The Impact of the COVID-19 "Infodemic" on Drug-Utilization Behaviors: Implications for Pharmacovigilance.

The coronavirus disease 2019 (COVID-19) pandemic that hit the world in 2020 triggered a massive dissemination of information (an "infodemic") about the disease that was channeled through the print, broadcast, web, and social media. This infodemic also included sensational and distorted information about drugs that likely first influenced opinion leaders and people particularly active on social media and then other people, thus affecting choices by individual patients everywhere. In particular, information has spread about some drugs approved for other indications (chloroquine, hydroxychloroquine, nonsteroidal anti-inflammatory drugs, angiotensin-converting enzyme inhibitors, angiotensin II receptor antagonists, favipiravir, and umifenovir) that could have led to inappropriate and therefore hazardous use. In this article, we analyze the rationale behind the claims for use of these drugs in COVID-19, the communication about their effects on the disease, the consequences of this communication on people's behavior, and the responses of some influential regulatory authorities in an attempt to minimize the actual or potential risks arising from this behavior. Finally, we discuss the role of pharmacovigilance stakeholders in emergency management and possible strategies to deal with other similar crises in the future.

[Ethics and social medicine: Michel Foucault's perspective]. / La ética y la medicina social: la perspectiva de Michel Foucault.

Michel Foucault's preoccupation with medicine, its history and its impact on society, is a constant in his work. The goal of this study is to contrast the content of the lectures Foucault gave in Rio de Janeiro, in October 1974, with the preparatory notes for them which are part of the archival holdings acquired by the National Library of France. One of the key questions in those lectures is the relationship between ethics and contemporary social medicine. This question, analyzed from Foucault's point of view, constitutes the background and ultimate interest of this article.

La preocupación de Michel Foucault por la medicina, su historia y su impacto en la sociedad, es una constante en su obra. El objetivo de este trabajo es contrastar el contenido de las conferencias que Foucault impartió en Río de Janeiro, en octubre de 1974, con los materiales preparatorios de las mismas que forman parte de los fondos adquiridos por la Biblioteca Nacional de Francia. Una de las cuestiones clave en dichas conferencias es la relación entre la ética y la medicina social contemporánea. Esa cuestión, analizada desde el punto de vista de Foucault, constituye el trasfondo e interés último del presente trabajo.

La ética y la medicina social: la perspectiva de Michel Foucault / Ethics and social medicine: Michel Foucault's perspective

Resumen La preocupación de Michel Foucault por la medicina, su historia y su impacto en la sociedad, es una constante en su obra. El objetivo de este trabajo es contrastar el contenido de las conferencias que Foucault impartió en Río de Janeiro, en octubre de 1974, con los materiales preparatorios de las mismas que forman parte de los fondos adquiridos por la Biblioteca Nacional de Francia. Una de las cuestiones clave en dichas conferencias es la relación entre la ética y la medicina social contemporánea. Esa cuestión, analizada desde el punto de vista de Foucault, constituye el trasfondo e interés último del presente trabajo.

Abstract Michel Foucault's preoccupation with medicine, its history and its impact on society, is a constant in his work. The goal of this study is to contrast the content of the lectures Foucault gave in Rio de Janeiro, in October 1974, with the preparatory notes for them which are part of the archival holdings acquired by the National Library of France. One of the key questions in those lectures is the relationship between ethics and contemporary social medicine. This question, analyzed from Foucault's point of view, constitutes the background and ultimate interest of this article.

[New insights into the neuroscience of human altruism]. / Neue Einblicke in die Psychobiologie altruistischer Entscheidungen.

Numerous honorary initiatives for humanitarian aid towards refugees illustrate the high prevalence of altruistic behavior in the population. In medicine, an exquisite example of a human propensity for altruism is organ donation. Current perspectives on the neurobiology of altruism suggest that it is deeply rooted in the motivational architecture of the social brain. This is reflected by the social evolution of cooperation and parochialism, both of which are modulated by the evolutionarily conserved peptide hormone oxytocin. From a psychiatric perspective, altruism varies along a dimensional spectrum, with pathological hyperaltruism resulting in unexpected harm for oneself and others.

Fundamental Interventions: How Clinicians Can Address the Fundamental Causes of Disease.

In order to enhance the "structural competency" of medicine-the capability of clinicians to address social and institutional determinants of their patients' health-physicians need a theoretical lens to see how social conditions influence health and how they might address them. We consider one such theoretical lens, fundamental cause theory, and propose how it might contribute to a more structurally competent medical profession. We first describe fundamental cause theory and how it makes the social causes of disease and health visible. We then outline the sorts of "fundamental interventions" that physicians might make in order to address the fundamental causes.

[Public health ethics. Necessity and discourse in Germany]. / Public-Health-Ethik. Bedarf und Diskurs in Deutschland.

The international discourse about public health ethics is becoming more intensive and complex. The starting point is bioethics. The debate about public health ethics is simultaneously a debate about an adequate identity of public health, its goals, tasks and standards. In Germany there is a tremendous need to take part in this discourse. German experiences within the traditions of social medicine, social hygiene and medical ethics could significantly contribute to the international discussion. Unfortunately the German speaking public health community has hardly acknowledged the topic of ethics. The reasons for this are not explicitly known. The Anglo-American discourse is much more developed, but the concepts, terms and paradigms should not simply be transferred. They should critically be proven.

William Pulteney Alison, the Scottish philosophy, and the making of a political medicine.

This article considers the public health and social-reform agitations of Dr. William Pulteney Alison (1790-1858), professor of medicine at Edinburgh University and leader of the Scottish medical profession, in the context of Scottish moral philosophy. Throughout his career, Alison reflected on what has come to be recognized as a central problem of social medicine: where did its domain end? At what point did the medical mission of identifying and eliminating factors that harm health pass into a non-medical domain-the provinces of political economy, individual liberty, participatory politics, or acceptance of nature's dictates? On these issues Alison was an expansionist, relentlessly pushing back the borders of medicine. Drawing on Alison's writings on such disparate topics as the philosophy of mind, the epidemiology of infectious diseases, and modes of agrarian organization, the article argues that the trajectory of much of Alison's work was to discover the structural implications of a comprehensive biological reading of human capacity and behavior. It is therefore appropriate to see him as a promulgator of a "political medicine," which he presented as a critical alternative to the classical political economy of the Scottish Malthusians. The article concludes by suggesting that Alison's work (and influence) have been under-recognized and remain pertinent to modern social epidemiology, public health, and medicine more broadly.

Latin American social medicine and global social medicine.

A fundamental change in the theory underlying public health and medicine is needed. Latin American social medicine (LASM), originating in a region of the world that has been subjected to colonial and postcolonial influence, will be part of this change. To the extent that the social production of disease among people in other regions is a consequence of various large-scale forms of domination, LASM offers a relevant analysis, models of resistance, and exemplars of social medicine in practice. I draw upon LASM to examine the social production of disease in the Marshall Islands and Iraq. I suggest a basis for a global social medicine in the shared experience of suffering and describe implications for public health theory and practice.