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2.
J Glob Health ; 10(2): 020103, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33110502

RESUMO

The COVID-19 pandemic has put health systems, economies and societies under unprecedented strain, calling for innovative approaches. Scotland's government, like those elsewhere, is facing difficult decisions about how to deploy digital technologies and data to help contain, control and manage the disease, while also respecting citizens' rights. This paper explores the ethical challenges presented by these methods, with particular emphasis on mobile apps associated with contact tracing. Drawing on UK and international experiences, it examines issues such as public trust, data privacy and technology design; how changing disease threats and contextual factors can affect the balance between public benefits and risks; and the importance of transparency, accountability and stakeholder participation for the trustworthiness and good-governance of digital systems and strategies. Analysis of recent technology debates, controversial programmes and emerging outcomes in comparable countries implementing contact tracing apps, reveals sociotechnical complexities and unexpected paradoxes that warrant further study and underlines the need for holistic, inclusive and adaptive strategies. The paper also considers the potential role of these apps as Scotland transitions to the 'new normal', outlines challenges and opportunities for public engagement, and poses a set of ethical questions to inform decision-making at multiple levels, from software design to institutional governance.


Assuntos
Busca de Comunicante/ética , Transmissão de Doença Infecciosa/ética , Direitos Humanos/ética , Aplicativos Móveis/ética , Pandemias/ética , Betacoronavirus , Busca de Comunicante/métodos , Infecções por Coronavirus/prevenção & controle , Transmissão de Doença Infecciosa/prevenção & controle , Governo , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Escócia/epidemiologia , Participação dos Interessados , Tecnologia/ética
3.
J Infect Dev Ctries ; 14(9): 968-970, 2020 09 30.
Artigo em Inglês | MEDLINE | ID: mdl-33031082

RESUMO

The COVID-19 pandemic has created new challenges on multiple fronts including a few ethical concerns. Timely and appropriate access to health services and the need to protect vulnerable people are some of them. An important aspect to consider, at the global level, is the frailty of health systems in many developing countries and the constant threat of these collapsing due to shortage of resources and medical supply. Special attention should be placed towards protecting the health of care workers who are highly exposed to SARS-CoV-2 infection. Research and clinical trials involving COVID-19 patients and healthy human volunteers must be done in strict adherence to the fundamental principles of bioethics, even if finding a solution is an urgent need. Shared responsibility must be assumed as we collectively face a common problem and ethical conflicts must be resolved using, as reference, the guidelines developed by the World Health Organization and other relevant international and national organizations. This would allow responsible action in the face of the pandemic without harming human rights, the individual and collective well-being.


Assuntos
Betacoronavirus , Saúde Global/ética , Pandemias/ética , Ensaios Clínicos como Assunto/ética , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Países em Desenvolvimento , Pessoal de Saúde/ética , Disparidades em Assistência à Saúde/ética , Direitos Humanos/ética , Humanos , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Triagem/ética
4.
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
8.
Hastings Cent Rep ; 50(3): 18-21, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32596887

RESUMO

Artificial intelligence surveillance can be used to diagnose individual cases, track the spread of Covid-19, and help provide care. The use of AI for surveillance purposes (such as detecting new Covid-19 cases and gathering data from healthy and ill individuals) in a pandemic raises multiple concerns ranging from privacy to discrimination to access to care. Luckily, there exist several frameworks that can help guide stakeholders, especially physicians but also AI developers and public health officials, as they navigate these treacherous shoals. While these frameworks were not explicitly designed for AI surveillance during a pandemic, they can be adapted to help address concerns regarding privacy, human rights, and due process and equality. In a time where the rapid implementation of all tools available is critical to ending a pandemic, physicians, public health officials, and technology companies should understand the criteria for the ethical implementation of AI surveillance.


Assuntos
Inteligência Artificial/ética , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Vigilância da População/métodos , Betacoronavirus , Direitos Humanos/ética , Humanos , Pandemias , Privacidade , Racismo/ética
10.
J Med Ethics ; 46(7): 451-454, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32424062

RESUMO

The Director-General of the WHO has suggested that China's approach to the COVID-19 crisis could be the standard of care for global epidemics. However, as remarkable as the Chinese strategy might be, it cannot be replicated in other countries and certainly not in Europe. In Europe, there is a distribution of power between the European Union and its member states. In contrast, China's political power is concentrated in the central government. This enables it to take immediate measures that affect the entire country, such as massive quarantines or closing borders. Moreover, the Chinese legal framework includes restrictions on privacy and other human rights that are unknown in Europe. In addition, China has the technological power to easily impose such restrictions. In most European countries, that would be science fiction. These conditions have enabled China to combat epidemics like no other country can. However, the WHO might have been overoptimistic. The Chinese standard of care for treating COVID-19 also raises problematic issues for human rights, and the real consequences of these actions remain to be seen.


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Padrão de Cuidado/ética , Padrão de Cuidado/normas , Betacoronavirus , China/epidemiologia , Europa (Continente)/epidemiologia , Direitos Humanos/ética , Direitos Humanos/normas , Humanos , Pandemias , Privacidade
11.
Nurs Ethics ; 27(4): 1056-1065, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32223503

RESUMO

The life perspectives of persons with disabilities have been neglected in many countries and particularly in lower- and middle-income countries that have fewer resources to adequately address the societal needs of these persons. Bioethics purports normative standards for the way in which we treat with others, and the virtue of care should be at the heart of everyday life. Human rights are norms that aspire to protect all persons everywhere. Within this milieu, persons with disabilities who make up a significant portion of all societies worldwide meet many social barriers that inhibit their quality of life and leave them greatly disadvantaged in comparison to able-bodied persons. This article focuses on the notion of quality of life, the presumed perspectives of biomedicine and bioethics on disability, the neglect of the lived experience of persons with disabilities, and the discrimination underlying the struggle for equal rights and opportunities for persons with disability. It argues for equal access to social and beneficial medical interventions for persons with disabilities; that persons with disabilities should be seen as different but equal; that their contributions to societal deliberations would enhance the richness of thought, views, narratives and perspectives; and that society should stop using the term disability and use instead the less value-laden term anomaly. Finally, it recommends educational campaigns to change negative attitudes towards persons with predicaments or anomalies, the respecting of human diversity, collaboration between upper-income and lower- and middle-income countries to develop strategies that seek to change negative attitudes towards persons with anomalies, and the inclusion worldwide of all these matters as a part of a bioethics agenda that advocates for respecting the human rights of persons with anomalies.


Assuntos
Pessoas com Deficiência/psicologia , Direitos Humanos/ética , Qualidade de Vida , Direito à Saúde/ética , Discriminação Social , Justiça Social/ética , Bioética , Países Desenvolvidos , Países em Desenvolvimento , Direitos Humanos/legislação & jurisprudência , Humanos , Internacionalidade
12.
Glob Health Action ; 13(sup1): 1699343, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32194016

RESUMO

Background: The presence of corruption in State institutions and broader society presents a significant obstacle to the right to the enjoyment of the highest attainable standard of health. The Universal Periodic Review, a Member State-led peer review system administered by the Human Rights Council, is a core tool of human rights, including the right to health accountability. This paper builds on existing research to examine processes that support State engagement on the issue of corruption. We identify opportunities for States to use the Universal Periodic Review to support anti-corruption, transparency and accountability to control corruption in the health-care sector.Objectives: This paper focuses on health sector how human rights mechanisms, and particularly the Universal Periodic Review, can be a tool for greater accountability for the right to health for corruption in the health sector.Methods: The research team applied qualitative content analysis methods to analyze all 135 Universal Periodic Review documents produced during 2018 in order to analyze how human rights mechanisms address the impact of corruption on the realization of the right to health.Results: Although health rights violations are often addressed within human rights mechanisms such as the UPR, corruption remains under-addressed, suggesting that there are gaps in understanding how corruption can seriously undermine the right to health.Conclusion: Human rights mechanisms should drive greater attention to the importance of addressing corruption in health. In order to make the UPR more effective, this paper suggests that there is a need to generate more awareness of corruption-based violations of the right to health in order to promote greater health accountabilityPractical tools such as strategic litigation and social audits can also contribute to creating greater transparency and accountability in dealing with corruption.


Assuntos
Setor de Assistência à Saúde/ética , Setor de Assistência à Saúde/organização & administração , Acesso aos Serviços de Saúde/ética , Direitos Humanos/ética , Direito à Saúde/ética , Responsabilidade Social , Humanos
13.
Med Law Rev ; 28(1): 65-92, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-30668764

RESUMO

Prisoners are often excluded from participating in clinical research (ie clinical trials and clinical investigations related to medicinal products and medical devices) due to the historical precedent of their abuse and exploitation. The exclusion of prisoners from clinical research is often deemed necessary to guarantee their protection from such abuse and exploitation. However, in this article, we argue that the right to science, which encompasses the right to access the benefits of science and research participation, is an emerging human right that is applicable to prisoners and may only be limited when this is necessary and proportionate. Whether this is necessary depends in part on the validity of a prisoner's informed consent. We discuss the importance of prison conditions for voluntary consent and examine the relationship between prison overcrowding and sub-par prison conditions by analysing the jurisprudence of the European Court of Human Rights on Article 3 of the European Convention on Human Rights on the prohibition of torture and inhuman treatment. We contend that the special circumstances of being in prison warrant additional protective measures, concurring with the Belgian Advisory Committee on Bioethics that research without the explicit aim of improving the situation of the individual prisoner or the prison community should be excluded. Given the complexity of the question of whether prisoners can give valid informed consent, rigorous oversight by an ethics committee with expertise concerning the prison system is necessary to provide a proportional balance between offering prisoners access to research and protection from abuse and exploitation.


Assuntos
Experimentação Humana/ética , Experimentação Humana/legislação & jurisprudência , Consentimento Livre e Esclarecido/ética , Consentimento Livre e Esclarecido/legislação & jurisprudência , Prisioneiros , Prisões/ética , Comitês Consultivos , Bioética , Ensaios Clínicos como Assunto , União Europeia , Direitos Humanos/ética , Direitos Humanos/legislação & jurisprudência , Humanos
14.
Nurs Philos ; 21(1): e12284, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31512809

RESUMO

The concept of equality is subject to many different interpretations, and it is closely connected to similar concepts such as equity, justice, fairness, and human rights. As an ideal, equality entails many aspects that are untenable. For instance, genetic and social inequalities may never be extinct, but they can both be ameliorated by proper distribution of society's resources. Likewise, within the context of health care, equality can be promoted by proper rationing of health resources, amongst which nursing care stands out. In the field of nursing, the principle of equality presents itself in various forms of ethical and deontological mandates. However, beyond good intentions and abstract notions, there is a need to examine the ways in which nurses enforce this principle in practice, within the reality of modern health systems. Although there is scarcity of qualitative evidence in the nursing care rationing literature, existing studies suggest that fair treatment pertains to a largely intuitive sense of equality which involves subjective perceptions and judgements about rationing. Nurses' initial predisposition is to view all patients as equal and treat them in an equal manner; yet, on an individual basis, each patient has a different starting point, different needs and different prospects that render rationing decisions complex and uncertain. Equality should be accepted with its unavoidable limitations in practice and be further examined within the context of nursing care rationing, in the hope that it can be advanced in a consistent way, despite the idealistic nature in many of its aspects.


Assuntos
Alocação de Recursos para a Atenção à Saúde/ética , Direitos Humanos/ética , Cuidados de Enfermagem/métodos , Alocação de Recursos para a Atenção à Saúde/tendências , Direitos Humanos/tendências , Humanos , Cuidados de Enfermagem/tendências , Justiça Social
15.
Bioethics ; 34(1): 33-40, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31222790

RESUMO

Germline genome editing is often disapproved of at the international policy level because of its possible threats to human dignity. However, from a critical perspective the relationship between this emerging technology and human dignity is relatively understudied. We explore the main principles that are referred to when 'human dignity' is invoked in this context; namely, the link with eugenics, the idea of a common genetic heritage, the principle of equal birth and broader equality and justice concerns. Yet the concept is also used in favour of germline genome editing as it might improve the overall well-being of future generations. We conclude that dignity concerns do not justify a complete ban on safe heritable genome editing but should inform the implementation of side constraints to ensure that the value judgements about human traits that are inherent in this practice do not result in a diminished basic respect for those people affected by them.


Assuntos
Edição de Genes/ética , Genoma Humano , Células Germinativas , Direitos Humanos/ética , Direitos Humanos/legislação & jurisprudência , Pessoalidade , Edição de Genes/legislação & jurisprudência , Humanos
16.
Front Public Health ; 8: 570243, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33490011

RESUMO

Introduction: COVID-19 requires governmental measures to protect healthcare system access for people. In this process, the collision of fundamental rights emerges as a crucial challenge for decision-making. Policy Options and Implications: This policy review analyzes selected articles by the PubMed searcher about extreme measures taken in several countries during precedent pandemics and the current pandemic, and selects hard decisions relating to the exceptional measures taken by judicial departments in Brazil, connecting them to the "collision of fundamental rights and law principles." The collision of rights and principles imposed on decision makers a duty to provide balanced rights, and to adopt the enforcement of some rights prioritization. Ethical concerns were also verified in this field involving rights limitations. During a pandemic, the importance of extreme measures to protect health rights and healthcare systems is instrumental for focused, fast, and correct decision making to avoid loss of life and the collapse of healthcare systems. The main goals of this research are to discuss the implications and guidelines for public health decision making, the indispensable ethical and legal aspects for safeguarding health systems and the lives of people, and the respect of the Justice principle and of fundamental health and dignity rights. We conclude that COVID-19 justifies the prioritization of collective and individual health access rights. Acceptable standards of fundamental rights restrictions are established at the constitutional and international levels and must be enforced by rules and governmental action, to ensure fast and accurate decision making during a pandemic. Freedom rights exercises must be linked to solidarity for the realization of social welfare, for the health rights of all individuals and for health systems to function well during a pandemic. Actionable Recommendations: All individuals are free and equal, therefore social exclusion is prohibited. Institutions must consider social inequalities when discussing public health measures and be guided by ethical standards, by law principles, and rules recognized by constitutional and international law for the benefit of all during a health pandemic. Conclusions: Collective and individual health rights prevail over the collision of rights when facing pandemic occurrences, case by case, in health systems protection, based on the literature, on precedent pandemics and on legitimate Public Health efforts.


Assuntos
Acesso aos Serviços de Saúde , Direitos Humanos/ética , Política Pública , Direito à Saúde , Brasil , Tomada de Decisões , Humanos , Saúde Pública
18.
J Acquir Immune Defic Syndr ; 82 Suppl 2: S91-S93, 2019 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-31658193

RESUMO

The fight against HIV started and continues to be a fight for human rights. AIDS was observed first in the United States in marginalized and stigmatized populations such as men who have sex with men, injection drug users, and commercial sex workers. Next were the observations of generalized epidemics in sub-Saharan Africa, a continent crippled by the legacy of colonialism. AIDS appeared in post-World War II, which witnessed independence of the former European colonies and the creation of the United Nations. There was remarkable advocacy that led to important advances in the rights of ethnic and racial minorities, sexual minorities, and women. This foundation of activism laid the groundwork to ensure that AIDS, and those infected with HIV, were addressed using the best of human rights frameworks. Social and behavioral sciences contributed important data to the human rights advances in the second half of the 20th century, and to the tools and resources needed for a human rights-based response to HIV. Remarkable investment in science have brought us new tools to treat and prevent HIV. Vigorous social and behavioral science research continues to be needed to ensure that the continued response to the HIV epidemic remains evidence-based, recognizing human rights, and ensuring that the scientific advances are available to everyone who needs them. Generations of scientists and activists need to continue as we are far from finished in the fight against HIV and for human rights.


Assuntos
Síndrome de Imunodeficiência Adquirida/prevenção & controle , Epidemias/prevenção & controle , Infecções por HIV/prevenção & controle , Direitos Humanos , Usuários de Drogas , Infecções por HIV/tratamento farmacológico , Infecções por HIV/psicologia , Disparidades nos Níveis de Saúde , Direitos Humanos/ética , Humanos , Profissionais do Sexo , Minorias Sexuais e de Gênero , Estigma Social , Pesquisa Médica Translacional
19.
CRISPR J ; 2(5): 293-298, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31599687

RESUMO

Genome editing has opened up the possibility of heritable alteration of the human germline. The potential of this powerful tool has spurred a call for establishing robust regulatory frameworks to outline permissible uses of genome editing and to map a rational and ethical course. In response, major national scientific bodies and international organizations have convened and released comprehensive reports outlining recommendations for ethical regulatory frameworks. Significantly, these include an emphasis on public participation and the development of principles to guide future applications of genome editing. While essential, public input and principles are not sufficient to ensure ethical uses of this technology. We propose an approach that relies not only on agreed-upon principles and a democratic process but requires a Human Rights Impact Assessment to evaluate the potential burdens that such biomedical interventions may place on human rights.


Assuntos
Edição de Genes/ética , Direitos Humanos/ética , Sistemas CRISPR-Cas , Células Germinativas , Humanos , Princípios Morais , Valores Sociais
20.
Bioethics ; 33(8): 908-913, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31532848

RESUMO

This article reflects on the challenges of developing academic research that is undertaken to create social change. I describe the ways that my research has been generated and guided by activism. Even though the descriptor of my research interests is generally gender-based violence and mental health, my research is situated within an ongoing political discourse that fundamentally opposes and normatively challenges ideologies such as those implemented at a governmental level during the Taliban regime in Afghanistan that continue to have power over Afghan women's lives. I critique the emergence of two research projects that work with women survivors of violence and develop trauma therapeutic interventions using traditional storytelling. My positionality as a woman of Muslim origin and an academic in the U.K. resulted in inescapable juxtapositions and the necessary blurring of the boundaries between personal and professional viewpoints as well as highlighting the potency of traumatic stories in contexts of conflict, oppression, silencing and marginalization. I go on to explain why I have a moral obligation as an ethicist working in global health, with resources and expertise, to systematically develop my research questions and objectives in accordance with the end-goal of tackling and deconstructing harmful ideologies and practices towards women and girls in societies marred by the violent complexities of national and international conflicts.


Assuntos
Bioética , Violência de Gênero/ética , Violência de Gênero/prevenção & controle , Direitos Humanos/ética , Ativismo Político , Sexismo/ética , Adolescente , Adulto , Afeganistão , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Pessoa de Meia-Idade , Reino Unido , Adulto Jovem
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