scholarly journals Ethical Issues in Scarce Resource Allocation in a Global Pandemic: Relevance to Craniofacial Surgery

FACE ◽  
2020 ◽  
Vol 1 (1) ◽  
pp. 41-43
Author(s):  
Christian J. Vercler
Keyword(s):  
Public Health ◽  
Ethical Issues ◽  
Biomedical Ethics ◽  
Ethical Responsibility ◽  
Individual Member ◽  
Protective Equipment ◽  
Ethical Guidelines ◽  
Life And Death ◽  
Scarce Resources ◽  
Global Pandemic

The response to the COVID-19 pandemic has necessitated a shift in how we apply the principles of biomedical ethics. The historical foundation of the ethical responsibility of the physician to the patient rests on the of that individual relationship. The patient comes first. However, in a pandemic, a public health ethics takes over, and the focus changes to what each individual member of society’s responsibility is to the collective. The greatest good for the greatest number trumps a given individual’s needs. Ethicists have focused primarily on creating guidelines that apply to allocating scarce life-and-death-determining resources. Very little attention has been paid to scarce resources that are more mundane, such as personal protective equipment (PPE) or operating room (OR) time. I present here a summary of the most recent ethical guidelines for allocation of scarce resources, note some concerns with these approaches, and discuss some of the shortcomings of applying these frameworks to the practice of craniofacial surgeons.

Pandemic Disease, Public Health, and Ethics

2019 ◽  
pp. 796-811 ◽  
Author(s):  
Maxwell Smith ◽  
Ross Upshur
Keyword(s):  
Public Health ◽  
Ethical Issues ◽  
Ethical Challenges ◽  
Pandemic Preparedness ◽  
Scarce Resources ◽  
Ethical Frameworks ◽  
Health Measures ◽  
Care Workers ◽  
The Face ◽  
Conducting Research

Infectious disease pandemics raise significant and novel ethical challenges to the organization and practice of public health. This chapter provides an overview of the salient ethical issues involved in preparing for and responding to pandemic disease, including those arising from deploying restrictive public health measures to contain and curb the spread of disease (e.g., isolation and quarantine), setting priorities for the allocation of scarce resources, health care workers’ duty to care in the face of heightened risk of infection, conducting research during pandemics, and the global governance of preventing and responding to pandemic disease. It also outlines ethical guidance from prominent ethical frameworks that have been developed to address these ethical issues and concludes by discussing some pressing challenges that must be addressed if ethical reflection is to make a meaningful difference in pandemic preparedness and response.

An Overview of Ethics and Environmental Health

2019 ◽  
pp. 697-703
Author(s):  
David B. Resnik
Keyword(s):  
Public Health ◽  
Environmental Health ◽  
Environmental Ethics ◽  
Ethical Issues ◽  
Biomedical Ethics ◽  
Public Health Ethics ◽  
Social Utility ◽  
Toxic Substances ◽  
Health Ethics ◽  
Wide Range

This chapter provides an overview of the ethics of environmental health, and it introduces five chapters in the related section of The Oxford Handbook of Public Health Ethics. A wide range of ethical issues arises in managing the relationship between human health and the environment, including regulation of toxic substances, air and water pollution, waste management, agriculture, the built environment, occupational health, energy production and use, environmental justice, population control, and climate change. The values at stake in environmental health ethics include those usually mentioned in ethical debates in biomedicine and public health, such as autonomy, social utility, and justice, as well as values that address environmental concerns, such as animal welfare, stewardship of biological resources, and sustainability. Environmental health ethics, therefore, stands at the crossroads of several disciplines, including public health ethics, environmental ethics, biomedical ethics, and business ethics.

ETHICAL ISSUES AND THE CORONAVIRUS EPIDEMIC

2021 ◽  
pp. 9-16
Author(s):  
Oleg Letov ◽  
Keyword(s):  
Public Health ◽  
English Language ◽  
Ethical Issues ◽  
Biomedical Ethics ◽  
Ethical Principles ◽  
Precautionary Approach ◽  
Ethical Problems ◽  
Health Advice ◽  
Analytical Review

The article is an analytical review of English-language articles on contemporary ethical issues related to the coronavirus epidemic. Such principles of biomedical ethics as respect for the freedom of the patient, non-harm are analyzed. A precautionary approach is formulated, the main norms of which are practicality, impartiality, proportionality and justification. It is emphasized that public health advice and action should be part of a broader effort to gain and maintain confidence in the action taken. Reasonable trust requires a serious attitude to the ethical problems associated with the implementation of the intended ethical principles.

scholarly journals Fallacy of the last bed dilemma

2021 ◽  
pp. medethics-2021-107333
Author(s):  
Luca Valera ◽  
María A. Carrasco ◽  
Ricardo Castro
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Critical Care ◽  
Medical Care ◽  
Ethical Issues ◽  
Moral Dilemma ◽  
Scarce Resources ◽  
Ethical View

The COVID-19 pandemic highlights the relevance of adequate decision making at both public health and healthcare levels. A bioethical response to the demand for medical care, supplies and access to critical care is needed. Ethically sound strategies are required for the allocation of increasingly scarce resources, such as rationing critical care beds. In this regard, it is worth mentioning the so-called ‘last bed dilemma’. In this paper, we examine this dilemma, pointing out the main criteria used to solve it and argue that we cannot face these ethical issues as though they are only a dilemma. A more complex ethical view regarding the care of COVID-19 patients that is focused on proportional and ordinary treatments is required. Furthermore, discussions and forward planning are essential because deliberation becomes extremely complex during an emergency and the physicians’ sense of responsibility may be increased if it is faced only as a moral dilemma.

scholarly journals 從莊子生命哲學到生命倫理學四原則的互補整合

2010 ◽  
Vol 8 (1) ◽  
pp. 61-79
Author(s):  
Yunzhang LIU ◽  
Jinping ZHAO ◽  
Jia XIE
Keyword(s):  
Ethical Issues ◽  
Moral Dilemmas ◽  
Biomedical Ethics ◽  
Human Beings ◽  
The West ◽  
Life And Death ◽  
Philosophy Of Life ◽  
Western Idea ◽  
Digital Commons ◽  
Bioethical Issues

LANGUAGE NOTE | Document text in Chinese; abstract also in English.構建中國生命倫理學基本原則所秉持的根本方法應是整合。筆者認為，莊子的生命哲學思想與比徹姆 (Tom L. Beauchamp) 和丘卓斯(James F. Childress) 的生命倫理四原則從不同的角度，為這種整合提供了理論資源。莊子的生命哲學內涵豐富，關注生命本身、關注生命的平等和關注生命存在的本真價值與意義；秉持生是適時，死是順應的自然主義生死觀；追求超越世俗的自由“逍遙”的生存狀態；重視“養生”、“可以盡年”，實踐無慾無為的養生觀；主張“以天地為棺槨”，反對“厚葬”的陋習等等，這些都具有積極意義。這些思想歸結起來就是要“和諧”。和諧是自然萬物的存在秩序，是人的身心健康的根本保障，也是我們在構建中國生命倫理學基本原則時所需要把握的核心價值。而比徹姆和丘卓斯的生命倫理四原則從醫療衞生事業的發展與醫療實踐的角度為我們提供了更清晰、更明確去解決生命倫理問題的原則指導。在此基礎上構建起來的中國生命倫理學基本原則是以“和諧”為中心的體現，在多領域中的原則總體，包括人與自然領域的“和諧生態”原則、人與社會領域的“和諧社會”原則、人與自身領域的“和諧人格”原則、人與醫學領域的“和諧醫學”原則等。運用這些基本原則指導人們的現實倫理生活，規範、分析和解決人們現實生活中存在的種種生命倫理問題，推進社會文明的進步與人類自我價值的提升。The four-principles approach to bioethics developed by Beauchamp and Childress in Principles of Biomedical Ethics is no doubt the most well known and influential example in the West of principle-based approaches to resolve ethical issues. The four principles are autonomy, non-maleficence, beneficence, and justice. This essay explores whether the four principles can be considered a universal core of morality that can be used in China to deal with current bioethical issues. It argues that although the four principles provide general guidelines, their implementation is much more complex. This essay attempts to show that Daoist thought, particularly Zhuangzi’s philosophy of life and death, conveys a certain sense of bioethics and carries profound moral implications that can overcome some of the limitations of principle-based ethics. The synthesis of the two traditions may help contemporary China to deal with various kinds of moral dilemmas. The Daoist notion of the interconnection among human beings and between human beings and nature challenges the Western idea of individualism and individual autonomy.DOWNLOAD HISTORY | This article has been downloaded 553 times in Digital Commons before migrating into this platform.

scholarly journals COVID-19 vaccine hesitancy and vaccine passports: Vaccination or restriction?

2021 ◽  
Author(s):  
Shohei Okamoto ◽  
Kazuki Kamimura ◽  
Kohei Komamura
Keyword(s):  
Public Health ◽  
Side Effects ◽  
Online Survey ◽  
Ethical Issues ◽  
Herd Immunity ◽  
Vaccine Safety ◽  
Careful Consideration ◽  
Vaccine Hesitancy ◽  
Global Pandemic ◽  
Novel Coronavirus

Objectives: While the development of vaccines against the novel coronavirus (COVID-19) brought the hope of establishing herd immunity, which might help end the global pandemic, vaccine hesitancy can hinder the progress towards herd immunity. In this study, we assess the determinants of vaccine hesitancy, reasons for hesitation, and effectiveness of vaccine passports in relaxing public health restrictions. Methods: Through an online survey that includes a conjoint experiment of a demographically representative sample of 5,000 Japanese adults aged 20-74, we assess the determinants of vaccine hesitancy, reasons for hesitation, and effectiveness of hypothetical vaccine passports. Results: We found that about 30% of respondents did not intend to vaccinate or have not yet decided, with major reasons for vaccine hesitancy being related to concerns about the safety and side effects of the vaccine. In line with previous findings, younger age, lower socioeconomic status, and psychological factors such as weaker COVID-19 fear were associated with vaccine hesitancy. The easing of public health restrictions such as travel, wearing face masks, and dining out at night was associated with an increase in vaccine acceptance by 4-10%. Conclusion: Vaccine hesitancy can be reduced by mitigating the concerns about vaccine safety and side effects, as well as by relaxing public health restrictions. However, the feasibility of vaccine passports needs to be sufficiently assessed, taking the ethical issues of passports and the public health impacts of the relaxation of restrictions into careful consideration.

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