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1.
Bioethics ; 38(3): 223-232, 2024 03.
Artigo em Inglês | MEDLINE | ID: mdl-37382040

RESUMO

During the COVID-19 pandemic, national triage guidelines were developed to address the anticipated shortage of life-saving resources, should ICU capacities be overloaded. Rationing and triage imply that in addition to individual patient interests, interests of population health have to be integrated. The transfer of theoretical and empirical knowledge into feasible and useful practice models and their implementation in clinical settings need to be improved. This paper analyzes how triage protocols could translate abstract theories of distributive justice into concrete material and procedural criteria for rationing intensive care resources during a pandemic. We reconstruct the development and implementation of a rationing protocol at a German university hospital: describing the ethical challenge of triage, clarifying the aspirational norms, and summarizing specific norms of fair triage and allocation for developing an institutional policy and practice model and implementing it. We reflect on how critical topics are seen by clinicians and what helped manage the perceived burdens of the triage dilemma. We analyze what can be learned from this debate regarding the difficult issues around triage protocols and their potential implementation into clinical settings. Analyzing the ought-to-is gap of triage, integrating abstract ethical principles into practical concepts, and evaluating those should clarify the benefits and risks of different allocation options. We seek to inform debates on triage concepts and policies to ensure the best possible treatment and fair allocation of resources as well as to help protect patients and professionals in worst-case scenarios.


Assuntos
Pandemias , Triagem , Humanos , SARS-CoV-2 , Alocação de Recursos para a Atenção à Saúde , Cuidados Críticos , Justiça Social
2.
Acta Trop ; 225: 106175, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34627762

RESUMO

The inaugural issue of Acta Tropica has been published in 1944, at a time of utmost international isolation and uncertainty due to World War II. Now, more than seven decades later, Acta Tropica is a trusted outlet to communicate and disseminate scientific advances in the fields of parasitology and tropical medicine. As a scholarly, peer-reviewed journal, Acta Tropica contributes to the 2030 Agenda for Sustainable Development, particularly the Sustainable Development Goal (SDG) 3, that is "Ensure healthy lives and promote well-being for all of all ages". This article explores how Acta Tropica has evolved over time. Our analysis is based on a systematic review of keywords derived from all issues published in a specific year, arbitrarily selected at decadal snapshots (1950, 1960, 1970, 1980, 1990, 2000, 2010, and 2020). Results indicate a decrease in interdisciplinarity in favour of more specialised expertise in various fields of infectious diseases research and public health with a particular emphasis on low- and middle-income countries. Yet, by examining first and last authors' institutional affiliations and classifying countries by the Human Development Index (HDI), we find that most authors are affiliated with institutions in high- and very high-HDI countries. Over time, the mean number of authors on a paper has increased severalfold (from 1.35 in 1950 to 7.51 in 2020). Taken together, Acta Tropica has become increasingly globally anchored and contributes not only to SDG 3, but increasingly also to SDG 17, that is "Revitalize the global partnership for sustainable development".


Assuntos
Desenvolvimento Sustentável , Medicina Tropical , Nível de Saúde , Humanos , Motivação , Saúde Pública
3.
Acta Trop ; 226: 106155, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34634266

RESUMO

Acta Tropica is an international, peer-reviewed journal advancing scientific research in the fields of tropical medicine and parasitology. This article elucidates the rich history of the journal and speculates about its future. Acta Tropica was launched in 1944 and formed an integral part of the establishment and running of the Swiss Tropical Institute in Basel. After two distinct periods of relatively small publication activities (1944-1976 and 1977-1988), in 1989, Acta Tropica was transferred to the Dutch publisher Elsevier. Subsequently, the annual number of publications steadily increased and the scope of the journal broadened to the biology of pathogens and their vectors, to genetics, host-parasite relationships, mechanisms of pathogenicity, diagnostics, and treatment of tropical diseases. The body of published articles contributed to an improved understanding of the prevention, surveillance, control, and elimination of diseases that are intimately linked to poverty, such as malaria and neglected tropical diseases. In recent years, the scope of Acta Tropica was widening to target emerging and re-emerging infectious diseases, epidemics and pandemics, interrelations of microbes, viruses, and parasites, co-dependencies of epidemiology, ecology, environment, and climate change. Importantly, non-communicable diseases are gaining interest in low- and middle-income countries due to urbanization, globalization, and rapidly changing life styles, and hence, these issues receive growing prominence. Acta Tropica continues to embrace inter- and, indeed, transdisciplinary research to address pressing global health issues and sustainable development.


Assuntos
Medicina Tropical , Mudança Climática , Saúde Global , Humanos , Doenças Negligenciadas , Desenvolvimento Sustentável
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