scholarly journals Who should be tested in a pandemic? Ethical considerations

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sven Ove Hansson ◽  
Gert Helgesson ◽  
Niklas Juth
Keyword(s):  
Legal Status ◽  
Careful Consideration ◽  
Medical Services ◽  
Residential Areas ◽  
Test Quality ◽  
Ethical Considerations ◽  
Scarce Resources ◽  
Direct To Consumer ◽  
Strict Regulation ◽  
Consumer Test

Abstract Background In the initial phase of the Covid-19 pandemic, difficult decisions had to be made on the allocation of testing resources. Similar situations can arise in future pandemics. Therefore, careful consideration of who should be tested is an important part of pandemic preparedness. We focus on four ethical aspects of that problem: how to prioritize scarce testing resources, the regulation of commercial direct-to-consumer test services, testing of unauthorized immigrants, and obligatory testing. Main text The distribution of scarce resources for testing: We emphasize the use of needs-based criteria, but also acknowledge the importance of choosing a testing strategy that contributes efficiently to stopping the overall spread of the disease. Commercial direct-to-consumer test services: Except in cases of acute scarcity, such services will in practice have to be allowed. We propose that they should be subject to regulation that ensures test quality and adequate information to users. Testing of unauthorized immigrants, their children and other people with unclear legal status: Like everyone else, these individuals may be in need of testing, and it is in society’s interest to reach them with testing in order to stop the spread of the disease. A society that offers comprehensive medical services to unauthorized immigrants is in a much better position to reach them in a pandemic than a society that previously excluded them from healthcare. Obligatory testing: While there are often strong reasons for universal testing in residential areas or on workplaces, there are in most cases better ways to achieve testing coverage than to make testing mandatory. Conclusion In summary, we propose (1) decision-making primarily based on needs-based criteria, (2) strict regulation but not prohibition of direct-to-consumer test services, (3) test services offered to unauthorized immigrants, preferably as part of comprehensive medical services, and (4) broad outreach of testing services whenever possible, but in general not obligatory testing.

THE ISSUE OF MINORS’S GUARDIANSHIP SENTENCED TO IMPRISONMENT

2020 ◽  
pp. 33-37
Author(s):  
Ирина Викторовна Евстафьева
Keyword(s):  
Juvenile Offenders ◽  
Legal Status ◽  
Careful Consideration ◽  
Point Of View ◽  
Sufficient Detail ◽  
Domestic Legislation ◽  
The Status ◽  
Correct Understanding ◽  
The Given

В статье исследуются вопросы попечительства в отношении несовершеннолетних, отбывающих наказание в виде лишения свободы. Проблема, поднимаемая автором настоящей статьи, многогранна, касается различных аспектов отбывания наказания несовершеннолетними в воспитательных колониях и требует комплексного исследования, способного ответить на определенно значимый вопрос: является ли колония законным представителем находящихся в ней несовершеннолетних со всеми вытекающими из статуса законных представителей последствиями. При этом необходимо обращать внимание на специфику правового статуса лиц, отбывающих наказание в воспитательных колониях, которые, во-первых, являются несовершеннолетними, то есть не обладают дееспособностью в полном объеме и нуждаются в особой заботе, защите и представительстве, а во-вторых, осуждены за совершение тяжкого или особо тяжкого преступления, влекущего изоляцию от общества и определенные ограничения и лишения. Отечественное законодательство достаточно детально регламентирует особенности режима отбывания наказания в виде лишения свободы несовершеннолетними, не определяя при этом статуса воспитательных колоний, кем они являются: воспитателями, попечителями или исключительно учреждениями исполнения наказаний. Между тем правильное понимание значения и роли воспитательной колонии в жизни находящихся в ней несовершеннолетних преступников, по мнению автора, поможет избежать ряда проблем, объективно складывающихся в учреждениях подобного рода. С этой точки зрения предлагаемая тема представляет интерес не только для ученых-теоретиков, но и для практиков - сотрудников соответствующих учреждений. Особо следует подчеркнуть, что исследований по данной тематике в специальной литературе нет. Отдельные исследования, встречающиеся в современной литературе, касаются исключительно общего гражданско-правового статуса несовершеннолетних осужденных. Однако это обстоятельство может свидетельствовать только о новизне данной темы, но никак не об отсутствии самой проблемы. The article analyzes the issues of the status of educational colonies as guardians of minors serving a sentence of imprisonment. In fact, the problem raised by the author of this article is multifaceted, concerns various aspects of the serving of punishment by minors in educational colonies and requires a comprehensive study that can answer, it seems, a definitely significant question: whether the colony is the legal representative of the minors in it with all the consequences arising from the status of legal representatives in the form of duties and responsibilities. At the same time, it seems, it is necessary to pay attention to the specifics of the legal status of citizens serving sentences in educational colonies, who, firstly, are minors, i.e. do not have full legal capacity and need special care, protection and representation, and, secondly, are convicted of committing a serious or particularly serious crime, entailing isolation from society and certain restrictions and deprivation. Domestic legislation regulates in sufficient detail the peculiarities of the regime of serving sentences in the form of deprivation of liberty by minors, without determining the status of educational colonies. Who are they: educators, Trustees or only institutions of execution of punishments. Meanwhile, the correct understanding of the importance and role of the educational colony in the life of juvenile offenders in it, according to the author, will help to avoid a number of problems that objectively develop in institutions of this kind. From this point of view, the proposed topic is of interest not only for theoretical scientists, but for practitioners-employees of relevant institutions. It should be emphasized that there are no studies on this subject in the special literature. However, this circumstance can testify only about novelty of the given subject, but in any way about absence of the problem. It seems that the relevance and importance of a problem is not always measured by the number of studies devoted to it. Sometimes these its traits are manifest only under particularly careful consideration.

Ethical Considerations in Emergency Planning, Preparedness, and Response to Acts of Terrorism

2003 ◽  
Vol 18 (3) ◽  
pp. 170-178 ◽  
Author(s):  
Gregory Luke Larkin ◽  
Jeffrey Arnold
Keyword(s):  
Critical Incident ◽  
Healthcare Workers ◽  
Healthcare Providers ◽  
Health Utility ◽  
Weapons Of Mass Destruction ◽  
Mass Destruction ◽  
Ethical Considerations ◽  
Patient Centered ◽  
Scarce Resources ◽  
Virtuous Behavior

AbstractThroughout the globe, healthcare providers are increasingly challenged with the specter of terrorism and the fallout from weapons of mass destruction. Preparing for and responding to such manmade emergencies, however, threatens the ethical underpinnings of routine, individualized, patient-centered, emergency healthcare. The exigency of a critical incident can instantly transform resource rich environs, to those of austerity. Healthcare workers, who only moments earlier may have been seeing two to three patients per hour, are instantly thrust into a sea of casualties and more basic lifeboat issues of quarantine, system overload and the thornier determinations of who will be given every chance to live and who will be allowed to die. Beyond the tribulations of triage, surge capacity, and the allocation of scarce resources, terrorism creates a parallel need for a host of virtues not commonly required in daily medical practice, including prudence, courage, justice, stewardship, vigilance, resilience, and charity. As a polyvalent counterpoint to the vices of apathy, cowardice, profligacy, recklessness, inflexibility, and narcissism, the virtues empower providers at all levels to vertically integrate principles of safety, public health, utility, and medical ethics at the micro, meso, and macro levels. Over time, virtuous behavior can be modeled, mentored, practiced, and institutionalized to become one of our more useful vaccines against the threat of terrorism in the new millennium.

scholarly journals Navigating conflict between research ethics and online platform terms and conditions: a reflective account

2021 ◽  
pp. 174701612110455
Author(s):  
Shi Min Chua
Keyword(s):  
Ethical Decision ◽  
Ethical Decision Making ◽  
Careful Consideration ◽  
Online Discussions ◽  
Ethical Considerations ◽  
Private Company ◽  
Online Platform ◽  
Learning Platform ◽  
Internet Users ◽  
Online Spaces

Internet users’ comments in online spaces have attracted researchers’ attention in recent years. Although this data is typically publicly available, its use requires careful consideration so as to not cause harm to the users, while complying with the terms and conditions (Ts & Cs) of the online spaces. However, the Ts & Cs and researchers’ ethical considerations may sometimes be in conflict. I faced such a conflict when I conducted discourse analysis of online discussions that were sourced from a public online learning platform owned by a private company. In this article, I reflect on how I navigated the Ts & Cs and copyright law, taking users’ likely expectations into consideration when deciding whether to seek informed consent and anonymize content. I employed an ‘attribution with anonymization’ method to acknowledge users for their comments while safeguarding their confidentiality. Given the variety of online spaces and research methods, ethical decision-making must be a contextualized process that requires researchers to consider the nature of the online platform and the potential experience of the users, rather than simply following guidelines or Ts & Cs.

scholarly journals Epistemic and ethical considerations in the direct-to-consumer health and ancestry genetic testing process

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Katherine Huerne
Keyword(s):  
Genetic Testing ◽  
Quantitative Methods ◽  
Ethical Issues ◽  
Social Issues ◽  
Clear Understanding ◽  
Feminist Ethics ◽  
Ethical Considerations ◽  
Ethical Implications ◽  
Direct To Consumer ◽  
The Cost

Background: Direct-to-consumer genetic testing (DTC-GT) is a popular and fast-growing field within the healthcare industry. Consumers often pursue DTC-GT without a clear understanding of its epistemic and medical limitations. This report will present the current state of DTC-GT technology, and highlight the ethical, legal and social issues of DTC-GT. Methods: Quantitative methods such as systematic reviews were used to evaluate the field of DTC-GT. Experimental data was taken from randomized control trials and case studies of 23andMe. Qualitative methods such as newspaper articles and surveys were also used. Relevant policies and regulatory information were analyzed in the context of 23andMe. Broader ethical issues are analyzed from the social disability model and feminist ethics frameworks. Results: Several aspects of direct-to-consumer genetic testing are outlined: (i) regulatory and legal distinctions of DTC-GT that separate its use from conventional genetic testing, (ii) epistemic issues of the genetic testing process within the direct-to-consumer context, and (iii) ethical considerations of DTC-GT in regard to genetic health and genetic ancestry. Conclusion: This report does not take a position for or against the use of DTC-GT; rather, it highlights the key ethical issues often missed in the DTC-GT process. There is no perfect method for understanding genetic health and race. DTC-GT offer consumers the ease and power of taking genetic data ‘in their own hands’, at the cost of exacerbating geneticization and race essentialism. Until further work is done to address the epistemic, regulatory and legal issues, ethical implications of DTC-GT usage will continue to exist.

LEGAL POSITION OF THE EXECUTOR OF MEDICAL SERVICES AS A SUBJECT OF LEGAL RELATIONS ON VOLUNTARY MEDICAL COSTS INSURANCE

2019 ◽  
pp. 25-35
Author(s):  
Olga Yuryevna Prokuda
Keyword(s):  
Health Services ◽  
Medical Care ◽  
Social Relations ◽  
Legal Status ◽  
Medical Service ◽  
The State ◽  
Medical Services ◽  
State Obligations ◽  
The Republic ◽  
Policy Priority

With the transition of the economy of the Republic of Belarus to market relations, it became necessary to search for new sources of income for financing socially important spheres of social relations. The social policy priority areas of the Republic of Belarus are the protection of citizen’s health and the provision of quality medical care. At the same time, the state is not able to provide the population with free medical care of adequate volume and quality. State obligations to provide such assistance are not fully provided with financial resources. The growing public demand for health services requires additional sources of funding. We believe that additional sources of financing for health services can be provided by health insurance. However, the minimum state guarantees of citizens for free medical care should also be fixed at the legislative level. We consider legal status of the independent subject of relations on voluntary medical insurance – the executor of medical service. Also we substantiate the expediency of fixing at the legislative level of medical service Institute executor. As the executor of medical services it is offered to consider not only the organizations of health care of the state and non – state forms of ownership providing medical care, but also other subjects which according to the legislation of Republic of Belarus, are authorized to carry out medical activity-individual entrepreneurs and other organizations.

scholarly journals Unregulated Health Research Using Mobile Devices: Ethical Considerations and Policy Recommendations

2020 ◽  
Vol 48 (S1) ◽  
pp. 196-226 ◽  
Author(s):  
Mark A. Rothstein ◽  
John T. Wilbanks ◽  
Laura M. Beskow ◽  
Kathleen M. Brelsford ◽  
Kyle B. Brothers ◽  
...  
Keyword(s):  
Mobile Devices ◽  
Policy Recommendations ◽  
Regulatory Requirements ◽  
Ethical Considerations ◽  
The Public ◽  
Direct To Consumer ◽  
Federal Research ◽  
Research Regulations ◽  
Policy Challenge ◽  
Conducting Research

Mobile devices with health apps, direct-to-consumer genetic testing, crowd-sourced information, and other data sources have enabled research by new classes of researchers. Independent researchers, citizen scientists, patient-directed researchers, self-experimenters, and others are not covered by federal research regulations because they are not recipients of federal financial assistance or conducting research in anticipation of a submission to the FDA for approval of a new drug or medical device. This article addresses the difficult policy challenge of promoting the welfare and interests of research participants, as well as the public, in the absence of regulatory requirements and without discouraging independent, innovative scientific inquiry. The article recommends a series of measures, including education, consultation, transparency, self-governance, and regulation to strike the appropriate balance.

scholarly journals A Scenario-Based Methodology for Analyzing the Ethical, Legal, and Social Issues in Genomic Data Sharing

2020 ◽  
Vol 15 (4) ◽  
pp. 355-364
Author(s):  
Rebekah McWhirter ◽  
Lisa Eckstein ◽  
Don Chalmers ◽  
Christine Critchley ◽  
Jane Nielsen ◽  
...  
Keyword(s):  
Data Sharing ◽  
Ethical Issues ◽  
Social Issues ◽  
Genomic Data ◽  
Community Members ◽  
Direct To Consumer ◽  
Public Sharing ◽  
Key Issues ◽  
Consumer Test ◽  
Legal And Ethical Issues

Sharing of genomic and associated data is essential to clinical practice and biomedical research, and is increasingly encouraged by journals and funding bodies. Grappling with the range of legal and ethical issues raised by genomic data sharing presents a significant challenge, given the diversity of practices: from defined sharing of individual patient data, to broad-scale public sharing of research data, to uploading of direct-to-consumer test data by community members. Most commentary to date has discussed these issues in broad terms, but the debate can only progress if we engage with more granularity, grounded in jurisdictional and contextual specifics. We developed an empirical approach, creating a set of prototypical scenarios that capture the diversity of current genomic data sharing practices, which allows legal and ethical analysis of key issues at a granular level. The specificity of this approach provides a strong foundation for developing useful and relevant regulatory recommendations.

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