[On the issues of additional public support of workers involved in medical care support during period of COVID-19].

The article considers issues of organizational and legal progress of social protection of workers involved in medical care during period of COVID-19. The purpose of the study is to analyze regulatory legal documents that define state guarantees that provide social protection for persons involved in the provision of medical care during COVID-19. The attempt was made to analyze international and national information on relevant morbidity, mortality and disability of health care workers, but respective data was not readily available in open admission. The analysis of international documents (the WHO, CDC, JHU reports), public documents of the Russian Federation, information from official websites of the President of the Russian Federation and the executive authorities of the Russian Federation (state reports on sanitary and epidemiological well-being of the population in the Russian Federation in 2020-2022) demonstrated the following. The whole world faced with the problem of protecting health care workers from contamination with new corona-virus infection. In the Russian Federation, unprecedented measures were taken to ensure social protection for this category of workers, including provision of additional social benefits.

Professional Standards for Specialist Medical Administrators: Over-the-top Downunder?

In Australia, there are only two publicly reported disciplinary cases against specialist medical administrators. In the most recent decision of Medical Board of Australia v Gruner, the Victorian Civil and Administrative Tribunal confirmed that specialist medical administrators owe patients and the public the same professional obligations as medical practitioners with direct patient contact. More controversially, the Tribunal also held that medical administrators have a professional obligation only to accept roles with clear position descriptions that afford them sufficient time and resources to ensure the safe delivery of health services. We argue that this imposes unrealistic expectations on medical administrators engaged by rural, regional, or private health services that already struggle to attract and retain specialist medical expertise. This may exacerbate existing health inequalities by disincentivising specialist medical administrators from seeking fractional appointments that assist under-funded areas of workforce shortage.

Do Physicians Have a Duty to Support Secondary Use of Clinical Data in Biomedical Research? An Inquiry into the Professional Ethics of Physicians.

Secondary use of clinical data in research or learning activities (SeConts) has the potential to improve patient care and biomedical knowledge. Given this potential, the ethical question arises whether physicians have a professional duty to support SeConts. To investigate this question, we analyze prominent international declarations on physicians' professional ethics to determine whether they include duties that can be considered as good reasons for a physicians' professional duty to support SeConts. Next, we examine these documents to identify professional duties that might conflict with a potential duty of physicians to support SeConts.

Wealth creation without domination. The fiduciary duties of corporations.

Corporations wield power in today's economies, and political theories of the corporation argue about the legitimacy conditions of corporate power. This paper argues in favour of a double-fiduciary theory for corporations. Based on a concession theory of markets, it sees all markets as authorized by states (in the name of society), for the purpose of creating economic value, or wealth. Hence corporations, as much as non-incorporated firms, have a fiduciary duty to the state/society to create wealth, in the competitive structure of the market. However, their pursuit of wealth often creates unbalanced relations of power between corporations and their stakeholders, which can at some point be classified as instances of domination. Therefore, corporations need to be subjected to a second fiduciary duty, i.e. not to dominate others in the economy. This duty is also, in the final instance, owed to the state/society. In an era when everyone can incorporate their business, states/societies can be interpreted as having, through corporate law, mandated shareholders as 'proximate beneficiaries', to incentivize corporations to create wealth. Now states/societies need to think about how to prevent corporations from dominating others. New mechanisms of accountability towards stakeholders and/or citizens as proximate beneficiaries are needed. Only in this way can corporations be effectively held to account for both of the fiduciary duties which characterize their normative status.

Navigating conflicts of reproductive rights: Unbundling parenthood and balancing competing interests.

Advances in assisted reproductive technologies can give rise to several ethical challenges. One of these challenges occurs when the reproductive desires of two individuals become incompatible and conflict. To address such conflicts, it is important to unbundle different aspects of (non)parenthood and to recognize the corresponding reproductive rights. This article starts on the premise that the six reproductive rights-the right (not) to be a gestational, genetic, and social parent-are negative rights that do not entail a right to assistance. Since terminating or continuing a pregnancy is a form of assistance, the right (not) to be a gestational parent should enjoy primacy in conflicts. However, while refusing assistance may hinder the reproductive project of another person, "prior assistance" does not entitle someone to violate a reproductive right. Therefore, our analysis provides reasons to argue that someone has a right to unilaterally use cryopreserved embryos or continue the development of an entity in an extracorporeal gestative environment (i.e., ectogestation). Although this could lead to a violation of the right not to be a genetic parent, it does not necessarily entail a violation of the right not to be a social parent.

Prevalence, risk factors and psychological consequences of workplace violence among health workers in the Greater Accra region, Ghana: a cross-sectional study.

BACKGROUND: Globally, close to one-third of all workplace violence (WV) occurs in the health sector. Exposure to WV among healthcare professionals in Ghana has been widely speculated, but there is limited evidence on the problem. This study therefore investigated WV, its risk factors, and the psychological consequences experienced by health workers in Ghana. METHODS: An analytic cross-sectional study was conducted in the Greater Accra region from January 30 to May 31, 2023, involving selected health facilities. The participants for the study were selected using a simple random sampling technique based on probability proportional-to-size. The data analyses were performed using STATA 15 software. Logistic regression analyses were employed to identify the factors associated with WV, considering a significance level of p-value < 0.05. RESULTS: The study was conducted among 607 healthcare providers and support personnel across 10 public and private hospitals. The lifetime career, and one-year exposure to any form of WV was 414 (68.2%) [95% CI: (64.3-71.9%)] and 363 (59.8%) [95% CI: (55.8-63.7%)], respectively. Compared to other forms of WV, the majority of healthcare workers, 324 (53.4%) experienced verbal abuse within the past year, and a greater proportion, 85 (26.2%) became 'super alert' or vigilant and watchful following incidents of verbal abuse. Factors significantly linked to experiencing any form of WV in the previous 12 months were identified as follows: older age [AOR = 1.11 (1.06, 1.17)], working experience [AOR = 0.91 (0.86, 0.96)], having on-call responsibilities [AOR = 1.75 (1.17, 2.61)], and feeling adequately secure within health facility [AOR = 0.45 (0.26, 0.76)]. CONCLUSION: There was high occurrence of WV, and verbal abuse was the most experienced form of WV. Age, work experience, on-call duties, and security within workplace were associated with exposure to WV. Facility-based interventions are urgently needed to curb the incidence of WV, especially verbal abuse.

A profile of occupational tasks performed by mounted police officers.

BACKGROUND: Within individual policing organisations, there are a wide variety of units and job roles. OBJECTIVE: To profile the occupational tasks performed by Australian mounted police officers, aiming to offer conditioning insight into this unique job role. METHODS: Thirteen fully qualified and operational mounted police officers (n = 11 females), who served in the mounted police unit for ∼3.3 (±2.3) years, participated in this observational cohort study. Participants completed a survey outlining common occupational tasks and were monitored throughout four consecutive shifts. Participants' heart rate (HR), respiratory rate (RR), and skin temperature (ST) data were collected via wearable monitoring (Equivital EQ-02, Hidalgo, UK) and body position, physical activity undertaken, task effort, and load carriage were recorded by researchers. A one-way ANOVA was used to assess mean differences in physiological measures between the three most reported tasks. RESULTS: Survey identified 130 tasks, with 38 listed as most common. The three most reported mounted police tasks were: 'horse riding' (n = 13, 34%), 'mounted patrols' (n = 10, 26%), and 'horse care' (n = 10, 26%). These were also reported as the most physically demanding. HR during 'horse care' and 'horse riding' were significantly higher than when 'mounted patrolling' (27±7bpm, p = 0.001 and 33±8bpm; p = 0.001, respectively). Mean RR was higher when 'horse riding' when compared to 'horse care' (5.3±1.6brpm) and 'mounted patrol' (8.5±1.9brpm). CONCLUSION: Mounted police officers experience unique physiological challenges throughout their routine occupational tasks. This study highlights the significance of understanding occupation-specific tasks and stressors undertaken by mounted police to develop relevant conditioning, rehabilitation, and monitoring procedures.

The harm threshold and Mill's harm principle.

The Harm Threshold (HT) holds that the state may interfere in medical decisions parents make on their children's behalf only when those decisions are likely to cause serious harm to the child. Such a high bar for intervention seems incompatible with both parental obligations and the state's role in protecting children's well-being. In this paper, I assess the theoretical underpinnings for the HT, focusing on John Stuart Mill's Harm Principle as its most plausible conceptual foundation. I offer (i) a novel, text-based argument showing that Mill's Harm Principle does not give justificatory force to the HT; and (ii) a positive account of some considerations which, beyond significant harm, would comprise an intervention principle normatively grounded in Mill's ethical theory. I find that substantive recommendations derived from Mill's socio-political texts are less laissez-faire than they have been interpreted by HT proponents. Justification for state intervention owes not to the severity of a harm, but to whether that harm arises from the failure to satisfy one's duty. Thus, a pediatric intervention principle derived from Mill ought not to be oriented around the degree of harm caused by a parent's healthcare decision, but rather, the kind of harm-specifically, whether the harm arises from violation of parental obligation. These findings challenge the interpretation of Mill adopted by HT proponents, eliminating a critical source of justification for a protected domain of parental liberty and reorienting the debate to focus on parental duties.

Development of infection prevention program standards for critical access hospitals.

Although critical access hospitals are small, the expected infection prevention activities remain extensive. Program standards, aligned with the Association for Professionals in Infection Control and Epidemiology infection prevention competency model domains, were developed and implemented in a midwestern health care system. Time estimates for completion of each activity were assigned and then extrapolated to offer guidance on necessary full-time equivalents for adequate staffing.

[Guardianship law - what doctors and patients should know about the latest amendment]. / Das reformierte Betreuungsrecht und die Folgen für die Arztpraxis.

With the latest amendment of the guardianship law the German legislator means to strengthen the patients' right of self-determination. The most significant new regulations are the introduction of mutual legal representation of married couples in emergency and changes restricting the guardian's legal position. New challenges for doctors and lawyers arise especially from the legal representation of married couples. General practitioners who advise their patients with the preparation of provision documents should particularly explain the importance of recordations in the central providing register (ZVR).

Experiences of Infection Prevention and Control Nurses (IPCNs) in performing their roles and duties in the Indonesia Army Central Hospital: A qualitative descriptive study.

Background: The Infection Prevention and Control Nurse (IPCN) is a professional nurse with a crucial role in promoting patient safety and service quality by preventing and controlling infections. However, little is known about their experiences regarding their roles and duties, particularly in Indonesia. Objective: This study aimed to explore IPCNs' experiences in performing their roles and responsibilities, including motivations and obstacles encountered, as well as organizational support while carrying out their jobs. Methods: This research used a qualitative descriptive study design, collecting data through Focus Group Discussions (FGDs) with six purposively sampled participants in April 2021 at the Gatot Soebroto Army Central Hospital (RSPAD), Jakarta, Indonesia. Thematic analysis was used to analyze the data. Results: Five themes were identified: 1) roles and duties of IPCNs, 2) conducive work environment, 3) constraints in carrying out tasks, 4) management support, and 5) hopes. Conclusion: This study provides new insights into IPCN roles and duties that require collaboration and coordination with multiple professions, as well as management support to overcome obstacles that hinder fulfilling tasks and hopes of improving IPCN performance according to competency-based career paths to achieve patient safety, service quality, and job satisfaction.

Group agents, moral competence and duty-bearers: the update argument.

According to some collectivists, purposive groups that lack decision-making procedures such as riot mobs, friends walking together, or the pro-life lobby can be morally responsible and have moral duties. I focus on plural subject- and we-mode-collectivism. I argue that purposive groups do not qualify as duty-bearers even if they qualify as agents on either view. To qualify as a duty-bearer, an agent must be morally competent. I develop the Update Argument. An agent is morally competent only if the agent has sufficient positive and negative control over updating their goal-seeking states. Positive control involves the general ability to update one's goal-seeking states, whereas negative control involves the absence of other agents with the capacity to arbitrarily interfere with updating one's goal-seeking states. I argue that even if purposive groups qualify as plural subjects or we-mode group agents, these groups necessarily lack negative control over updating their goal-seeking states. This creates a cut-off point for groups as duty-bearers: Organized groups may qualify as duty-bearers, whereas purposive groups cannot qualify as duty-bearers.

[Patient's consent to the medical act]. / Le consentement à l'acte médical.

The right to consent has become over time a fundamental right in both French and international law. Even if it is not formalized, the patient's consent is now required for each medical act. Moreover, it is always revocable. This article proposes to outline the historical evolution of consent in French legal texts.

Do Clinicians Have a Duty to Participate in Pragmatic Clinical Trials?

Clinicians have good moral and professional reasons to contribute to pragmatic clinical trials (PCTs). We argue that clinicians have a defeasible duty to participate in this research that takes place in usual care settings and does not involve substantive deviation from their ordinary care practices. However, a variety of countervailing reasons may excuse clinicians from this duty in particular cases. Yet because there is a moral default in favor of participating, clinicians who wish to opt out of this research must justify their refusal. Reasons to refuse include that the trial is badly designed in some way, that the trial activities will violate the clinician's conscience, or that the trial will impose excessive burdens on the clinician.

Legal Liability of Clinical Ethics Services in Australia: "Should I Be More Worried Than I Am?"

A key function of clinical ethics services (CESs) is to provide decision-making support to health care providers in ethically challenging cases. Cases referred for ethics consultation are likely to involve diverging views or conflict, or to confront the boundaries of appropriate medical practice. Such cases might also attract legal action due to their contentious nature. As CESs become more prevalent in Australia, this article considers the potential legal liability of a CES and its members. With no reported litigation against a CES in Australia, we look to international experience and first principles. We consider the prospects of a claim in negligence, the most likely legal action against a CES, through application of legal principles to a hypothetical case scenario. We conclude that, although unlikely to be successful at this time, a CES could face answerable claims in negligence brought by patients (and families) who are the subject of ethics case consultation.

Assisted Death, Dignity, and Respect for Humanity.

Recent works on the concept of dignity have opened up the otherwise quite deadlocked debate about assisted death (AD). Rather than just reinforcing already fixed positions, it seems to me that these conceptions of dignity make room for a moderate and normatively richer position on the moral permissibility of AD. I do not think that we have seen the full potential of the said conceptions and interpretations. I try in this article to contribute my part. First, I briefly recapitulate some of the paradoxical ways in which dignity is typically invoked in the debate and try to clear up some of the obvious confusions. Then, I go on to explore a particular Kantian line of thought in some recent works on dignity and AD that seems to pave the way for a moderate position with a more principled foundation than the usual compromise positions.

A Snapshot of the Experience of Dietitians during the COVID-19 Crisis in Five Arab Countries: Findings from a Regional Cross-Sectional Study.

COVID-19's intimidating spread has challenged the resilience of the global health systems, causing shifts in the practices of healthcare workers, including dietitians. The current study aimed to assess the change in dietitians' practices and duties in hospitals/clinics after the commencement of COVID-19 pandemic. This cross-sectional study was conducted in five Arab countries between November 2020 and January 2021. A convenient sample of 903 dietitians filled an online self-administered questionnaire to meet the study aims. Nearly 40.0% of the dietitians experienced a change in their workload and caseload during the pandemic. Besides, 18.7% of the dietitians had been assigned additional tasks in their facilities. Nearly half the dietitians (46.9%) had started giving remote nutrition consultations, associated with a 21% drop in the number of dietitians offering in-person consultations (p = 0.001). Approximately 58.9% of the dietitians provided nutrition care to COVID-19 patients, with 48.4% having access to personal protective equipment. Moreover, 17.0% of dietitians supported COVID-19 patients with enteral and parenteral nutrition. In addition, 45.0% of dietitians reported that managing COVID-19 was challenging given that it was a newly discovered condition.

Corporate Counterspeech.

Are corporations ever morally obligated to engage in counterspeech-that is, in speech that aims to counter hate speech and misinformation? While existing arguments in moral and political philosophy show that individuals and states have such obligations, it is an open question whether those arguments apply to corporations as well. In this essay, I show how two such arguments-one based on avoiding complicity, and one based on duties of rescue-can plausibly be extended to corporations. I also respond to several objections to corporate counterspeech.

Traditional Conceptions of the Legal Person and Nonhuman Animals.

Since Roman law, the category of the legal person has been the most relevant legal category, allowing humans and entities to act within the law and enter into legal relations. The legal system does not consider nonhuman animals as legal persons but as property or as sentient beings regulated by the rules of property. Throughout history, there have been different concepts of the legal person, and some are still relevant today. This article examines four traditional concepts of legal personhood, arguing that nonhuman animals can be considered persons according to each concept. The article reaches three main conclusions. First, the legal person is not the same as the human. Second, the debate between the equivalence and the subset views poses a dilemma between a revolution or the reform of animals' legal status. Third, an ecumenical defense of animal legal personhood may benefit animals as it supports animal persons according to any of the traditional concepts of legal personhood.