gender Minorities ◽  
Gender Minorities ◽  
Assessment And Treatment ◽  
Literature Base ◽  
Current Assessment ◽  
And Gender ◽  
Minority Stress Model

Rates of anxiety disorders are significantly elevated among sexual and gender minorities. In this chapter, the minority stress model is discussed as a framework for conceptualizing anxiety among sexual and gender minorities, and the authors review the literature on the relationships between specific minority stressors and symptoms. The authors examine prevalence rates of anxiety disorders among sexual minorities and gender minorities, separately and in comparison to heterosexual and cisgender individuals. Also reviewed is the literature on anxiety disorders among sexual and gender minorities with a racial or ethnic minority status. Current assessment and treatment approaches are identified and reviewed. Finally, limitations to the current literature base are discussed and recommendations are provided for future studies.

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