Towards an actionable One Health approach.

BACKGROUND: Despite the increasing focus on strengthening One Health capacity building on global level, challenges remain in devising and implementing real-world interventions particularly in the Asia-Pacific region. Recognizing these gaps, the One Health Action Commission (OHAC) was established as an academic community for One Health action with an emphasis on research agenda setting to identify actions for highest impact. MAIN TEXT: This viewpoint describes the agenda of, and motivation for, the recently formed OHAC. Recognizing the urgent need for evidence to support the formulation of necessary action plans, OHAC advocates the adoption of both bottom-up and top-down approaches to identify the current gaps in combating zoonoses, antimicrobial resistance, addressing food safety, and to enhance capacity building for context-sensitive One Health implementation. CONCLUSIONS: By promoting broader engagement and connection of multidisciplinary stakeholders, OHAC envisions a collaborative global platform for the generation of innovative One Health knowledge, distilled practical experience and actionable policy advice, guided by strong ethical principles of One Health.

Digital Humans to Combat Loneliness and Social Isolation: Ethics Concerns and Policy Recommendations.

Social isolation and loneliness are growing concerns around the globe that put people at increased risk of disease and early death. One much-touted approach to addressing them is deploying artificially intelligent agents to serve as companions for socially isolated and lonely people. Focusing on digital humans, we consider evidence and ethical arguments for and against this approach. We set forth and defend public health policies that respond to concerns about replacing humans, establishing inferior relationships, algorithmic bias, distributive justice, and data privacy.

Dying a lonely death: A conceptual and normative analysis.

This paper argues that a lonely death is, by definition, a bad death and that society as a whole, as well as individuals in society are obligated to assure a certain degree of well-being, flourishing, or care among and for fellow individuals. Individuals can then be said to have a right against dying a lonely death. Such a right has corresponding duties. The paper further specifies what such duties may entail based on what individuals may need on their deathbed, specifically focusing on the need for human touch. Assuming that human touch might indeed be needed by some individuals in order to avoid a lonely death, the paper explores potential implications from a public health perspective, particularly during infectious disease outbreaks such as COVID.

The duty of care and the right to be cared for: is there a duty to treat the unvaccinated?

Vaccine hesitancy or refusal has been one of the major obstacles to herd immunity against Covid-19 in high-income countries and one of the causes for the emergence of variants. The refusal of people who are eligible for vaccination to receive vaccination creates an ethical dilemma between the duty of healthcare professionals (HCPs) to care for patients and their right to be taken care of. This paper argues for an extended social contract between patients and society wherein vaccination against Covid-19 is conceived as essential for the protection of the right of healthcare providers to be taken care of. Thus, a duty of care is only valid when those who can receive vaccination actually receive it. Whenever that is not the case, the continuing functioning of HCPs can only be perceived as supererogatory and not obligatory.

Against loneliness we unite: A solidarity-based account of loneliness.

Loneliness is ubiquitous and is bad for our health, making it a bioethical concern. It is perhaps true now more than ever before. Recent publications in bioethics have discussed loneliness in the context of responsibility, solidarity, and autonomy, especially relational autonomy. In this paper, I elaborate on the relation between solidarity and loneliness, proposing an account of loneliness as lack of solidarity. Some cases of loneliness, I argue, may be defined and explained by not having someone to identify with you in some relevant aspect or without someone to assist you. I specifically use the work of George Orwell to make my case.

The Human Genome Organisation (HUGO) and a vision for Ecogenomics: the Ecological Genome Project.

BACKGROUND: The following outlines ethical reasons for widening the Human Genome Organisation's (HUGO) mandate to include ecological genomics. MAIN: The environment influences an organism's genome through ambient factors in the biosphere (e.g. climate and UV radiation), as well as the agents it comes into contact with, i.e. the epigenetic and mutagenic effects of inanimate chemicals and pollution, and pathogenic organisms. Emerging scientific consensus is that social determinants of health, environmental conditions and genetic factors work together to influence the risk of many complex illnesses. That paradigm can also explain the environmental and ecological determinants of health as factors that underlie the (un)healthy ecosystems on which communities rely. We suggest that The Ecological Genome Project is an aspirational opportunity to explore connections between the human genome and nature. We propose consolidating a view of Ecogenomics to provide a blueprint to respond to the environmental challenges that societies face. This can only be achieved by interdisciplinary engagement between genomics and the broad field of ecology and related practice of conservation. In this respect, the One Health approach is a model for environmental orientated work. The idea of Ecogenomics-a term that has been used to relate to a scientific field of ecological genomics-becomes the conceptual study of genomes within the social and natural environment. CONCLUSION: The HUGO Committee on Ethics, Law and Society (CELS) recommends that an interdisciplinary One Health approach should be adopted in genomic sciences to promote ethical environmentalism. This perspective has been reviewed and endorsed by the HUGO CELS and the HUGO Executive Board.

Using Ethics Committees to Justify Force-Feeding Political Prisoners in Israel.

Thousands of Palestinian prisoners are held in Israeli prisons without trial. For some of them, engaging in hunger strikes is the last resort in opposing unlawful detention and inhumane prison conditions. While mainstream bioethics deliberation, reasonable arguments, and international legal and medical professional declarations prohibit force-feeding, local ethical deliberations, professional medical guidelines, and legislation allow the use of medical judgment and clinical ethics committees to force-feed these prisoners. Until now, Israeli physicians have refused to do so, but this may change in the future. The international medical and bioethics communities need to stand behind these medical professionals, as well as prisoners. Clinical ethics committees in Israel must choose whether they serve the interests of these prisoner-patients and perhaps their political or human rights agenda, or whether they are subservient to an unjust, oppressive regime.

The responsibility of bioethicists: The case study of Yemen.

In this article, we describe in detail the health and general living conditions resulting from the ongoing armed conflict in Yemen, including the historical and geopolitical underpinnings. In addition to mere reporting, we use Yemen as a case study to examine the responsibility of bioethicists in general. We find it unacceptable that bioethics neglects the largest humanitarian crisis taking place in the world at the moment as well as the largest Cholera outbreak in history. We argue that bioethicists should do more to address armed conflicts and their resulting basic human rights violations. We end with a few recommendations to prevent such neglect.

Tackling global health security by building an academic community for One Health action.

BACKGROUND: One Health approach is crucial to tackling complex global public health threats at the interface of humans, animals, and the environment. As outlined in the One Health Joint Plan of Action, the international One Health community includes stakeholders from different sectors. Supported by the Bill & Melinda Gates Foundation, an academic community for One Health action has been proposed with the aim of promoting the understanding and real-world implementation of One Health approach and contribution towards the Sustainable Development Goals for a healthy planet. MAIN TEXT: The proposed academic community would contribute to generating high-quality scientific evidence, distilling local experiences as well as fostering an interconnected One Health culture and mindset, among various stakeholders on different levels and in all sectors. The major scope of the community covers One Health governance, zoonotic diseases, food security, antimicrobial resistance, and climate change along with the research agenda to be developed. The academic community will be supported by two committees, including a strategic consultancy committee and a scientific steering committee, composed of influential scientists selected from the One Health information database. A workplan containing activities under six objectives is proposed to provide research support, strengthen local capacity, and enhance global participation. CONCLUSIONS: The proposed academic community for One Health action is a crucial step towards enhancing communication, coordination, collaboration, and capacity building for the implementation of One Health. By bringing eminent global experts together, the academic community possesses the potential to generate scientific evidence and provide advice to local governments and international organizations, enabling the pursuit of common goals, collaborative policies, and solutions to misaligned interests.

Loneliness-a clinical primer.

INTRODUCTION: loneliness is prevalent worldwide. It is also associated with an increased risk for depression, high blood pressure, cardiovascular disease, stroke and early death. As such, loneliness is a major public health issue. This paper summarizes the salient points clinicians should know and encourages clinicians to assume an active part in the identification, mitigation and prevention of loneliness. SOURCES OF DATA: white papers, academic publications. AREAS OF AGREEMENT: loneliness is a distressful subjective experience, which does not always correlate with social isolation. Both internal (personal) and external (contextual, societal) factors determine whether an individual would feel lonely in a given situation. AREAS OF CONTROVERSY: identifying loneliness in the clinic may be time consuming and challenging. There is a scarce robust evidence to support interventions. GROWING POINTS: due to increased individualization and incidence of infectious diseases, loneliness is likely to become even more prevalent. AREAS TIMELY FOR DEVELOPING RESEARCH: more research is needed to further elucidate the health impacts of loneliness as well as to find evidence-based interventions to prevent and mitigate loneliness that could then be implemented by policy-makers and clinicians.

Eating in Isolation: A Normative Comparison of Force Feeding and Solitary Confinement.

The practice of solitary confinement (SC) is established within the literature as a common occurrence of torture within the prison system, and many international and national human rights organizations have called for its abolition. A somewhat more contentious topic in the literature is the practice of force feeding (FF) of hunger-striking prisoners. The paper aims to make a case against FF by establishing a parity argument that states the following: If SC is considered an immoral practice (and indeed it should be), it should follow that FF is morally impermissible as well. In conclusion, this paper will argue that FF of hunger-striking prisoners is a violation of their fundamental moral rights and constitutes cruel and inhumane treatment and, therefore, should be abolished.

Loneliness at the age of COVID-19.

Loneliness has been a major concern for philosophers, poets and psychologists for centuries. In the past several decades, it has concerned clinicians and public health practitioners as well. The research on loneliness is urgent for several reasons. First, loneliness has been and still is extremely ubiquitous, potentially affecting people across multiple demographics and geographical areas. Second, it is philosophically intriguing, and its analysis delves into different branches of philosophy including phenomenology, existentialism, philosophy of mind, etc. Third, empirical research has shown that loneliness is a significant health risk factor. Loneliness may thus be defined as a (negative) social determinant of health.Having that said, COVID-19 has demonstrated how little we as members of humanity have been prepared to face the loneliness resulting from the global response to the virus. As people worldwide are literally dying from loneliness, we still do not know what makes one feel lonely while making another feel being in solitude, or how is it that one feels lonely in the heart of London.In this essay, I first review loneliness in general and specifically in the context of COVID-19. I then argue that loneliness should be understood as a social determinant of health. Lastly, I argue that individuals have a right not to be lonely. Such right stems in turn from the right to healthcare or even a right to health.

Technological solutions to loneliness-Are they enough?

Loneliness is a major public health concern, particularly during pandemics such as Covid. It is extremely common, and it poses a major risk to human health. Technological solutions including social media, robots, and virtual reality have been advocated and implemented to relieve loneliness, and their use will undoubtedly increase in the near future. This paper explores the use of technological solutions from a normative perspective, asking whether and to what extent such measures should indeed be relied upon. The conclusion is that technological solutions are unquestionably part of the solution to loneliness, but that they cannot and should not constitute the whole solution. It is important to note that this is not a straw-man argument, as several organizations and scholars have strictly focused on such technological solutions for loneliness.

Responsibility and vaccine nationalism in the Israeli-Palestinian conflict.

In this article we articulate a case from moral responsibility to assist Palestinians living in the Occupied Palestinian Territory (OPT). We contextualize this responsibility by focusing on access to healthcare and the provision of vaccines against COVID-19. We specifically present two arguments from responsibility, one that is global or cosmopolitan, and one that is country-specific. For the latter, we focus on Israel.

Social Robots to Fend Off Loneliness?

Social robots are increasingly being deployed to address social isolation and loneliness, particularly among older adults. Clips on social media attest that individuals availing themselves of this option are pleased with their robot companions. Yet, some people find the use of social robots to meet fundamental human emotional needs disturbing. This article clarifies and critically evaluates this response. It sets forth a framework for loneliness, which characterizes one kind of loneliness as involving an affective experience of lacking human relations that provide certain social goods. Next, the article discusses social robots and critically reviews the literature on the ethics of using them in light of this loneliness characterization. Third, we present a normative argument connecting the philosophical critique of loneliness-as-absence with the design and deployment of social robots. Finally, we draw out the implications of our analysis for public health and for interrogating the aims of commercial companies who make social robots.

Zoonoses and Animal Culling: The Need for One Health Policy.

One Health (OH) as a biomedical and social movement calls to reorient public health approaches toward more holistic, nonanthropocentric approaches that do not exclude the interests of animals and ecosystems. OH thus urges reexamination, from both scientific and moral perspectives, of the practice of culling pet, farm, or wild animals in the face of a zoonosis. Pandemics such as Covid and monkeypox highlight the need for more rigorous analysis of the justifications traditionally provided to back these culling practices. Such analyses should then ground reasonable OH policies and legislation that consider the rights of humans, animals, and the environment. Bill S.861, "Advancing Emergency Preparedness through One Health Act of 2021," which was introduced in the U.S. Congress, is a step in the right direction.