scholarly journals COVID-19 Pandemic in Thailand: Implementing Containment Measures and Their Ethical Challenges

2020 ◽  
Author(s):  
Hongsuda Sornklin ◽  
Thitiwan Kerdsomboon ◽  
Yongyuth Yuthavong ◽  
Prasit Palittapongarnpim ◽  
Soraj Hongladarom ◽  
...  

Abstract Containment measures have been implemented in Thailand after the country was hit by the Covid-19 pandemic. The top priority is to save people’s lives. Unavoidably, serious consequences that affected the people’s income, privacy, needs, equality, and equity emerged, presenting new challenges. In order to begin to investigate these complex ethical questions, the Office of Research Integrity of National Science and Technology Development Agency organized a meeting in order to bring together key experts in various fields related to the Covid-19 pandemic to discuss what was going on in Thailand and how to manage it properly. Three key ethical settings, each of which caused significant effects, were discussed in the meeting, namely public health, medical services, and research and clinical trial settings. Many key ethical issues were revealed during the meeting, as well as how best to address and manage them properly.

Author(s):  
Maxwell Smith ◽  
Ross Upshur

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.


Author(s):  
Alessandro Blasimme ◽  
Effy Vayena

This chapter explores ethical issues raised by the use of artificial intelligence (AI) in the domain of biomedical research, healthcare provision, and public health. The litany of ethical challenges that AI in medicine raises cannot be addressed sufficiently by current regulatory and ethical frameworks. The chapter then advances the systemic oversight approach as a governance blueprint, which is based on six principles offering guidance as to the desirable features of oversight structures and processes in the domain of data-intense biomedicine: adaptivity, flexibility, inclusiveness, reflexivity, responsiveness, and monitoring (AFIRRM). In the research domain, ethical review committees will have to incorporate reflexive assessment of the scientific and social merits of AI-driven research and, as a consequence, will have to open their ranks to new professional figures such as social scientists. In the domain of patient care, clinical validation is a crucial issue. Hospitals could equip themselves with “clinical AI oversight bodies” charged with the task of advising clinical administrators. Meanwhile, in the public health sphere, the new level of granularity enabled by AI in disease surveillance or health promotion will have to be negotiated at the level of targeted communities.


2022 ◽  
Vol 6 ◽  
pp. 263
Author(s):  
Melati Nungsari ◽  
Chuah Hui Yin ◽  
Nicole Fong ◽  
Veena Pillai

Background: Globally, vulnerable populations have been disproportionately affected by the COVID-19 pandemic and subsequent responses, such as lockdown measures and mass vaccinations. Numerous ethical challenges have arisen at different levels, be it at the policy-making level or on the ground. For example, policymakers have to contain a highly contagious disease with high morbidity using scarce resources, while minimizing the medium- to long-term social and economic impacts induced by containment measures. This study explores the impact of COVID-19 on vulnerable populations in Malaysia by using an intersectional framework that accounts for overlapping forms of marginalization.   Methods: This study utilizes in-depth qualitative data obtained from 34 individuals and organizations to understand the impact of the COVID-19 outbreak on vulnerable populations in Malaysia. We utilize four principles of ethics to guide our coding and interpretation of the data – namely beneficence, non-maleficence, justice and autonomy. We utilize a frequency analysis to roughly understand the types of ethical issues that emerged. Using hermeneutic content analysis (HCA), we then explore how the principles interact with each other. Results: Through the frequently analysis, we found that although beneficence was very prevalent in our dataset, so was a significant amount of harm – as perpetuated through injustice, the removal or lack of autonomy and maleficence. We also unearthed a worrying landscape of harm and deep systemic issues associated with a lack of support for vulnerable households – further exacerbated during the pandemic. Conclusions: Policy recommendations for aid organizations and society to mitigate these ethical problems are presented, such as long overdue institutional reforms and stronger ethical practices rooted in human rights principles, which government agencies and aid providers can then use in the provision of aid to vulnerable populations.


2021 ◽  
Vol 6 ◽  
pp. 263
Author(s):  
Melati Nungsari ◽  
Hui Yin Chuah ◽  
Nicole Fong ◽  
Veena Pillai

Background: Globally, vulnerable populations have been disproportionately affected by the COVID-19 pandemic and subsequent responses, such as lockdown measures and mass vaccinations. Numerous ethical challenges have arisen at different levels, be it at the policy-making level or on the ground. For example, policymakers have to contain a highly contagious disease with high morbidity using scarce resources, while minimizing the medium- to long-term social and economic impacts induced by containment measures. This study explores the impact of COVID-19 on vulnerable populations in Malaysia by using an intersectional framework that accounts for overlapping forms of marginalization.   Methods: This study utilizes in-depth qualitative data obtained from 34 individuals and organizations to understand the impact of the COVID-19 outbreak on vulnerable populations in Malaysia. We utilize four principles of ethics to guide our coding and interpretation of the data – namely beneficence, non-maleficence, justice and autonomy. We utilize a frequency analysis to roughly understand the types of ethical issues that emerged. Using hermeneutic content analysis (HCA), we then explore how the principles interact with each other. Results: Through the frequently analysis, we found that although beneficence was very prevalent in our dataset, so was a significant amount of harm – as perpetuated through injustice, the removal or lack of autonomy and maleficence. We also unearthed a worrying landscape of harm and deep systemic issues associated with a lack of support for vulnerable households – further exacerbated during the pandemic. Conclusions: Policy recommendations for aid organizations and society to mitigate these ethical problems are presented, such as long overdue institutional reforms and stronger ethical practices rooted in human rights principles, which government agencies and aid providers can then use in the provision of aid to vulnerable populations.


Author(s):  
Laura Greisman ◽  
Barbara Koenig ◽  
Michele Barry

This chapter delves into the ethical issues surrounding the implementation of public health interventions for control of mosquito-borne illnesses. Emerging and reemerging mosquito-borne infections remain a public health threat worldwide, prompting public health agencies to strengthen individual and population-wide measures for mosquito control. Ethical issues surrounding surveillance activities and key public health interventions for mosquito control are discussed, including provision of insecticide-treated nets (ITNs), the spraying of aerial pesticides, and the introduction of genetically modified mosquitoes. A case study of Zika virus disease highlights specific ethical challenges surrounding the safety of insect repellent use in pregnancy and the complex issue of women’s reproductive rights arising in a fast-moving epidemic. The chapter emphasizes the need for community engagement at all levels of mosquito control interventions, and it highlights the disproportionate impact of mosquito-borne disease on the poor, calling to action the need to strengthen health systems in low- and middle-income countries.


2020 ◽  
Vol 24 (5) ◽  
pp. 27-31
Author(s):  
P. Hummel ◽  
N. Ahamed ◽  
F. Amanullah

Each year, at least one million children become ill with tuberculosis (TB) and more than 253 000 died of TB in 2016. The ethical issues surrounding childhood TB remain underexplored, and established or proposed management strategies are scarce. In this paper, we identify ethical challenges that are raised by childhood TB. Some of them are familiar from TB in other populations but arise with increased severity in children. We discuss interconnected and mutually reinforcing difficulties clustered around the topics of susceptibility, diagnosis, reporting, service provision, treatment, psychological and social support, and research and development (R&D) neglect. We formulate suggestions on how to address these ethical issues. For developing sound research agendas and policies based on the WHO End TB Strategy, it is essential that diagnosis and reporting improve. There is a duty to care for and provide available interventions to children with TB even if they are not a major source of transmission, and therefore no major impact on public health is expected. Treatment should be accompanied by counselling, health education, psychological and material support to TB-affected children and their families. Children need to be included equitably and more systematically into the TB research agenda.


2018 ◽  
Author(s):  
Lester Darryl Geneviève ◽  
Andrea Martani ◽  
Tenzin Wangmo ◽  
Daniela Paolotti ◽  
Carl Koppeschaar ◽  
...  

UNSTRUCTURED Advances in information technology are changing public health at an unprecedented rate. Participatory surveillance systems are contributing to public health by actively engaging digital (eg, Web-based) communities of volunteer citizens to report symptoms and other pertinent information on public health threats and also by empowering individuals to promptly respond to them. However, this digital model raises ethical issues on top of those inherent in traditional forms of public health surveillance. Research ethics are undergoing significant changes in the digital era where not only participants’ physical and psychological well-being but also the protection of their sensitive data have to be considered. In this paper, the digital platform of Influenzanet is used as a case study to illustrate those ethical challenges posed to participatory surveillance systems using digital platforms and mobile apps. These ethical challenges include the implementation of electronic consent, the protection of participants’ privacy, the promotion of justice, and the need for interdisciplinary capacity building of research ethics committees. On the basis of our analysis, we propose a framework to regulate and strengthen ethical approaches in the field of digital public health surveillance.


2021 ◽  
Vol 14 ◽  
pp. 251686572110636
Author(s):  
Eline M Bunnik ◽  
Ineke LLE Bolt

New epigenomics technologies are being developed and used for the detection and prediction of various types of cancer. By allowing for timely intervention or preventive measures, epigenomics technologies show promise for public health, notably in population screening. In order to assess whether implementation of epigenomics technologies in population screening may be morally acceptable, it is important to understand – in an early stage of development – ethical and societal issues that may arise. We held 3 focus groups with experts in science and technology studies (STS) (n = 13) in the Netherlands, on 3 potential future applications of epigenomic technologies in screening programmes of increasing scope: cervical cancer, female cancers and ‘global’ cancer. On the basis of these discussions, this paper identifies ethical issues pertinent to epigenomics-based population screening, such as risk communication, trust and public acceptance; personal responsibility, stigmatisation and societal pressure, and data protection and data governance. It also points out how features of epigenomics (eg, modifiability) and changing concepts (eg, of cancer) may challenge the existing evaluative framework for screening programmes. This paper aims to anticipate and prepare for future ethical challenges when epigenomics technologies can be tested and introduced in public health settings.


Author(s):  
Enitan SS ◽  
Oyekale AO ◽  
Akele RY ◽  
Olawuyi KA ◽  
Olabisi EO ◽  
...  

Background: Developing an effective and safe COVID-19 vaccine is a global public health necessity in containing the pandemic, however, recruiting volunteers can be challenging in a clinical trial phase because of poor knowledge, negative perception, ethical issues and safety concerns.


Author(s):  
Omrana Pasha ◽  
Myra F. Hyder ◽  
Adnan A. Hyder

This chapter discusses the ethical issues and impact of interpersonal and self-directed violence on the health of the global population. Interpersonal and self-directed violence (self-harm) are leading causes of death and disability globally, and international guidelines recommend provision of services to those affected by violence, research into the prevalence of violence, and advocacy and training to prevent violence. Importantly, public health practice and research on violence present both global and context-specific ethical challenges. This chapter describes the impact of violence on public health, the role of public health practitioners in addressing violence, fundamental ethical principles and guidelines for public health workers to address violence, and ethical challenges for research and programs dealing with violence, including fair approaches to violence screening and response, safe means of collecting data about violence, reducing risks when resources are limited, and autonomy versus paternalism in suicide management. The chapter concludes by suggesting strategies for the ethical practice of public health in the context of violence.


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