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1.
Chiropr Man Therap ; 28(1): 65, 2020 11 18.
Artigo em Inglês | MEDLINE | ID: mdl-33208144

RESUMO

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.


Assuntos
Quiroprática/ética , Informação de Saúde ao Consumidor/ética , Decepção , Pandemias/ética , Má Conduta Profissional , Betacoronavirus , Comunicação , Infecções por Coronavirus , Humanos , Manipulação da Coluna/ética , Pneumonia Viral
2.
Rev Esp Salud Publica ; 942020 Nov 06.
Artigo em Espanhol | MEDLINE | ID: mdl-33154346

RESUMO

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.


Assuntos
Infecções por Coronavirus/epidemiologia , Ética Médica , Equidade em Saúde , Pandemias/ética , Pneumonia Viral/epidemiologia , Betacoronavirus , Controle de Doenças Transmissíveis/métodos , Humanos , Vírus da Influenza A Subtipo H1N1 , Influenza Humana/epidemiologia , Espanha/epidemiologia
3.
Rev. bioét. derecho ; (50): 37-61, nov. 2020.
Artigo em Espanhol | IBECS | ID: ibc-191345

RESUMO

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


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Pandemias/ética , Protocolos Clínicos , Triagem/ética , Tomada de Decisões/ética
4.
Rev. bioét. derecho ; (50): 133-148, nov. 2020.
Artigo em Espanhol | IBECS | ID: ibc-191350

RESUMO

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


Assuntos
Humanos , Registros de Saúde Pessoal/ética , Cooperação Internacional , Infecções por Coronavirus , Pneumonia Viral , Pandemias/ética , Pandemias/legislação & jurisprudência
5.
Rev. bioét. derecho ; (50): 333-352, nov. 2020.
Artigo em Português | IBECS | ID: ibc-191361

RESUMO

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


Assuntos
Humanos , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Pandemias/ética , Saúde Mental , Bioética , Prioridades em Saúde , Gestão de Recursos , Alocação de Recursos/ética , Brasil/epidemiologia
11.
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
15.
Acad Med ; 95(10): 1488-1491, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33006868

RESUMO

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.


Assuntos
Educação Médica/ética , Ética Médica/educação , Pandemias/ética , Profissionalismo/educação , Betacoronavirus , Infecções por Coronavirus , Humanos , Pneumonia Viral , Profissionalismo/ética , Faculdades de Medicina , Sociedades Médicas
16.
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
18.
BMJ Open ; 10(10): e040638, 2020 10 16.
Artigo em Inglês | MEDLINE | ID: mdl-33067300

RESUMO

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.


Assuntos
Grupo com Ancestrais do Continente Africano , Grupo com Ancestrais do Continente Asiático , Betacoronavirus , Hospitais/estatística & dados numéricos , Grupos Minoritários , Pandemias/ética , Idoso , Idoso de 80 Anos ou mais , Causas de Morte , Comorbidade , Infecções por Coronavirus , Feminino , Humanos , Londres/epidemiologia , Masculino , Pneumonia Viral , Estudos Retrospectivos , Taxa de Sobrevida/tendências
19.
J Med Ethics ; 46(11): 726-731, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32913116

RESUMO

It has recently been reported that some hospitals in the UK have placed a blanket restriction on the provision of maternal request caesarean sections (MRCS) as a result of the COVID-19 pandemic. Pregnancy and birthing services are obviously facing challenges during the current emergency, but we argue that a blanket ban on MRCS is both inappropriate and disproportionate. In this paper, we highlight the importance of MRCS for pregnant people's health and autonomy in childbirth and argue that this remains crucial during the current emergency. We consider some potential arguments-based on pregnant people's health and resource allocation-that might be considered justification for the limitation of such services. We demonstrate, however, that these arguments are not as persuasive as they might appear because there is limited evidence to indicate either that provision of MRCS is always dangerous for pregnant people in the circumstances or would be a substantial burden on a hospital's ability to respond to the pandemic. Furthermore, we argue that even if MRCS was not a service that hospitals are equipped to offer to all pregnant persons who seek it, the current circumstances cannot justify a blanket ban on an important service and due attention must be paid to individual circumstances.


Assuntos
Cesárea/ética , Tomada de Decisões/ética , Alocação de Recursos para a Atenção à Saúde/ética , Direitos Humanos , Pandemias/ética , Complicações Infecciosas na Gravidez/prevenção & controle , Betacoronavirus , Cesárea/efeitos adversos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/virologia , Procedimentos Cirúrgicos Eletivos/efeitos adversos , Procedimentos Cirúrgicos Eletivos/ética , Feminino , Saúde , Hospitais , Humanos , Mães , Pandemias/prevenção & controle , Autonomia Pessoal , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/virologia , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/etiologia , Complicações Infecciosas na Gravidez/virologia , Gestantes , Reino Unido
20.
J Med Ethics ; 46(11): 732-735, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32958693

RESUMO

A recent update to the Geneva Declaration's 'Physician Pledge' involves the ethical requirement of physicians to share medical knowledge for the benefit of patients and healthcare. With the spread of COVID-19, pockets exist in every country with different viral expressions. In the Chareidi ('ultra-orthodox') religious community, for example, rates of COVID-19 transmission and dissemination are above average compared with other communities within the same countries. While viral spread in densely populated communities is common during pandemics, several reasons have been suggested to explain the blatant flouting of public health regulations. It is easy to fault the Chareidi population for their proliferation of COVID-19, partly due to their avoidance of social media and internet aversion. However, the question remains: who is to blame for their community crisis? The ethical argument suggests that from a public health perspective, the physician needs to reach out and share medical knowledge with the community. The public's best interests are critical in a pandemic and should supersede any considerations of cultural differences. By all indications, therefore, the physician has an ethical obligation to promote population healthcare and share medical knowledge based on ethical concepts of beneficence, non-maleficence, utilitarian ethics as well as social, procedural and distributive justice. This includes the ethical duty to reduce health disparities and convey the message that individual responsibility for health has repercussions within the context of broader social accountability. Creative channels are clearly demanded for this ethical challenge, including measured medical paternalism with appropriate cultural sensitivity in physician community outreach.


Assuntos
Educação em Saúde/ética , Obrigações Morais , Pandemias/ética , Médicos/ética , Papel Profissional , Responsabilidade Social , Acesso à Informação , Beneficência , Betacoronavirus , Códigos de Ética , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/virologia , Competência Cultural , Cultura , Teoria Ética , Equidade em Saúde , Promoção da Saúde/ética , Humanos , Internet , Pandemias/prevenção & controle , Paternalismo , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/virologia , Saúde Pública/ética , Religião , Justiça Social
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