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1.
S Afr Med J ; 110(9): 858-863, 2020 08 13.
Artigo em Inglês | MEDLINE | ID: mdl-32880268

RESUMO

As COVID-19 spreads rapidly across Africa, causing havoc to economies and disruption to already fragile healthcare systems, it is becoming clear that despite standardised global health strategies, national and local government responses must be tailored to their individual settings. Some African countries have adopted stringent measures such as national lockdown, quarantine or isolation, in combination with good hand hygiene, mandatory wearing of masks and physical distancing, to prevent an impending healthcare crisis. The impact of stringent measures in low- to middle-income African countries has bought time for healthcare facilities to prepare for the onslaught of COVID-19 cases, but some measures have been challenging to implement. In some settings, public health measures have been associated with serious violations of individual rights owing to abuse of power and gaps in implementation of well-intentioned policy. Collateral damage with regard to non-COVID-19 diseases that were suboptimally managed in pre-pandemic times may mean that lives lost from other diseases could exceed those saved from COVID-19. While individuals complying with lockdown regulations have embraced an acceptance of the concept of the common good, at a broad community level many are finding the transition from individualism to collective thinking required during a pandemic difficult to navigate. In this article, we look at government responses to the pandemic in six African countries (Malawi, South Africa, Uganda, Zambia, Zimbabwe and Botswana), and highlight ethical concerns arising in these contexts.


Assuntos
Direitos Civis/ética , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Autonomia Pessoal , Pneumonia Viral/prevenção & controle , Saúde Pública/ética , África , Betacoronavirus , Botsuana , Direitos Civis/legislação & jurisprudência , Infecções por Coronavirus/epidemiologia , Liberdade , Humanos , Malaui , Pneumonia Viral/epidemiologia , Saúde Pública/legislação & jurisprudência , África do Sul , Uganda , Zâmbia , Zimbábue
5.
Pediatrics ; 146(Suppl 1): S25-S32, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32737229

RESUMO

In this article, I examine the role of minors' competence for medical decision-making in modern American law. The doctrine of parental consent remains the default legal and bioethical framework for health care decisions on behalf of children, complemented by a complex array of exceptions. Some of those exceptions vest decisional authority in the minors themselves. Yet, in American law, judgments of minors' competence do not typically trigger shifts in decision-making authority from adults to minors. Rather, minors' decisional capacity becomes relevant only after legislatures or courts determine that the default of parental discretion does not achieve important policy goals or protect implicated constitutional rights in a particular health care context and that those goals can best be achieved or rights best protected by authorizing capable minors to choose for themselves. It is at that point that psychological and neuroscientific evidence plays an important role in informing the legal inquiry as to whether minors whose health is at issue are legally competent to decide.


Assuntos
Tomada de Decisão Clínica , Competência Mental/legislação & jurisprudência , Menores de Idade/legislação & jurisprudência , Consentimento dos Pais/legislação & jurisprudência , Adolescente , Desenvolvimento do Adolescente , Criança , Desenvolvimento Infantil , Serviços de Saúde da Criança/legislação & jurisprudência , Educação Infantil , Bem-Estar da Criança/legislação & jurisprudência , Direitos Civis , Tomada de Decisão Clínica/ética , Família , Acesso aos Serviços de Saúde/legislação & jurisprudência , Humanos , Consentimento Informado por Menores/ética , Consentimento Informado por Menores/legislação & jurisprudência , Competência Mental/normas , Menores de Idade/psicologia , Relações Pais-Filho , Consentimento dos Pais/ética , Patient Self-Determination Act , Autonomia Pessoal , Procurador/legislação & jurisprudência , Recusa do Paciente ao Tratamento/legislação & jurisprudência , Estados Unidos
8.
Soins ; 65(843-844): 20-23, 2020.
Artigo em Francês | MEDLINE | ID: mdl-32563501

RESUMO

Whatever their discipline or place of practice, caregivers inevitably encounter migrants, foreign nationals who are ill and often in real physical and psychological distress. It is important that all caregivers are aware of the international and national legal rights protecting migrants, social security cover, state medical assistance and supplementary universal health insurance. The support needs to be multi-disciplinary, encouraging maximum collaboration between Government organisations, refugee charities, ONGs involved in the reception of migrants, volunteers and interpreters and, of course, caregivers.


Assuntos
Cuidadores , Migrantes , Direitos Civis , Humanos , Refugiados , Migrantes/legislação & jurisprudência , Cobertura Universal do Seguro de Saúde
11.
Psychol Trauma ; 12(5): 542-545, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32551774

RESUMO

This commentary describes some of the aspects of the COVID-19 pandemic in Poland. The 1st part of the text covers issues related to actions introduced by the Polish government to minimize the risk of infection as well as statistics and difficulties resulting from the restrictions introduced. In the 2nd part, we present the results of our own research, including predictors of posttraumatic stress disorder symptom severity associated with the pandemic situation, and we discuss the results. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Sintomas Comportamentais/psicologia , Infecções por Coronavirus , Controle de Infecções , Transtornos Mentais/psicologia , Pandemias , Pneumonia Viral , Adulto , Sintomas Comportamentais/etiologia , Direitos Civis , Humanos , Transtornos Mentais/etiologia , Polônia , Transtornos de Estresse Pós-Traumáticos/psicologia
12.
Eur Psychiatry ; 63(1): e50, 2020 05 29.
Artigo em Inglês | MEDLINE | ID: covidwho-434810

RESUMO

The COVID-19 pandemic has raised significant concerns for population mental health and the effective provision of mental health services in the light of increased demands and barriers to service delivery [1]. Particular attention is being directed toward the possible neuropsychiatric sequelae of both COVID-19 and of the stringent societal mitigation steps deployed by national governments, concerns that are informed by historical increases in the incidence of psychotic disorders following influenza pandemics [2]. However, so far there has been scant attention paid to other important areas of psychiatry during COVID-19, including medico-legal aspects and human rights. In this paper, we discuss the legal implications for psychiatry of the COVID-19 pandemic and report a novel situation in which psychiatric patients may experience diminution of their statutory protections. We believe that this represents a paradigm shift in psychiatric care and that the consideration of the fundamental rights of psychiatric patients as "less important" than infection control measures compel mental health professionals to "advocate for … patients and their caregivers" in this time of crisis [1].


Assuntos
Infecções por Coronavirus , Direitos Humanos , Serviços de Saúde Mental , Saúde Mental , Pessoas Mentalmente Doentes , Pandemias , Pneumonia Viral , Betacoronavirus , Direitos Civis , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Surtos de Doenças , Pessoal de Saúde , Humanos , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Psiquiatria
14.
J Law Med ; 27(3): 527-534, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32406617

RESUMO

The reputation of the pioneering gynaecologist J Marion Sims has been brought into question by a scandal over experimental surgery on African American slave women. Sims attempted to find a surgical cure for vesico-vaginal fistulae - an obstetric injury resulting from bladder damage after obstructed labour. His statue was removed from Central Park, New York, in 2018 in deference to the public outcry regarding his racist behaviour. A debate has raged over failures of consent for up to 30 procedures on a single patient which were performed without anaesthesia on vulnerable young slave women. However, this may be an example of "presentism" whereby the "beliefs, attitudes and practices of the 21st century are anachronistically projected retrograde to the early 19th century". This column argues that there are two separate issues: namely, the proposition that slaves could not freely give consent and that the surgery was deliberately tantamount to torture. In the 1850s United States slaves had no civil rights and no adequate anaesthesia was available during the period of surgical experimentation between 1841 and 1845.


Assuntos
Anestésicos , Ginecologia , Fístula Vesicovaginal , Afro-Americanos , Direitos Civis , Feminino , História do Século XIX , Humanos , Gravidez , Estados Unidos
16.
Eur Psychiatry ; 63(1): e50, 2020 05 29.
Artigo em Inglês | MEDLINE | ID: mdl-32468988

RESUMO

The COVID-19 pandemic has raised significant concerns for population mental health and the effective provision of mental health services in the light of increased demands and barriers to service delivery [1]. Particular attention is being directed toward the possible neuropsychiatric sequelae of both COVID-19 and of the stringent societal mitigation steps deployed by national governments, concerns that are informed by historical increases in the incidence of psychotic disorders following influenza pandemics [2]. However, so far there has been scant attention paid to other important areas of psychiatry during COVID-19, including medico-legal aspects and human rights. In this paper, we discuss the legal implications for psychiatry of the COVID-19 pandemic and report a novel situation in which psychiatric patients may experience diminution of their statutory protections. We believe that this represents a paradigm shift in psychiatric care and that the consideration of the fundamental rights of psychiatric patients as "less important" than infection control measures compel mental health professionals to "advocate for … patients and their caregivers" in this time of crisis [1].


Assuntos
Infecções por Coronavirus , Direitos Humanos , Serviços de Saúde Mental , Saúde Mental , Pessoas Mentalmente Doentes , Pandemias , Pneumonia Viral , Betacoronavirus , Direitos Civis , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Surtos de Doenças , Pessoal de Saúde , Humanos , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Psiquiatria
19.
Am Surg ; 86(3): 213-219, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-32223800

RESUMO

Grady Memorial Hospital is a pillar of public medical and surgical care in the Southeast. The evolution of this institution, both in its physical structure as well as its approach to patient care, mirrors the cultural and social changes that have occurred in the American South. Grady Memorial Hospital opened its doors in 1892 built in the heart of Atlanta's black community. With its separate and unequal facilities and services for black and white patients, the concept of "the Gradies" was born. Virtually, every aspect of care at Grady continued to be segregated by race until the mid-20th century. In 1958, the opening of the "New Grady" further cemented this legacy of the separate "Gradies," with patients segregated by hospital wing. By the 1960s, civil rights activists brought change to Atlanta. The Atlanta Student Movement, with the support of Dr. Martin Luther King Jr., led protests outside of Grady, and a series of judicial and legislative rulings integrated medical boards and public hospitals. Eventually, the desegregation of Grady occurred with a quiet memo that belied years of struggle: on June 1, 1965, a memo from hospital superintendent Bill Pinkston read "All phases of the hospital are on a non-racial basis, effective today." The future of Grady is deeply rooted in its past, and Grady's mission is unchanged from its inception in 1892: "It will nurse the poor and rich alike and will be an asylum for black and white."


Assuntos
Direitos Civis/história , Dessegregação/história , Dessegregação/legislação & jurisprudência , Afro-Americanos/estatística & dados numéricos , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Georgia , Hispano-Americanos/estatística & dados numéricos , História do Século XX , Hospitais Públicos/história , Humanos
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