scholarly journals COVID-19 pandemic causing medical and public health ethical dilemmas: A case report and review of literature

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Jarelys Hernandez ◽  
Barbara Lubrano di Ciccone ◽  
Sarah Thirlwell ◽  
Margaret Booth-Jones ◽  
Sadaf Aslam ◽  
...  
Keyword(s):  
Public Health ◽  
Healthcare Workers ◽  
Hematological Malignancy ◽  
Ethical Dilemmas ◽  
Standard Of Care ◽  
Moral Injury ◽  
Review Of Literature ◽  
Ethical Challenges ◽  
Advanced Directive ◽  
The Public

The COVID-19 pandemic presented myriad of unprecedented and daunting ethical dilemmas to healthcare workers, patients, their families, and the public health. Here we present a case of a 42-years-old Hispanic female with underlying hematological malignancy that developed severe SARS-COV-2 infection amidst the pandemic. This case illustrates some remarkable ethical dilemmas during pandemic times, including the lack of advanced directive planning, the repercussions of restricting family visits, and what ethics in crisis and moral injury entails. Identifying the ethical challenges emerging from the pandemic will assist physicians and other providers in making proper decisions and maintaining the best standard of care.

Navigating the Ethics of Big Data in Public Health

2019 ◽  
pp. 353-367
Author(s):  
Effy Vayena ◽  
Lawrence Madoff
Keyword(s):  
Public Health ◽  
Big Data ◽  
Credit Card ◽  
Health Sector ◽  
Public Health Research ◽  
Ethical Challenges ◽  
The Public ◽  
Health Community ◽  
Digital Disease Detection ◽  
The Public Sphere

“Big data,” which encompasses massive amounts of information from both within the health sector (such as electronic health records) and outside the health sector (social media, search queries, cell phone metadata, credit card expenditures), is increasingly envisioned as a rich source to inform public health research and practice. This chapter examines the enormous range of sources, the highly varied nature of these data, and the differing motivations for their collection, which together challenge the public health community in ethically mining and exploiting big data. Ethical challenges revolve around the blurring of three previously clearer boundaries: between personal health data and nonhealth data; between the private and the public sphere in the online world; and, finally, between the powers and responsibilities of state and nonstate actors in relation to big data. Considerations include the implications for privacy, control and sharing of data, fair distribution of benefits and burdens, civic empowerment, accountability, and digital disease detection.

scholarly journals Mental health care for medical staff and affiliated healthcare workers during the COVID-19 pandemic

2020 ◽  
Vol 9 (3) ◽  
pp. 241-247 ◽  
Author(s):  
Matthew Walton ◽  
Esther Murray ◽  
Michael D Christian
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Health Care ◽  
Medical Staff ◽  
Healthcare Workers ◽  
Valuable Resource ◽  
Public Health Response ◽  
Critical Part ◽  
The Public ◽  
Health Response

The COVID-19 pandemic is an unprecedented challenge for society. Supporting the mental health of medical staff and affiliated healthcare workers (staff) is a critical part of the public health response. This paper details the effects on staff and addresses some of the organisational, team and individual considerations for supporting staff (pragmatically) during this pandemic. Leaders at all levels of health care organisations will find this a valuable resource.

Análise das políticas públicas de saúde do idoso: estudo de revisão de literatura

2009 ◽  
Vol 3 (2) ◽  
pp. 317
Author(s):  
Alessandra Conceição Leite Funchal Camacho ◽  
Maria José Coelho
Keyword(s):  
Public Health ◽  
Public Policies ◽  
The Elderly ◽  
Health Policies ◽  
Review Of Literature ◽  
Publication Type ◽  
Public Health Policies ◽  
The Public ◽  
Knowledge Database ◽  
Revisión Sistemática

ABSTRACTObjective: to examine the public health policies of the elderly in the references of the main databases from 2004 to 2008. Method: study of systematic review of literature conducted on databases of the Library of Health, in September 2008. For information analysis was organized the content found on the year, publication type and methods/techniques, content and essence of the production of knowledge, database, the authors' recommendations. Results: the references that were analyzed 26 and 10 in the database SCIELO, one in the BDENF and 15 in the LILACS. Conclusion: we observed an increase in publications dealing with professionals in health operationalized the public health policies of the elderly as the main recommendations bringing the development of public policies that take into account the specifics of the elderly, facilitating their access and that could reduce inequality. Mention the importance of visibility of the aging process and adequacy of public policies aimed at expansion of the strategies that have the caregiver as the leading subject. Descriptors: health public policy; aged; nursing.RESUMOObjetivo: analisar as políticas públicas de saúde do idoso nas referências das principais bases de dados de 2004 a 2008. Método: estudo de revisão de literatura sistemática realizada nas bases de dados da Biblioteca Virtual da Saúde, em setembro de 2008. Para análise das informações foi realizada a organização do conteúdo encontrado quanto ao ano, tipo de publicação e métodos/técnicas, essência do conteúdo e produção do conhecimento, base de dados, recomendações dos autores. Resultados: as referências analisadas foram 26 sendo 10 na base de dados SCIELO, uma na BDENF e 15 na LILACS. Conclusão: Verificamos um aumento de publicações que tratam de profissionais na área da saúde operacionalizando as políticas públicas de saúde do idoso trazendo como principais recomendações o desenvolvimento de políticas públicas que levem em conta as especificidades do idoso, facilitando o seu acesso e que possam reduzir desigualdades. Referem a relevância da visibilidade do processo de envelhecimento e adequação das políticas públicas visando à ampliação de estratégias que tenham o cuidador como sujeito principal. Descritores: políticas públicas de saúde; idoso; enfermagem.RESUMENObjetivo: analizar las políticas de salud pública a los ancianos en las referencias de las principales bases de datos de 2004 a 2008. Método: estudio de revisión sistemática de literatura sobre las bases de datos de la Biblioteca de la Salud, en setiembre de 2008. Resultados: las referencias que se analizaron fueron 26, tenendo 10 en la base de datos SCIELO, 01 referencia en la BDENF y 15 en el LILACS. Conclusión: se observó un aumento de publicaciones relacionadas a los profesionales de la salud en la práctica las políticas de salud pública de los ancianos con principales recomendaciones sobre el desarrollo de políticas públicas que tengan en cuenta las características específicas de los ancianos, facilitando su acceso y que podrían reducir la desigualdad. Mencionan la importancia de la visibilidad del proceso de envejecimiento y la adecuación de las políticas públicas con la ampliación de estrategias que tienen el cuidador como principal sujeto. Descriptores: políticas públicas de salud; ancianos; enfermería.

Beyond the Boundary Between Science and Values: re-evaluating the moral dimension of the nurse’s role in cot death prevention

2002 ◽  
Vol 9 (2) ◽  
pp. 137-154 ◽  
Author(s):  
Klasien Horstman ◽  
Engeline van Rens-Leenaarts
Keyword(s):  
Public Health ◽  
Ethical Dilemmas ◽  
Public Health Nurses ◽  
The Public ◽  
Cot Death ◽  
Science And Values ◽  
Rules And Principles ◽  
Standards And Guidelines ◽  
Prone Sleeping ◽  
Health Nursing

This article combines a philosophical critique of the idea that public health nurses are primary technicians who neutrally hand over scientifically established facts on risks to the public and an empirical analysis of the actual work of public health nurses. It is argued that the relationship between facts and values in public health is complex and that, despite the introduction of several scientifically-based standards and guidelines, public health nurses are not technicians. They do moral work and experience ethical dilemmas. To get a grip on the specific character of this moral work, we distance ourselves from the idea that there are ethical dilemmas in public health nursing for which we can provide general ethical rules and principles. Instead we suggest a contextual ethical approach, in which several different kinds of consideration may be important. To illustrate this, we analysed 15 in-depth interviews with nurses involved in the prevention of cot deaths in the Netherlands. It is shown that these nurses do not neutrally pass on the epidemiological facts on the risks of prone sleeping, warm bedclothes and passive smoking, but they are the moral architects of this preventive practice. It is also shown that this moral work and the ethical dilemmas they experience cannot be characterized in terms of general ethical rules and principles. It becomes clear that the moral work of nurses differs according to the three main risks at stake: the balance between virtue, risk taking and responsibility depends on the specific context.

scholarly journals Epidemics, genome editing and human rights

2021 ◽  
pp. 199-209
Author(s):  
Branislav Fabry
Keyword(s):  
Public Health ◽  
Human Rights ◽  
Genome Editing ◽  
Legal Regulation ◽  
Western World ◽  
Health Issues ◽  
Ethical Challenges ◽  
The Public ◽  
New Treatment ◽  
The Impact

The article deals with the contemporary legal and ethical challenges, caused by coronavirus COVID-19. It analyses the reason why the western world was so much surprized by that pandemics. The text mentions the succeses of western medicine in the battle against epidemics in the 20th century and sees it as one of the reason for underestimating the public health issues in 21st century. The article also emphasizes on other contemporary threat, the antimicrobiotic resistance and the need for new legal answers to pandemics. It deals with problem of human genome editing as the central topic by creating of hereditary immunity against new viral threats. The text also mentions the risks of such new treatment and the impact on human dignity that is understood as leading value in the contemporary legal regulation on biotechnology.

scholarly journals Assessment of Radiation Risk on Healthcare Workers and Public in & around Two Largest Hospital Campuses of Bangladesh

2021 ◽  
pp. 48-57
Keyword(s):  
Public Health ◽  
Effective Dose ◽  
Healthcare Workers ◽  
Radiation Risk ◽  
Radiation Monitoring ◽  
Radiation Hazard ◽  
Lifetime Cancer Risk ◽  
The Public ◽  
Continuous Radiation ◽  
Yearly Effective Dose

Ionizing radiation gives tremendous benefit to mankind in the hospital through diagnosis and treatment to patients but unnecessary radiation may cause harm to healthcare workers & the public. The purpose of the study is to continuous radiation monitoring in & around the three largest radiological facilities of Bangladesh such as Atomic Energy Centre Dhaka (AECD), Dhaka Medical College Hospital (DMCH) & Bangabandhu Sheikh Mujib Medical University (BSMMU) campuses, and estimation of radiation risk on healthcare workers & public health. Continuous radiation monitoring was performed in & around the AECD, DMCH, BSMMU campuses from August-October 2020 using the Chemiluminescent Dosimeters. The yearly effective doses to healthcare workers and the public due to radiation released from the facilities were ranged from 0.606 ± 0.031 mSv to 0.801 ± 0.0.042 mSv with a mean of 0.707 ± 0.053 mSv. The excess lifetime cancer risk (ELCR) on healthcare workers & public health were evaluated based on the yearly effective dose and ranged from 2.486 Χ 10-3 to 3.287 Χ 10-3 with a mean of 2.900 Χ 10-3. The average yearly effective dose and ELCR on healthcare workers & public health were lower than those of the worldwide permissible values. Continuous radiation monitoring in & around the largest radiological facilities is required for detection of the radiation generating equipment’s malfunctions and improper handling of the radioactive materials. The study would help for minimization of radiation risk on healthcare workers & the public and this keeps the hospital’s environment free from radiation hazard.

scholarly journals Determinants of COVID-19 vaccine hesitancy and vaccine uptake in a national cohort of U.S. adults

2021 ◽  
Author(s):  
Madhura S Rane ◽  
Shivani Kochhar ◽  
Emily Poehlein ◽  
William You ◽  
McKaylee Robertson ◽  
...  
Keyword(s):  
Public Health ◽  
Healthcare Workers ◽  
Vaccine Uptake ◽  
Vaccine Hesitancy ◽  
Lower Odds ◽  
The Public ◽  
National Longitudinal Study ◽  
Public Health Threat ◽  
National Cohort ◽  
The U.S

Background Vaccine hesitancy in the U.S. may limit the potential to alleviate the public health threat caused by the COVID-19 pandemic. Methods We estimated trends in and correlates of vaccine hesitancy, and its association with subsequent vaccine uptake among 5,085 United States adults from the CHASING COVID Cohort study, a national longitudinal study. Trends in willingness to vaccinate were examined longitudinally in three rounds of interviews from September to December 2020. We assessed correlates of willingness to vaccinate in December 2020. We also estimated the association between willingness to vaccinate in December 2020 and subsequent vaccine uptake in February 2021. Results Vaccine hesitancy and resistance decreased from 51% and 8% in September 2020 to 35% and 5% in December 2020, respectively. Compared to Non-Hispanic (NH) White participants, NH Black and Hispanic participants had higher adjusted odds ratios (aOR) for both vaccine hesitancy (aOR: 3.3 [95% CI: 2.6, 4.2] for NH Black and 1.8 [95% CI: 1.5, 2.2] for Hispanic) and vaccine resistance (aOR: 6.4 [95% CI: 4.3, 9.4] for NH Black and 1.9 [95% CI: 1.3, 2.7] for Hispanic). Willingness to vaccinate was associated with lower odds of vaccine uptake among 65+ year olds (aOR: 0.4, 95% CI: 0.3, 0.6 for hesitancy; aOR: 0.1, 95% CI: 0.01, 0.6 for resistance) and healthcare workers (aOR: 0.2, 95% CI: 0.1, 0.3 for hesitancy; aOR: 0.04, 95% CI: 0.006, 0.2 for resistance). Conclusions Awareness and distribution efforts should focus on vaccine hesitant vulnerable populations.

War and Health

2019 ◽  
Keyword(s):  
Public Health ◽  
Social Workers ◽  
Healthcare Workers ◽  
Military Families ◽  
Ethnographic Research ◽  
The Public ◽  
Us Military ◽  
The People ◽  
The Us ◽  
Drone Strikes

War affects human lives and public health far beyond the battlefield, long after combat ceases. Based on ethnographic research by anthropologists, healthcare workers, social workers, and activists, these chapters cover a range of subjects from maternal health in Afghanistan, to the public health effects of US drone strikes in Pakistan, to Iraq’s deteriorating cancer care system, to the struggles of US military families to recover from combat-related trauma, among other topics. With a spotlight on the US-led wars in Afghanistan, Iraq, and Pakistan, started ostensibly to root out terrorism, the book argues that the terror and wounds of war have no clear resolution for the people who experience it, and for the communities where battles are fought.

Whole-genome sequencing for TB source investigations: principles of ethical precision public health

2021 ◽  
Vol 25 (3) ◽  
pp. 222-227
Author(s):  
A. Van Rie ◽  
D. G. de Viedma ◽  
C. Meehan ◽  
I. Comas ◽  
T. H. Heupink ◽  
...  
Keyword(s):  
Public Health ◽  
Whole Genome Sequencing ◽  
Real Time ◽  
Genome Sequencing ◽  
Sensitive Information ◽  
Whole Genome ◽  
Ethical Challenges ◽  
Personal Privacy ◽  
The Public ◽  
The Right

BACKGROUND: Whole-genome sequencing (WGS) of Mycobacterium tuberculosis allows rapid, accurate inferences about the sources, location and timing of transmission. However, in an era of heightened concern for personal privacy and science distrust, such inferences could result in unintended harm and undermine the public´s trust.METHODS: We held interdisciplinary stakeholder discussions and performed ethical analyses of real-world illustrative cases to identify principles that optimise benefit and mitigate harm of M. tuberculosis WGS‐driven TB source investigations.RESULTS: The speed and precision with which real‐time WGS can be used to associate M. tuberculosis strains with sensitive information has raised important concerns. While detailed understanding of transmission events could mitigate harm to vulnerable patients and communities when otherwise unfairly blamed for TB outbreaks, the precision of WGS can also identify transmission events resulting in social blame, fear, discrimination, individual or location stigma, and the use of defaming language by the public, politicians and scientists. Public health programmes should balance the need to safeguard privacy with public health goals, transparency and individual rights, including the right to know who infects whom or where.CONCLUSIONS: Ethical challenges raised by real‐time WGS‐driven TB source investigation requires public health authorities to move beyond their current legal mandate and embrace transparency, privacy and community engagement.

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