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1.
J Clin Ethics ; 32(1): 35-37, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33656455

RESUMEN

The excellent article by Daniel J. Benedetti, Mithya Lewis-Newby, Joan S. Roberts, and Douglas S. Diekema draws strength by dealing both with micro ethical (personal) and macro ethical (institutional policies and structures) considerations. One should further note that often, the macro factors are even stronger than the article implies, although individuals can affect the macro context. A particularly important macro factor for all matters concerning healthcare, indeed all human services, is the tension between the profit motive and ethical decisions.


Asunto(s)
Enfermedades Transmisibles/terapia , Ética Institucional , Ética Profesional , Pandemias/ética , Personal de Salud/ética , Humanos , Obligaciones Morales
3.
Clin J Oncol Nurs ; 25(1): 61-68, 2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-33480884

RESUMEN

BACKGROUND: The disruption in the supply chain of resources and interruptions in cancer treatments caused by the pandemic presented tremendous challenges to the healthcare system. OBJECTIVES: This article describes the National Academy of Medicine-defined states of medical and nursing care delivery for which local plans should be drawn and the shifting and evolving systems framework that can guide decisions to optimize the crisis standards of care. METHODS: A case study is presented to describe the process of shifting the state of medical and nursing care delivery and bioethical nursing considerations during the pandemic and beyond. FINDINGS: An evolving and shifting systems framework for crises rooted in deontology, principlism, and the ethics of care model provide meaningful guidance for establishing priorities for patient care.


Asunto(s)
/enfermería , Toma de Decisiones/ética , Prestación de Atención de Salud/ética , Neoplasias/enfermería , Enfermería Oncológica/ética , Enfermería Oncológica/normas , Pandemias/ética , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias/prevención & control , Guías de Práctica Clínica como Asunto
6.
Artículo en Español | IBECS | ID: ibc-196557

RESUMEN

Las emergencias de salud pública, como la que estamos viviendo con la pandemia originada por el coronavirus SARS-CoV-2, han originado trágicas limitaciones de recursos que impiden salvar vidas. Provocan tensiones en la atención sanitaria centrada en el paciente como eje del sistema en condiciones normales, y en la misma atención sanitaria en situaciones de emergencia originadas en la COVID-19. En esta revisión abordamos algunos de los problemas asistenciales, organizativos y éticos que este escenario ha provocado en la atención primaria, como: cancelación de actividades programadas; escasa atención domiciliaria y seguimiento de pacientes ancianos, enfermos crónicos e inmovilizados; desabastecimiento de EPI y exposición al riesgo de los profesionales sanitarios, y finalmente los problemas asociados a la telemedicina y a la atención telefónica a los pacientes


Public health emergencies, such as the current SARS-CoV-2 coronavirus pandemic, have led to tragic resource constraints that prevent lives from being saved. This has led to tensions in patient-centered care as the backbone of the system in normal conditions and the same care in emergencies originating in the COVID-19. In this review we address some of the healthcare, organizational and ethical problems that this scenario has caused in primary care such as: cancellation of programmed activities; scarce home care and follow-up of elderly, chronically ill and immobilized patients; shortage of PPE and the exposure to risk of healthcare professionals, and finally the problems associated with telemedicine and telephone attention to patients


Asunto(s)
Humanos , Infecciones por Coronavirus/terapia , Neumonía Viral/terapia , Pandemias/ética , Atención Primaria de Salud/ética , Atención Primaria de Salud/métodos , Telemedicina/ética
8.
Chiropr Man Therap ; 28(1): 65, 2020 11 18.
Artículo en Inglés | MEDLINE | ID: mdl-33208144

RESUMEN

BACKGROUND: In March 2020, the World Health Organization elevated the coronavirus disease (COVID-19) epidemic to a pandemic and called for urgent and aggressive action worldwide. Public health experts have communicated clear and emphatic strategies to prevent the spread of COVID-19. Hygiene rules and social distancing practices have been implemented by entire populations, including 'stay-at-home' orders in many countries. The long-term health and economic consequences of the COVID-19 pandemic are not yet known. MAIN TEXT: During this time of crisis, some chiropractors made claims on social media that chiropractic treatment can prevent or impact COVID-19. The rationale for these claims is that spinal manipulation can impact the nervous system and thus improve immunity. These beliefs often stem from nineteenth-century chiropractic concepts. We are aware of no clinically relevant scientific evidence to support such statements. We explored the internet and social media to collect examples of misinformation from Europe, North America, Australia and New Zealand regarding the impact of chiropractic treatment on immune function. We discuss the potential harm resulting from these claims and explore the role of chiropractors, teaching institutions, accrediting agencies, and legislative bodies. CONCLUSIONS: Members of the chiropractic profession share a collective responsibility to act in the best interests of patients and public health. We hope that all chiropractic stakeholders will view the COVID-19 pandemic as a call to action to eliminate the unethical and potentially dangerous claims made by chiropractors who practise outside the boundaries of scientific evidence.


Asunto(s)
Quiropráctica/ética , Información de Salud al Consumidor/ética , Decepción , Pandemias/ética , Mala Conducta Profesional , Betacoronavirus , Comunicación , Infecciones por Coronavirus , Humanos , Manipulación Espinal/ética , Neumonía Viral
9.
Rev Esp Salud Publica ; 942020 Nov 06.
Artículo en Español | MEDLINE | ID: mdl-33154346

RESUMEN

In 2009, the H1N1 pandemic raised a series of ethical considerations that influenced the approach to the crisis. In the framework of the SARS-CoV-2 coronavirus pandemic, these issues have been repeated, and the analysis of what happened in 2009 can be seen as a warning. The principles of justice, solidarity, equity, transparency and reciprocity should be included in future pandemic response plans, including lessons learned.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Ética Médica , Equidad en Salud , Pandemias/ética , Neumonía Viral/epidemiología , Betacoronavirus , Control de Enfermedades Transmisibles/métodos , Humanos , Subtipo H1N1 del Virus de la Influenza A , Gripe Humana/epidemiología , España/epidemiología
10.
Rev. bioét. derecho ; (50): 37-61, nov. 2020.
Artículo en Español | IBECS | ID: ibc-191345

RESUMEN

Este documento ofrece una propuesta desde la perspectiva de la bioética para la elaboración de un protocolo de triaje en el contexto de la pandemia de COVID-19. Dicha propuesta incluye recomendaciones sobre las normas procedimentales y normas sustantivas que deben regir la asignación y reasignación de recursos terapéuticos en condiciones de escasez extrema


This document offers a proposal for the elaboration of a triage guideline in the context of the COVID-19 pandemic. This proposal includes recommendations on the procedural norms and substantive norms that should govern the allocation and reallocation of therapeutic resources in conditions of extreme scarcity


Aquest document ofereix una proposta des de la perspectiva de la bioètica per a l'elaboració d'un protocol de triatge en el context de la pandèmia de COVID-19. L'esmentada proposta inclou recomanacions sobre les normes procedimentals I normes substantives que han de regir l'assignació I reassignació de recursos terapèutics en condicions d'escassetat extrema


Asunto(s)
Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Pandemias/ética , Protocolos Clínicos , Triaje/ética , Toma de Decisiones/ética
11.
Rev. bioét. derecho ; (50): 133-148, nov. 2020.
Artículo en Español | IBECS | ID: ibc-191350

RESUMEN

El presente artículo ambiciona defender la necesidad y la virtualidad de emprender una acción colectiva, primero, paneuropea y luego, internacional para hacer frente con la mayor celeridad, eficiencia y eficacia posibles a la emergencia sanitaria suscitada por la COVID-19, abordando, específicamente, la problemática ética y legal de la compartición internacional de datos personales. Todo ello con la firme pretensión de lograr una mayor y mejor cooperación internacional en materia de investigación médico-científica con datos de carácter personal


This article aims to defend the need of taking a pan-European and international collective action to tackle as rapidly, efficiently and effectively as possible the public health emergency caused by the COVID-19, addressing, specifically, the ethical and legal issues of the international sharing of personal data. On the whole, intending to improve international cooperation in medical and scientific research with personal data


El present article ambiciona defensar la necessitat I la virtualitat d'emprendre una acció col·lectiva, primer, paneuropea I després, internacional per fer front amb la major celeritat, eficiència I eficàcia possibles a l'emergència sanitària suscitada per la COVID-19, abordant, específicament, la problemàtica ètica I legal de la compartició internacional de dades personals. Tot això amb la ferma pretensió d'aconseguir una major I millor cooperació internacional en matèria d'investigació medico-científica amb dades de caràcter personal


Asunto(s)
Humanos , Registros de Salud Personal/ética , Cooperación Internacional , Infecciones por Coronavirus , Neumonía Viral , Pandemias/ética , Pandemias/legislación & jurisprudencia
12.
Rev. bioét. derecho ; (50): 333-352, nov. 2020.
Artículo en Portugués | IBECS | ID: ibc-191361

RESUMEN

Pretende-se mostrar como a pandemia de COVID-19 causada pelo novo coronavírus Sars-CoV-2, afeta a distribuição equitativa de recursos sanitários no Brasil, bem como evidenciar os dilemas e entraves éticos e psicológicos vivenciados pelos profissionais da saúde no contexto de combate à doença. O presente estudo objetivou revisar conhecimentos acerca de questões bioéticas referentes à escassez de recursos e saúde mental. Realizou-se, desse modo, uma análise de protocolos sobre alocação de recursos recém-publicados no Brasil


Se pretende mostrar cómo la pandemia de COVID-19 causada por el nuevo coronavirus Sars-CoV-2, afecta la distribución equitativa de los recursos de salud en Brasil, así como resaltar los dilemas y barreras éticas y psicológicas advertidas por los profesionales de la salud en el contexto de lucha contra la enfermedad. El presente estudio tuvo como objetivo revisar el conocimiento sobre cuestiones bioéticas relacionadas con la escasez de recursos y la salud mental. Así, se realizó un análisis de protocolos sobre la asignación de recursos recientemente publicados en Brasil


It is intended to show how the COVID-19 pandemic caused by the new Sars-CoV-2 coronavirus, affects the equitable distribution of health resources in Brazil, as well as to highlight the ethical and psychological dilemmas and barriers experienced by health professionals in the context of fighting disease. The present study aimed to go through knowledge about bioethical issues related to the scarcity of resources and mental health. Thus, an analysis of protocols on the allocation of newly published resources in Brazil was carried out


Es pretén mostrar com la pandèmia de COVID-19 causada pel nou coronavirus Sars-COV-2, afecta la distribució equitativa dels recursos de salut al Brasil, així com ressaltar els dilemes I les barreres ètiques I psicològiques reconegudes pels professionals de la salut en el context de lluita contra la malaltia. El present estudi va tenir com a objectiu revisar el coneixement sobre qüestions bioètiques relacionades amb l'escassetat de recursos I la salut mental. Així, es va realitzar una anàlisi de protocols sobre l'assignació de recursos recentment publicats al Brasil


Asunto(s)
Humanos , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Pandemias/ética , Salud Mental , Bioética , Prioridades en Salud , Gestión de Recursos , Asignación de Recursos/ética , Brasil/epidemiología
15.
Acad Med ; 95(10): 1488-1491, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-33006868

RESUMEN

In response to the COVID-19 pandemic, the Association of American Medical Colleges has called for a temporary suspension of clinical teaching activities for medical students. Planning for the continued involvement of learners in patient care during this pandemic should include teaching learners professional formation. The authors provide an ethical framework to guide such teaching, based on the ethical principle of beneficence and the professional virtues of courage and self-sacrifice from professional ethics in medicine. The authors show that these concepts support the conclusion that learners are ethically obligated to accept reasonable, but not unreasonable, risk. Based on this ethical framework, the authors provide an account of the process of teaching professional formation that medical educators and academic leaders should implement. Medical educators and academic leaders should embrace the opportunity that the COVID-19 pandemic presents for teaching professional formation. Learners should acquire the conceptual vocabulary of professional formation. Learners should recognize that risk of infection from patients is unavoidable. Learners should become aware of established ethical standards for professional responsibility during epidemics from the history of medicine. Learners should master understandable fear. Medical educators and academic leaders should ensure that didactic teaching of professional formation continues when it becomes justified to end learners' participation in the processes of patient care; topics should include the professionally responsible management of scarce medical resources. The COVID-19 pandemic will not be the last major infectious disease that puts learners at risk. Professional ethics in medicine provides powerful conceptual tools that can be used as an ethical framework to guide medical educators to teach learners, who will bear leadership responsibilities in responses to future pandemics, professional formation.


Asunto(s)
Educación Médica/ética , Ética Médica/educación , Pandemias/ética , Profesionalismo/educación , Betacoronavirus , Infecciones por Coronavirus , Humanos , Neumonía Viral , Profesionalismo/ética , Facultades de Medicina , Sociedades Médicas
19.
BMJ Open ; 10(10): e040638, 2020 10 16.
Artículo en Inglés | MEDLINE | ID: mdl-33067300

RESUMEN

OBJECTIVE: To undertake a case review of deaths in a 6-week period during the COVID-19 pandemic commencing with the first death in the hospital from COVID-19 on 12th of March 2020 and contrast this with the same period in 2019. SETTING: A large London teaching hospital. PARTICIPANTS: Three groups were compared: group 1-COVID-19-associated deaths in the 6-week period (n=243), group 2-non-COVID deaths in the same period (n=136) and group 3-all deaths in a comparison period of the same 6 weeks in 2019 (n=194). PRIMARY AND SECONDARY OUTCOME MEASURES: This was a descriptive analysis of death case series review and as such no primary or secondary outcomes were pre-stipulated. RESULTS: Deaths in patients from the Black, Asian and minority ethnic (BAME) communities in the pandemic period significantly increased both in the COVID-19 group (OR=2.43, 95% CI=1.60-3.68, p<0.001) and the non-COVID group (OR=1.76, 95% CI=1.09-2.83, p=0.02) during this time period and the increase was independent of differences in comorbidities, sex, age or deprivation. While the absolute number of deaths increased in 2020 compared with 2019, across all three groups the distribution of deaths by age was very similar. Our analyses confirm major risk factors for COVID-19 mortality including male sex, diabetes, having multiple comorbidities and background from the BAME communities. CONCLUSIONS: There was no evidence of COVID-19 deaths occurring disproportionately in the elderly compared with non-COVID deaths in this period in 2020 and 2019. Deaths in the BAME communities were over-represented in both COVID-19 and non-COVID groups, highlighting the need for detailed research in order to fully understand the influence of ethnicity on susceptibility to illness, mortality and health-seeking behaviour during the pandemic.


Asunto(s)
Grupo de Ascendencia Continental Africana , Grupo de Ascendencia Continental Asiática , Betacoronavirus , Hospitales/estadística & datos numéricos , Grupos Minoritarios , Pandemias/ética , Anciano , Anciano de 80 o más Años , Causas de Muerte , Comorbilidad , Infecciones por Coronavirus , Femenino , Humanos , Londres/epidemiología , Masculino , Neumonía Viral , Estudios Retrospectivos , Tasa de Supervivencia/tendencias
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