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4.
J Neurovirol ; 27(1): 168-170, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33405207

RESUMO

People living with HIV (PLWH) may be at higher risk for adverse outcomes indirectly associated with the severe acute respiratory syndrome coronavirus (SARS-CoV-2). When comparing responses to questionnaires administered when social distancing and quarantine guidelines were first implemented, we found that PLWH were more likely to have restricted access to medical care, increased financial stress, increased symptoms of anxiety and depression, and increased substance use compared to demographically-similar people without HIV.


Assuntos
Ansiedade/epidemiologia , Depressão/epidemiologia , Infecções por HIV/epidemiologia , Pandemias , Estresse Psicológico/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto , Idoso , Ansiedade/economia , Ansiedade/psicologia , Ansiedade/virologia , /psicologia , Comorbidade , Depressão/economia , Depressão/psicologia , Depressão/virologia , Feminino , Infecções por HIV/economia , Infecções por HIV/psicologia , Infecções por HIV/virologia , HIV-1/patogenicidade , Acesso aos Serviços de Saúde/economia , Acesso aos Serviços de Saúde/ética , Humanos , Masculino , Pessoa de Meia-Idade , Missouri/epidemiologia , Quarentena/economia , Quarentena/psicologia , Estresse Psicológico/economia , Estresse Psicológico/virologia , Transtornos Relacionados ao Uso de Substâncias/economia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Transtornos Relacionados ao Uso de Substâncias/virologia , Inquéritos e Questionários
7.
Semergen ; 47(2): 122-130, 2021 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-33358090

RESUMO

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.


Assuntos
/prevenção & controle , Alocação de Recursos para a Atenção à Saúde/ética , Acesso aos Serviços de Saúde/ética , Controle de Infecções/métodos , Atenção Primária à Saúde/ética , Telemedicina/ética , /epidemiologia , Alocação de Recursos para a Atenção à Saúde/métodos , Alocação de Recursos para a Atenção à Saúde/organização & administração , Acesso aos Serviços de Saúde/organização & administração , Serviços de Saúde para Idosos/ética , Serviços de Saúde para Idosos/organização & administração , Humanos , Controle de Infecções/instrumentação , Controle de Infecções/organização & administração , Pandemias , Equipamento de Proteção Individual/provisão & distribução , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/organização & administração , Qualidade da Assistência à Saúde/ética , Qualidade da Assistência à Saúde/organização & administração , Espanha/epidemiologia , Telemedicina/métodos , Telemedicina/organização & administração
8.
Cuad Bioet ; 31(102): 167-182, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-32910670

RESUMO

In this paper present, from a bioethical perspective, a reflection on how to reconcile efforts to combat the COVID-19 pandemic with the safeguard of human rights. To do this, I develop three points. First, the regulatory framework that justifies the restriction or suspension of rights in the face of serious threats to public health. Second, the declarations of the international bioethics committees on the way in which human rights should be protected during public health crisis. And third, a review of the main rights threatened both by the public health crisis and by the means adopted to combat it. Before going into each of these points, I offer a preliminary note to clarify certain legal concepts and underline the need to overcome disjunctive approaches in considering human rights.


Assuntos
Betacoronavirus , Controle de Doenças Transmissíveis/legislação & jurisprudência , Direitos Humanos/ética , Pandemias/prevenção & controle , Saúde Pública/ética , Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Comissão de Ética , União Europeia , Liberdade , Recursos em Saúde/ética , Recursos em Saúde/provisão & distribução , Acesso aos Serviços de Saúde/ética , Direitos Humanos/legislação & jurisprudência , Humanos , Pandemias/ética , Pandemias/legislação & jurisprudência , Direitos do Paciente/ética , Direitos do Paciente/legislação & jurisprudência , Autonomia Pessoal , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Guias de Prática Clínica como Assunto , Saúde Pública/legislação & jurisprudência , Quarentena/ética , Quarentena/legislação & jurisprudência , Sujeitos da Pesquisa , Alocação de Recursos/ética , Espanha , UNESCO
9.
Cuad Bioet ; 31(102): 183-202, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-32910671

RESUMO

The article deals with the analysis of the criteria for the allocation of scarce health resources during the pandemic produced by the COVID 19 virus in Spain. It critically analyses the absence of a legal-constitutional perspective in the elaboration of such criteria and suggests the incorporation of the criterion of equity as a guarantee of the effective exercise of the constitutional right to health protection by vulnerable persons.


Assuntos
Betacoronavirus , Recursos em Saúde/ética , Pandemias/ética , Alocação de Recursos/ética , Constituição e Estatutos , Infecções por Coronavirus/prevenção & controle , Teoria Ética , Órgãos Governamentais , Prioridades em Saúde , Recursos em Saúde/legislação & jurisprudência , Recursos em Saúde/provisão & distribução , Acesso aos Serviços de Saúde/ética , Acesso aos Serviços de Saúde/legislação & jurisprudência , Direitos Humanos/legislação & jurisprudência , Humanos , Grupos Minoritários , Pandemias/legislação & jurisprudência , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Publicações , Alocação de Recursos/legislação & jurisprudência , Papel (figurativo) , Justiça Social , Sociedades Médicas , Espanha/epidemiologia , Triagem/ética , Populações Vulneráveis
11.
PLoS One ; 15(8): e0237776, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32822404

RESUMO

While medical advocacy is mandated as a core professional commitment in a growing number of ethical codes and medical training programs, medical advocacy and social justice engagement are regularly subordinated to traditional clinical responsibilities. This study aims to provide insight into factors that motivate clinician engagement and perseverance with medical advocacy, so as to inform attempts by policymakers, leaders and educators to promote advocacy practices in medicine. Furthermore, this study aims to provide an analysis of the role of medical advocates in systems where patients' rights are perceived to be infringed and consider how we might best support and protect these medical advocates as a profession, by exploring the experiences and perspectives of Australian clinicians defending the health of detained asylum seekers. In this qualitative study thirty-two medical and health professionals advocating on asylum seeker health in immigration detention were interviewed. Transcripts were coded both inductively and deductively from interview question domains and thematically analysed. Findings suggested that respondents' motivations for advocacy stemmed from deeply intertwined professional and personal ethics. Overall, advocacy responses originated from the union of three integral stimuli: personal ethics, proximity and readiness. We conclude that each of these three integral factors must be addressed in any attempt to foster advocacy within the medical profession. In light of current global trends of increasingly protectionist immigration practices, promoting effective physician advocacy may become essential in ensuring patients' universal right to health.


Assuntos
Acesso aos Serviços de Saúde , Defesa do Paciente , Refugiados , Austrália , Feminino , Acesso aos Serviços de Saúde/ética , Acesso aos Serviços de Saúde/legislação & jurisprudência , Humanos , Masculino , Defesa do Paciente/ética , Defesa do Paciente/legislação & jurisprudência , Assistência Centrada no Paciente/ética , Assistência Centrada no Paciente/legislação & jurisprudência , Refugiados/legislação & jurisprudência
16.
Aust N Z J Public Health ; 44(5): 349-352, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32510724

RESUMO

OBJECTIVE: To measure public opinion about access to abortion in South Australia. METHODS: An online survey conducted in 2019. SPSS statistical package version 22 was used for data analysis, with data weighted by age, gender, and region. RESULTS: The majority (65%) of the 1,012 respondents supported the ready availability of abortion care and an additional 25% supported availability in certain circumstances. Most (70%) were unaware that abortion remains in criminal law and 80% supported decriminalisation. Support for safe access zones (88%) and the application of existing protections (69%) and obligations (94%) for conscientious objectors was high. A majority (63%) considered that later abortion should be available 'when the woman and her healthcare team decide it is necessary'. CONCLUSIONS: These results confirm the trend of increasing support for access to abortion and add two new insights. There was majority support for using existing general protections for the rights and obligations of those with a conscientious objection to abortion. Second, there was strong support for decisions about later abortion to be decided through normal clinical consultation. These results indicate general community approval of abortion being normalised as healthcare, with the safeguards and accountabilities that status entails. Implications for public health: These results invite repeal of special laws about abortion care, to enable better access.


Assuntos
Aborto Induzido/ética , Aborto Legal/legislação & jurisprudência , Acesso aos Serviços de Saúde/ética , Acesso aos Serviços de Saúde/estatística & dados numéricos , Serviços de Saúde Materna/organização & administração , Opinião Pública , Aborto Induzido/legislação & jurisprudência , Aborto Legal/ética , Aborto Legal/estatística & dados numéricos , Adolescente , Adulto , Atitude do Pessoal de Saúde , Feminino , Acesso aos Serviços de Saúde/legislação & jurisprudência , Humanos , Gravidez , Serviços de Saúde Reprodutiva , Austrália do Sul , Saúde da Mulher , Direitos da Mulher , Adulto Jovem
17.
Psychiatry Res ; 290: 113118, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32593807

RESUMO

This article has the purpose of examining the problem of getting help for the medical-psychiatric-substance use group of "homeless" people on the streets of our cities, who refuse treatment. The problem has gradually worsened since closure of state hospitals and subsequent lack of community resources. It has been stalemated, in part, by advocates, who argue for personal autonomy and freedom rather than involuntary diagnosis and treatment over the life of these people. It has reached a crisis situation secondary to such potential patients being imprisoned and/or sick with COVID-19 being potential health and legal threats. We review A) the nature of the problem, B) the current social-legal availability of treatment and long-term management (or lack of one) in the context of societal rejection of these potential patients, and C) suggest what might be done, locally and nationally. Mandating scientifically-based medical orders to citizens regardless of personal freedom - are now being implemented to manage the COVID-19 pandemic. We argue for creating a similar med-psych short- and long-term system as a new approach to help this group. They are now mostly being ignored "to die on the streets."


Assuntos
Acesso aos Serviços de Saúde/ética , Pessoas em Situação de Rua/psicologia , Transtornos Mentais/terapia , Pandemias/ética , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Betacoronavirus , Infecções por Coronavirus/psicologia , Infecções por Coronavirus/terapia , Humanos , Transtornos Mentais/epidemiologia , Transtornos Mentais/virologia , Autonomia Pessoal , Pneumonia Viral/psicologia , Pneumonia Viral/terapia
18.
Hastings Cent Rep ; 50(3): 79-80, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32596905

RESUMO

The pandemic creates unprecedented challenges to society and to health care systems around the world. Like all crises, these provide a unique opportunity to rethink the fundamental limiting assumptions and institutional inertia of our established systems. These inertial assumptions have obscured deeply rooted problems in health care and deflected attempts to address them. As hospitals begin to welcome all patients back, they should resist the temptation to go back to business as usual. Instead, they should retain the more deliberative, explicit, and transparent ways of thinking that have informed the development of crisis standards of care. The key lesson to be learned from those exercises in rational deliberation is that justice must be the ethical foundation of all standards of care. Justice demands that hospitals take a safety-net approach to providing services that prioritizes the most vulnerable segments of society, continue to expand telemedicine in ways that improve access without exacerbating disparities, invest in community-based care, and fully staff hospitals and clinics on nights and weekends.


Assuntos
Infecções por Coronavirus/epidemiologia , Alocação de Recursos para a Atenção à Saúde/ética , Pneumonia Viral/epidemiologia , Padrão de Cuidado/ética , Betacoronavirus , Acesso aos Serviços de Saúde/ética , Acesso aos Serviços de Saúde/organização & administração , Disparidades em Assistência à Saúde/ética , Disparidades em Assistência à Saúde/organização & administração , Humanos , Pandemias , Admissão e Escalonamento de Pessoal/ética , Admissão e Escalonamento de Pessoal/organização & administração , Padrão de Cuidado/organização & administração , Telemedicina/ética , Telemedicina/organização & administração
19.
Hastings Cent Rep ; 50(3): 65-67, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32596908

RESUMO

While the domestic effect of structural racism and other social vulnerabilities on Covid-19 mortality in the United States has received some attention, there has been much less discussion (with some notable exceptions) of how structural global inequalities will further exacerbate Covid-related health disparity across the world. This may be partially due to the delayed availability of accurate and comparable data from overwhelmed systems, particularly in low- and middle-income countries. However, early methods to procure and develop treatments and vaccines by some high-income countries reflect ongoing protectionist and nationalistic attitudes that can systemically exclude access for people in regions with weaker health systems. What's needed is a global coordinated effort, based on the principle of solidarity, to foster equitable health care access.


Assuntos
Infecções por Coronavirus/epidemiologia , Saúde Global , Disparidades nos Níveis de Saúde , Pneumonia Viral/epidemiologia , Betacoronavirus , Infecções por Coronavirus/mortalidade , Países em Desenvolvimento , Acesso aos Serviços de Saúde/ética , Acesso aos Serviços de Saúde/organização & administração , Humanos , Pandemias , Pneumonia Viral/mortalidade , Estados Unidos/epidemiologia
20.
Hastings Cent Rep ; 50(3): 63-64, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32596915

RESUMO

Given the enduring inequities in US health and health care, it is no surprise that particular communities are bearing the disproportionate brunt of the Covid-19 pandemic and our responses to it. Many ethical aspects of the pandemic involve diverse communities bound by race, ethnicity, disability, income, residence, age, and more. How does bioethics engage these communities in theory and in practice? Only faintly, despite Covid-19's relentless reminder that communities matter morally. This article sketches initial directions for developing a community-inclusive bioethics, one that understands communities as critical moral participants in the work of bioethics as well as in health and health care.


Assuntos
Temas Bioéticos , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Características de Residência/estatística & dados numéricos , Fatores Etários , Betacoronavirus , Infecções por Coronavirus/etnologia , Infecções por Coronavirus/mortalidade , Acesso aos Serviços de Saúde/ética , Humanos , Princípios Morais , Pandemias , Pneumonia Viral/etnologia , Pneumonia Viral/mortalidade , Capital Social , Fatores Socioeconômicos , Estados Unidos/epidemiologia
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