{"title":"Towards Universal Health Coverage — A contribution to the debate","authors":"Ravi Duggal","doi":"10.20529/ijme.2024.046","DOIUrl":"https://doi.org/10.20529/ijme.2024.046","url":null,"abstract":"","PeriodicalId":35523,"journal":{"name":"Indian journal of medical ethics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141800095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Dr Marthanda Varma Sankaran Valiathan (1934-2024)","authors":"Sunil K Pandya","doi":"10.20529/ijme.2024.045","DOIUrl":"https://doi.org/10.20529/ijme.2024.045","url":null,"abstract":"","PeriodicalId":35523,"journal":{"name":"Indian journal of medical ethics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141816056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The commentary “Public health ethics and the Kerala Public Health Act, 2023" published on January 27, 2024 in the Indian Journal of Medical Ethics (IJME) has received a response from members of the State Health Systems Resource Centre and Government Medical College, Malappuram, Kerala. They explain that the Kerala Public Health Act (KPHA) is a legal document and not required to explicitly include accountability mechanisms and social obligations of the state. Given the very real danger of state over-reach as was evident during the Covid pandemic, these checks and balances should, in fact, be non-negotiable. The position of KPHA on healthcare of migrant workers and patients with tuberculosis goes against existing public healthcare principles. There is therefore a need to revisit the Act to explicitly include state accountability.
2024 年 1 月 27 日发表在《印度医学伦理学杂志》（IJME）上的评论文章《公共卫生伦理学与 2023 年喀拉拉邦公共卫生法》收到了喀拉拉邦国家卫生系统资源中心（State Health Systems Resource Centre）和马拉普拉姆政府医学院（Government Medical College, Malappuram, Kerala）成员的回复。他们解释说，《喀拉拉邦公共卫生法》（KPHA）是一份法律文件，不需要明确包括该邦的问责机制和社会义务。考虑到在 Covid 大流行期间各州明显存在过度干预的现实危险，这些制衡机制实际上应该是不容讨价还价的。KPHA 在外来务工人员和肺结核患者医疗保健问题上的立场违背了现有的公共医疗保健原则。因此，有必要重新审查该法，明确纳入国家问责制。
{"title":"KPHA 2023 should explicitly include state accountability: Response to Fernandez et al","authors":"Sylvia Karpagam","doi":"10.20529/ijme.2024.044","DOIUrl":"https://doi.org/10.20529/ijme.2024.044","url":null,"abstract":"The commentary “Public health ethics and the Kerala Public Health Act, 2023\" published on January 27, 2024 in the Indian Journal of Medical Ethics (IJME) has received a response from members of the State Health Systems Resource Centre and Government Medical College, Malappuram, Kerala. They explain that the Kerala Public Health Act (KPHA) is a legal document and not required to explicitly include accountability mechanisms and social obligations of the state. Given the very real danger of state over-reach as was evident during the Covid pandemic, these checks and balances should, in fact, be non-negotiable. The position of KPHA on healthcare of migrant workers and patients with tuberculosis goes against existing public healthcare principles. There is therefore a need to revisit the Act to explicitly include state accountability.","PeriodicalId":35523,"journal":{"name":"Indian journal of medical ethics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141830623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Kaala Paani and epidemic ethics: hit or miss?","authors":"V. Gopichandran","doi":"10.20529/ijme.2023.079","DOIUrl":"https://doi.org/10.20529/ijme.2023.079","url":null,"abstract":"","PeriodicalId":35523,"journal":{"name":"Indian journal of medical ethics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141827672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Injuries and deaths following Covid-19 vaccination: The ethical and legal case for compensation","authors":"Veena Johari, Sandhya Srinivasan","doi":"10.20529/ijme.2024.041","DOIUrl":"https://doi.org/10.20529/ijme.2024.041","url":null,"abstract":"","PeriodicalId":35523,"journal":{"name":"Indian journal of medical ethics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141831073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Culturally competent healthcare improves patient satisfaction and clinical outcomes. Many drugs, dressings and implants have human or animal-derived content which may conflict with patients’ religious beliefs, and may even have medicolegal implications. Methods: This cross-sectional study (anonymous web-based survey) was done to understand the informed consent process followed by paediatricians and neonatologists in India, their views regarding disclosure pertaining to the animal origin of exogenous surfactants to patients’ families, and their willingness and ability to provide alternative surfactants based on parental preferences. Results: A total of 114 neonatologists/paediatricians involved in neonatal care and using surfactants in their practice responded to the survey. Although 61(53.5%) neonatal care units stocked two or more brands of surfactant in their inventory, only 38(33.3%) units had both bovine and porcine preparations. Most (104, 91.2%) of the doctors always take parental consent before administering surfactants; but only a few (12,10.5%) said they always inform parents about its animal origin. None of the respondents offer parents a choice between bovine or porcine-origin surfactants, most (73, 64%) presuming that it would be irrelevant for the parents. However, many respondents (27, 23.7%) mentioned that they want to offer the choice to parents but are unable to do so because they do not stock both bovine and porcine preparations. Conclusion: Although most parents might agree to a life-saving medicine in emergency situations, this does not mean they do not want to be informed. Healthcare professionals should not have a dismissive attitude to parental belief systems. They must use the antenatal period to take the cultural/spiritual history and the necessary consent.
{"title":"Surfactants and the importance of informed consent: Nurturing culturally competent care in healthcare settings","authors":"Priyanka Gupta, Vishwajeet Singh, Prince Pareek","doi":"10.20529/ijme.2024.042","DOIUrl":"https://doi.org/10.20529/ijme.2024.042","url":null,"abstract":"Background: Culturally competent healthcare improves patient satisfaction and clinical outcomes. Many drugs, dressings and implants have human or animal-derived content which may conflict with patients’ religious beliefs, and may even have medicolegal implications. Methods: This cross-sectional study (anonymous web-based survey) was done to understand the informed consent process followed by paediatricians and neonatologists in India, their views regarding disclosure pertaining to the animal origin of exogenous surfactants to patients’ families, and their willingness and ability to provide alternative surfactants based on parental preferences. Results: A total of 114 neonatologists/paediatricians involved in neonatal care and using surfactants in their practice responded to the survey. Although 61(53.5%) neonatal care units stocked two or more brands of surfactant in their inventory, only 38(33.3%) units had both bovine and porcine preparations. Most (104, 91.2%) of the doctors always take parental consent before administering surfactants; but only a few (12,10.5%) said they always inform parents about its animal origin. None of the respondents offer parents a choice between bovine or porcine-origin surfactants, most (73, 64%) presuming that it would be irrelevant for the parents. However, many respondents (27, 23.7%) mentioned that they want to offer the choice to parents but are unable to do so because they do not stock both bovine and porcine preparations. Conclusion: Although most parents might agree to a life-saving medicine in emergency situations, this does not mean they do not want to be informed. Healthcare professionals should not have a dismissive attitude to parental belief systems. They must use the antenatal period to take the cultural/spiritual history and the necessary consent.","PeriodicalId":35523,"journal":{"name":"Indian journal of medical ethics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141829235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In this response, we seek to analyse and rebut the observations of Karpagam S using an understanding of the Kerala Health system and the general purpose of the Kerala Public Health Act (KPHA). The KPHA was crafted with a greater focus on a one-health and preventive approach. It does not seek to interfere in an individual’s preferred choice of treatment, except in the case of public health emergencies. KPHA is not a standalone document, but a supporting tool to the existing Kerala Health Policy and various other health policies and programmes instrumental in improving the health and quality of life of the people of the State. The KPHA is intended to be an enforcement tool for legal provisions to ensure welfare maximisation of the society at large, and thus detailed discussions regarding actions to be taken beyond these legal provisions do not fall within the purview of the Act.
在本答复中，我们试图通过对喀拉拉邦卫生系统和《喀拉拉邦公共卫生法》（KPHA）总体目标的理解，对 Karpagam S 的意见进行分析和反驳。喀拉拉邦公共卫生法》在制定时更加注重单一保健和预防方法。除公共卫生突发事件外，该法不干涉个人对治疗方法的选择。KPHA 不是一份独立的文件，而是现有喀拉拉邦卫生政策和其他各种卫生政策与计划的辅助工具，有助于改善喀拉拉邦人民的健康和生活质量。KPHA 旨在作为法律规定的执行工具，以确保整个社会的福利最大化，因此有关这些法律规定之外的行动的详细 讨论不属于该法的范围。
{"title":"Reflections on the Kerala Public Health Act 2023: A response to Dr Karpagam’s commentary","authors":"B. Fernandez, Veetilakath Jithesh, Anish Ts","doi":"10.20529/ijme.2024.043","DOIUrl":"https://doi.org/10.20529/ijme.2024.043","url":null,"abstract":"In this response, we seek to analyse and rebut the observations of Karpagam S using an understanding of the Kerala Health system and the general purpose of the Kerala Public Health Act (KPHA). The KPHA was crafted with a greater focus on a one-health and preventive approach. It does not seek to interfere in an individual’s preferred choice of treatment, except in the case of public health emergencies. KPHA is not a standalone document, but a supporting tool to the existing Kerala Health Policy and various other health policies and programmes instrumental in improving the health and quality of life of the people of the State. The KPHA is intended to be an enforcement tool for legal provisions to ensure welfare maximisation of the society at large, and thus detailed discussions regarding actions to be taken beyond these legal provisions do not fall within the purview of the Act.","PeriodicalId":35523,"journal":{"name":"Indian journal of medical ethics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141830382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Beauty under the blade","authors":"Sneha Mehta","doi":"10.20529/ijme.2024.040","DOIUrl":"https://doi.org/10.20529/ijme.2024.040","url":null,"abstract":"","PeriodicalId":35523,"journal":{"name":"Indian journal of medical ethics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141676054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"I’d like to die only once","authors":"Vasundhara Rangaswamy","doi":"10.20529/ijme.2024.032","DOIUrl":"https://doi.org/10.20529/ijme.2024.032","url":null,"abstract":"","PeriodicalId":35523,"journal":{"name":"Indian journal of medical ethics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141108111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Occasional Human Sacrifice: A testament to moral courage","authors":"J. W. Boyd","doi":"10.20529/ijme.2024.031","DOIUrl":"https://doi.org/10.20529/ijme.2024.031","url":null,"abstract":"","PeriodicalId":35523,"journal":{"name":"Indian journal of medical ethics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141118040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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