Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.134
Filtrar
1.
Bull World Health Organ ; 99(2): 155-161, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33551509

RESUMO

Restrictive measures imposed because of the coronavirus disease 2019 (COVID-19) pandemic have resulted in severe social, economic and health effects. Some countries have considered the use of immunity certification as a strategy to relax these measures for people who have recovered from the infection by issuing these individuals a document, commonly called an immunity passport. This document certifies them as having protective immunity against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the virus that causes COVID-19. The World Health Organization has advised against the implementation of immunity certification at present because of uncertainty about whether long-term immunity truly exists for those who have recovered from COVID-19 and concerns over the reliability of the proposed serological test method for determining immunity. Immunity certification can only be considered if scientific thresholds for assuring immunity are met, whether based on antibodies or other criteria. However, even if immunity certification became well supported by science, it has many ethical issues in terms of different restrictions on individual liberties and its implementation process. We examine the main considerations for the ethical acceptability of immunity certification to exempt individuals from restrictive measures during the COVID-19 pandemic. As well as needing to meet robust scientific criteria, the ethical acceptability of immunity certification depends on its uses and policy objectives and the measures in place to reduce potential harms, and prevent disproportionate burdens on non-certified individuals and violation of individual liberties and rights.


Assuntos
/ética , Certificação/ética , Pandemias , Saúde Pública/ética , Humanos , Imunidade Humoral
3.
Vaccine ; 39(6): 994-999, 2021 02 05.
Artigo em Inglês | MEDLINE | ID: mdl-33423839

RESUMO

Vaccination plays an important role in pandemic planning and response. The possibility of developing an effective vaccine for a novel pandemic virus is not assured. However, as we have seen with SARS-CoV-2 vaccine development, with sufficient resources and global focus, successful outcomes can be achieved in a relatively short period. However even when vaccine is available it will initially be scarce. When one becomes available, how should it be distributed? In this paper we explicate how ethical thinking that is carefully attuned to context is essential to decisions about how we should conduct vaccination in a pandemic where demand exceeds supply. We focus on two key issues. First, setting the aims for a pandemic vaccination programme. Second, thinking about the means of delivering a chosen aim. We outline how pandemic vaccine distribution strategies can be implemented with distinct aims, e.g. protecting groups at greater risk of harm, saving the most lives, or ensuring societal benefit. Each aim will result in a focus on a different priority population and each strategy will have a different benefit-harm profile. Once we have decided our aim, we still have choices to make about delivery. We may achieve at least some ends via direct or indirect strategies. Such policy decisions are not merely technical, but necessarily involve ethics. One important general issue is that such planning decisions about distribution will always be made under conditions of uncertainty about vaccine safety and effectiveness. However, planning how to distribute vaccine for SARS-CoV-2 is even harder because we understand relatively little about the virus, transmission, and its immunological impact in the short and long term.


Assuntos
/prevenção & controle , Programas de Imunização , Pandemias/prevenção & controle , Vacinação/ética , Vacinação/métodos , Assistência à Saúde/métodos , Assistência à Saúde/normas , Humanos , Programas de Imunização/ética , Programas de Imunização/métodos , Saúde Pública/ética , Saúde Pública/métodos , Vacinação/psicologia
5.
Genome Med ; 12(1): 95, 2020 11 09.
Artigo em Inglês | MEDLINE | ID: mdl-33168072

RESUMO

Genomic studies of patients with COVID-19, or exposed to it, are underway to delineate host factors associated with variability in susceptibility, infectivity, and disease severity. Here, we highlight the ethical implications-both potential benefits and harms-of genomics for clinical practice and public health in the era of COVID-19.


Assuntos
Infecções por Coronavirus/patologia , Predisposição Genética para Doença/genética , Testes Genéticos/ética , Genômica/ética , Pneumonia Viral/patologia , Saúde Pública/ética , Betacoronavirus , Tomada de Decisão Clínica/métodos , Infecções por Coronavirus/terapia , Genômica/métodos , Humanos , Pandemias , Pneumonia Viral/terapia , Saúde Pública/métodos
10.
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
11.
S Afr Med J ; 110(6): 469-472, 2020 04 22.
Artigo em Inglês | MEDLINE | ID: mdl-32880555

RESUMO

Quarantine is a very effective method for containing the spread of highly infectious diseases in large populations during a pandemic, but it is only effective if properly implemented. The co-operation and compliance of people entering quarantine are critical to its success. However, owing to the isolating and social distancing nature of quarantine, it often leads to extreme economic hardship and shortages in basic needs such as food, medicine, water and communication - and to the curtailment of certain universal social norms such as attending a parent's funeral. To escape these hardships, people often refuse to enter voluntary quarantine, or breach quarantine rules. In these circumstances, health authorities are obliged to act in the best interests of the public and obtain court orders to force some people into quarantine. In further extreme circumstances, when a national lockdown is ordered, non-compliance with quarantine measures may result in arrests and penalties. The scope of this article is limited to the period prior to and following such a lockdown, during which quarantine may still be vital for the containment of COVID-19. Because a quarantine order will deprive an individual of his or her freedom, this must be carefully balanced with the public interest. This article explains the legal and ethical considerations of this balancing exercise and provides practical guidance for obtaining quarantine orders.


Assuntos
Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Saúde Pública/legislação & jurisprudência , Quarentena/legislação & jurisprudência , Infecções por Coronavirus/epidemiologia , Humanos , Pneumonia Viral/epidemiologia , Saúde Pública/ética , Quarentena/ética , África do Sul/epidemiologia
12.
Rev Esp Salud Publica ; 942020 Sep 07.
Artigo em Espanhol | MEDLINE | ID: mdl-32894259

RESUMO

The SARS-CoV-2 pandemic (Covid-19) has had a major impact on residents of assisted-living facilities. While it is plausible that the characteristics of these patients and their special clinical fragility have contributed to their greater vulnerability to infection, other related factors cannot be ruled out, such as the quality of management at these centers and the lack of planning for actions taken before and during the health crisis. Both aspects pertain to the field of public health, where the ethics of the common good conflicts with the autonomy of the individual.


Assuntos
Moradias Assistidas/ética , Planejamento em Saúde Comunitária/ética , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Saúde Pública/ética , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Humanos , Pneumonia Viral/epidemiologia , Fatores de Risco , Espanha/epidemiologia
13.
BMC Med Ethics ; 21(1): 91, 2020 09 22.
Artigo em Inglês | MEDLINE | ID: mdl-32962671

RESUMO

BACKGROUND: In response to COVID-19 pandemic, the Government of Uganda adopted public health measures to contain its spread in the country. Some of the initial measures included refusal to repatriate citizens studying in China, mandatory institutional quarantine, and social distancing. Despite being a public health emergency, the measures adopted deserve critical appraisal using an ethics and human rights approach. The goal of this paper is to formulate an ethics and human rights criteria for evaluating public health measures and use it to reflect on the ethical propriety of those adopted by the government of Uganda to contain the spread of COVID-19. MAIN BODY: We begin by illustrating the value of ethics and human rights considerations for public health measures including during emergencies. We then summarize Uganda's social and economic circumstances and some of the measures adopted to contain the spread of COVID-19. After reviewing some of the ethics and human rights considerations for public health, we reflect upon the ethical propriety of some of Uganda's responses to COVID-19. We use content analysis to identify the measures adopted by the government of Uganda to contain the spread of COVID-19, the ethics and human rights considerations commonly recommended for public health responses and their importance. Our study found that some of the measures adopted violate ethics and human rights principles. We argue that even though some human rights can sometimes be legitimately derogated and limited to meet public health goals during public health emergencies, measures that infringe on human rights should satisfy certain ethics and human rights criteria. Some of these criteria include being effective, strictly necessary, proportionate to the magnitude of the threat, reasonable in the circumstances, equitable, and least restrictive. We reflect on Uganda's initial measures to combat the spread of COVID-19 and argue that many of them fell short of these criteria, and potentially limit their effectiveness. CONCLUSION: The ethical legitimacy of public health measures is valuable in itself and for enhancing effectiveness of the measures. Such legitimacy depends on the extent to which they conform to ethics and human rights principles recommended for public health measures.


Assuntos
Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/epidemiologia , Direitos Humanos , Pneumonia Viral/epidemiologia , Saúde Pública/ética , Betacoronavirus , Países em Desenvolvimento , Humanos , Pandemias , Uganda/epidemiologia
14.
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
15.
Am J Hum Genet ; 107(4): 743-752, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32946764

RESUMO

Analyzing genomic data across populations is central to understanding the role of genetic factors in health and disease. Successful data sharing relies on public support, which requires attention to whether people around the world are willing to donate their data that are then subsequently shared with others for research. However, studies of such public perceptions are geographically limited and do not enable comparison. This paper presents results from a very large public survey on attitudes toward genomic data sharing. Data from 36,268 individuals across 22 countries (gathered in 15 languages) are presented. In general, publics across the world do not appear to be aware of, nor familiar with, the concepts of DNA, genetics, and genomics. Willingness to donate one's DNA and health data for research is relatively low, and trust in the process of data's being shared with multiple users (e.g., doctors, researchers, governments) is also low. Participants were most willing to donate DNA or health information for research when the recipient was specified as a medical doctor and least willing to donate when the recipient was a for-profit researcher. Those who were familiar with genetics and who were trusting of the users asking for data were more likely to be willing to donate. However, less than half of participants trusted more than one potential user of data, although this varied across countries. Genetic information was not uniformly seen as different from other forms of health information, but there was an association between seeing genetic information as special in some way compared to other health data and increased willingness to donate. The global perspective provided by our "Your DNA, Your Say" study is valuable for informing the development of international policy and practice for sharing genomic data. It highlights that the research community not only needs to be worthy of trust by the public, but also urgent steps need to be taken to authentically communicate why genomic research is necessary and how data donation, and subsequent sharing, is integral to this.


Assuntos
Genoma Humano , Genômica/ética , Disseminação de Informação/ética , Análise de Sequência de DNA/ética , Confiança/psicologia , Adulto , América , Ásia , Austrália , Europa (Continente) , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Masculino , Saúde Pública/ética , Inquéritos e Questionários
16.
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
17.
Am J Trop Med Hyg ; 103(4): 1367-1369, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32861265

RESUMO

Polio is a deadly viral disease that has been paralyzing many children in Afghanistan. Despite fundamental efforts, primarily vaccination, to reduce the number of cases in Afghanistan, there are still many children who are deprived of the vaccine every year. Afghanistan is one of the two remaining countries endemic for polio, and the country has undergone various challenges that have hampered the eradication of this disease. The underlying challenges include inaccessibility of unsecured areas, illiteracy, refusal, and, most recently, COVID-19. The country is in the midst of a battle against COVID-19, and polio has almost entirely been neglected. Sadly, polio cases are increasing in the country, particularly in polio-free provinces. After an initial lockdown, many businesses have been allowed to resume, but the mass polio vaccination campaign has not restarted. New cases of polio will surge if endemic regions remain unvaccinated or inaccessible. To curb the further spread of polio, Afghanistan needs to resume nationwide house-to-house vaccination as restrictions due to COVID-19 are loosened.


Assuntos
Infecções por Coronavirus/epidemiologia , Surtos de Doenças , Programas de Imunização/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Poliomielite/epidemiologia , Poliomielite/prevenção & controle , Vacinas contra Poliovirus/administração & dosagem , Vacinação/estatística & dados numéricos , Afeganistão/epidemiologia , Betacoronavirus/patogenicidade , Pré-Escolar , Coinfecção , Infecções por Coronavirus/economia , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/virologia , Doenças Endêmicas/economia , Feminino , Humanos , Incidência , Lactente , Alfabetização/estatística & dados numéricos , Masculino , Pandemias/economia , Pneumonia Viral/economia , Pneumonia Viral/imunologia , Pneumonia Viral/virologia , Poliomielite/economia , Poliomielite/imunologia , Poliovirus/patogenicidade , Pobreza/estatística & dados numéricos , Saúde Pública/ética , Terrorismo/estatística & dados numéricos
18.
Lancet Psychiatry ; 7(11): 991-996, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32861267

RESUMO

The COVID-19 pandemic and the World War 2 aerial bombing campaign against the UK between 1939 and 1945 both exposed the civilian population to a sustained threat. Risk, whether from exposure to viral load or the density of the bombing, led to a range of protective measures and behavioural regulations being implemented. The V1 and V2 missiles used in summer and autumn, 1944, functioned as a second wave of bombing, arriving after people believed the danger had passed. Adherence to lockdown and a reluctance to return to work after the lifting of lockdown during the COVID-19 pandemic in the UK were mirrored in the preference for using home-based bomb shelters during the air raids. Heightened sensitivity to risk, or a so-called deep shelter mentality, did not materialise even during the second wave of bomb attacks and some deep bomb shelters were closed because of low occupancy. The most popular protective measures were those that reflected people's preferences, and not necessarily those that provided the greatest safety. As with the COVID-19 pandemic, the public drove government policy as much as they followed it.


Assuntos
Defesa Civil , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Psicologia Social , Saúde Pública , II Guerra Mundial , Betacoronavirus , Defesa Civil/ética , Defesa Civil/história , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , História do Século XX , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/psicologia , Saúde Pública/ética , Saúde Pública/métodos , Responsabilidade Social , Reino Unido
19.
Am J Trop Med Hyg ; 103(4): 1357-1359, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32828138

RESUMO

The COVID-19 pandemic has had a severe impact worldwide. Developed countries, such as the United States, United Kingdom, Italy, and Spain, had their highly efficient medical infrastructure greatly stressed and suffered from high death tolls. Similarly, Bangladesh, a poverty-stricken South Asian country, is losing its battle against the pandemic, but mainly because of its incompetent healthcare system. The casualties are escalating and public sufferings are becoming unimaginable. On this backdrop, this perspective piece discusses the healthcare crisis in Bangladesh during the pandemic. This article also identifies three responsible issues for the country's deteriorating health care: 1) poor governance and increased corruption, 2) inadequate healthcare facilities, and 3) weak public health communication.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/epidemiologia , Análise do Modo e do Efeito de Falhas na Assistência à Saúde , Pandemias , Pneumonia Viral/epidemiologia , Saúde Pública/ética , Bangladesh/epidemiologia , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Países em Desenvolvimento , Humanos , Incidência , Pneumonia Viral/diagnóstico , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Pobreza , Índice de Gravidade de Doença
20.
QJM ; 113(10): 717-719, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-32780855

RESUMO

Societies are organizing themselves to keep the COVID-19 virus at bay for the foreseeable future. The World Health Organization (WHO) has proposed that every country implement a comprehensive set of measures to prevent infection, detect cases, interrupt transmission, control clusters, suppress outbreaks and reduce mortality. Throughout the world, four systems capabilities are emerging that are important for societies to get ahead of the virus and become COVID-19 ready. First: understand the pattern of infection locally and act on it effectively: assess the status of the outbreak; act rapidly and robustly to interrupt transmission. Second: enable people to be active participants in their own responses. Third: focus on the places where people are most at risk of infection. Fourth: assess the performance of responses to COVID-19 infection: detecting cases, interrupting chains of transmission, minimizing adverse consequences, protecting the most vulnerable and ensuring opportunities for sustainable livelihoods and well-being for all, leaving no-one behind. These four capabilities are being woven together within societies: successful weaving can be helped through focusing on three interlinked elements: making information available; assessing and reducing risk; and being able to suppress outbreaks rapidly. This means involving everyone in the response and having strong public health defences. Governments, authorities, public health teams, employers and community organizations make it possible for us to stay safe but, in the end, what happens is up to all of us, individually and collectively. If we are to live well with the threat of COVID-19, solidarity really does matter.


Assuntos
Defesa Civil/organização & administração , Controle de Doenças Transmissíveis , Infecções por Coronavirus , Transmissão de Doença Infecciosa/prevenção & controle , Saúde Global , Pandemias , Pneumonia Viral , Saúde Pública , Betacoronavirus/isolamento & purificação , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Participação da Comunidade/métodos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Saúde Global/normas , Saúde Global/tendências , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Saúde Pública/ética , Saúde Pública/métodos , Saúde Pública/tendências , Medição de Risco/métodos , Responsabilidade Social
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA