Wir müssen abwägen – aber wie sollen wir abwägen?

2021 ◽  
Vol 69 (1) ◽  
pp. 29-66
Author(s):  
Lutz Wingert

Abstract The global Covid-19 crisis raises at least three moral questions, which my contribution answers as follows: (1) Which patient should get treatment according to triage criteria? The patient whose treatment has the best prospect of success. (2) How should we resolve the conflict between public health measures and economic needs? Public health should have priority, but reaches its limits where the individual right to stay afloat through one’s own work is violated. (3) How should we resolve the conflict between public health measures and civil liberties? Public health should have priority, but reaches its limits where the restriction of freedom violates the integrity of individual health and personal freedom. The answers and the arguments behind these are developed through the discussion of a wide range of current public health policies, concrete measures, and competing approaches to moral questions in the Covid-19 pandemic.

2020 ◽  
Vol 32 (4) ◽  
pp. 163-164
Author(s):  
Jeconiah Louis Dreisbach

The 2019 coronavirus disease (COVID-19) presents a great challenge to developing countries with limited access to public health measures in grassroots communities. The World Health Organization lauded the Vietnamese government for its proactive and steady investment in health facilities that mitigate the risk of the infectious disease in Vietnam. This short communication presents cases that could benchmark public health policies in developing countries.


2021 ◽  
Vol 9 ◽  
Author(s):  
Jinghua Gao ◽  
Pengfei Zhang

Background: China is generally regarded internationally as an “authoritarian” state. Traditional definitions have assigned many negative connotations surrounding the term of authoritarian. We realize that it might not be considered value-neutral in other countries. But authoritarian in the Chinese context emphasizes more on centralized decision making, collectivism, coordinating all activities of the nation, and public support, which is considered a value-neutral term. Therefore, it is adopted in this paper. We would like to clarify this. Authoritarian governance is considered an important mechanism for developing China's economy and solving social problems. The COVID-19 crisis is no exception. Most of the current research on crisis management and government crises focuses on advanced, democratic countries. However, the consequences of crisis management by authoritarian governments have not been fully appreciated. Although prior research has addressed authoritarian initiatives to manage crises in China, authoritarian interventions have rarely been theorized in public health emergencies.Methods: Based on a literature review and theoretical analysis, we use a descriptive and qualitative approach to assess public health policies and mechanisms from an authoritarian perspective in China. In light of the key events and intervention measures of China's government in response to COVID-19, the strategic practices of the Communist Party of China (CPC) to construct, embody, or set political goals through authoritarian intervention in public health crisis management are discussed.Results: China's government responded to the COVID-19 pandemic with a comprehensive authoritarian intervention, notably by establishing a top-down leadership mechanism, implementing a resolute lockdown, rapidly establishing square cabin hospitals, enhancing cooperation between different government departments, mobilizing a wide range of volunteer resources, enforcing the use of health codes, imposing mandatory quarantine on those returning from abroad, and implementing city-wide nucleic acid testing. These measures ensured that China was able to contain the outbreak quickly and reflect on the unique role of the Chinese authoritarian system in responding to public health crises.Conclusions: Our paper contributes to expanding the existing understanding of the relationship between crisis management and authoritarian system. China's response to COVID-19 exemplifies the unique strengths of authoritarian institutions in public health crisis management, which is a helpful and practical tool to further enhance the CPC's political legitimacy. As a socialist model of crisis management with Chinese characteristics, it may offer desirable experiences and lessons for other countries still ravaged by the epidemic.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Komaroff ◽  
A A Belhouchet

Abstract Background Was the world prepared to face the pandemic with a standard strategy? Objectives To evaluate the association between public health interventions against the COVID-19 outbreak and the outcome. Methods The observational study included data on incidence of confirmed COVID-19 cases (outcome) and public health non-pharmaceutical interventions (exposure) from five countries: France, Italy, Japan, South Korea, and the USA, December 31, 2019 through April 12, 2020. The public health measures were grouped into five categories: lockdown, movement restrictions, public health measures, social (including social distancing) and economic measures, and use of facial mask. The multiple linear regressions were utilized to test the hypothesis that implementation of some public health measures was associated with the change in the incident number of COVID-19 cases, 2-sided, α = 0.05. Results The incidence of COVID-19 would be significantly greater without lockdown (1.89 times, p-value <.0001), public health and economic measures (25.17, p-value <.0001), and using masks (11.93, p-value=0.002), assuming that all other public health policies are the same. The effectiveness increases with earlier time of implementation. Among considered countries, South Korea was the most efficacious, where all measures were statistically significantly efficacious (p-value <0.05). Conclusions The findings demonstrate an association between public health measures and the outcome. The experience from South Korea should be studied further as the most effective non-pharmacological approach to fight the disease. This paper is the first step to develop the standardized approach utilizing the public health interventions to be applied effectively to the globe population. Key messages the most effective measures to control the COVID-19, and future outbreaks. The effect of particular measure varied by country and time of implementation.


2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Rodrigo Lopez Barreda

In the current medical ethics literature, the concept of agency is receiving growing attention. Nevertheless, many of those definitions are narrow in scope. This article intends to provide a deeper understanding of this concept, allowing for its use in clinical practice and public health policies. First, it revises the current concept of agency and some of its shortcomings. Then, the article presents two philosophical accounts of agency, identifying three relevant features, namely time-extended organised planfulness, endorsement of their own actions, and identification with the activity. Lastly, the article depicts how those features may help in the application of agency to the analysis of health issues by means of a number of examples at the individual and collective levels. When analysing health issues, the health status is a key component, but the process that brought about the outcome must be examined; agency informs about this procedural dimension.


2019 ◽  
Vol 49 (4) ◽  
pp. 531-555 ◽  
Author(s):  
Klaus Hoeyer

‘Personalized medicine’ might sound like the very antithesis of population science and public health, with the individual taking the place of the population. However, in practice, personalized medicine generates heavy investments in the population sciences – particularly in data-sourcing initiatives. Intensified data sourcing implies new roles and responsibilities for patients and health professionals, who become responsible not only for data contributions, but also for responding to new uses of data in personalized prevention, drawing upon detailed mapping of risk distribution in the population. Although this population-based ‘personalization’ of prevention and treatment is said to be about making the health services ‘data-driven’, the policies and plans themselves use existing data and evidence in a very selective manner. It is as if data-driven decision-making is a promise for an unspecified future, not a demand on its planning in the present. I therefore suggest interrogating how ‘promissory data’ interact with ideas about accountability in public health policies, and also with the data initiatives that the promises bring about. Intensified data collection might not just be interesting for what it allows authorities to do and know, but also for how its promises of future evidence can be used to postpone action and sidestep uncomfortable knowledge in the present.


2022 ◽  
Author(s):  
Ozan Aksoy

Compliance with public health measures of adolescents who are often unfairly portrayed as spreaders of the Coronavirus is essential for controlling the pandemic. But does adolescents’ compliance develop independently from their parents? Using nationally representative longitudinal data and cross-lagged Structural Equation Panel Models I study compliance with social distancing measures of 6,754 triplets that comprise the adolescent child (age 19), their mother, and father during two national lockdowns in the UK. Results show that adolescents have the lowest and their mothers have the highest levels of compliance, and compliance generally drops over time. Moreover, parents, particularly mothers have significant influence on their adolescent child’s compliance. The child also has, albeit smaller effects on their parents’ compliance. Parental influence on adolescents’ compliance documented here thus redistributes some of the responsibility off adolescents towards all generations and calls for public health policies and campaigns that consider these family dynamics.


JAMIA Open ◽  
2021 ◽  
Author(s):  
Bo Peng ◽  
Rowland W Pettit ◽  
Christopher I Amos

Abstract Objectives We developed COVID-19 Outbreak Simulator (https://ictr.github.io/covid19-outbreak-simulator/) to quantitatively estimate the effectiveness of preventative and interventive measures to prevent and battle COVID-19 outbreaks for specific populations. Materials and methods Our simulator simulates the entire course of infection and transmission of the virus among individuals in heterogeneous populations, subject to operations and influences, such as quarantine, testing, social distancing, and community infection. It provides command-line and Jupyter notebook interfaces and a plugin system for user-defined operations. Results The simulator provides quantitative estimates for COVID-19 outbreaks in a variety of scenarios and assists the development of public health policies, risk-reduction operations, and emergency response plans. Discussion Our simulator is powerful, flexible, and customizable, although successful applications require realistic estimation and robustness analysis of population-specific parameters. Conclusion Risk assessment and continuity planning for COVID-19 outbreaks are crucial for the continued operation of many organizations. Our simulator will be continuously expanded to meet this need.


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