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COVID Remains 2023 2023年仍有COVID
Pub Date : 2023-06-01 DOI: 10.18785/jhe.1901.01
S. Davis
Editor's introduction to Vol. 19, Issue 1 of the Journal of Health Ethics
编辑对《健康伦理学杂志》第19卷第1期的介绍
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引用次数: 0
A Framework for Personal Respiratory Ethics 个人呼吸伦理框架
Pub Date : 2023-06-01 DOI: 10.18785/jhe.1901.04
I. Goddard
The Covid-19 pandemic raises the need for an ethical framework that addresses the unique ethical challenges and questions arising from airborne infectious diseases. For example, are we ever ethically obliged to wear a face mask? If so, why and when? The Respiratory Ethics Framework (REF) herein proposes pathways to answers grounded in ethical norms and the moral principles of non-harm, beneficence and respect for personal autonomy. REF is a personal ethics wherein your ethical duty to increase your respiratory hygiene efforts—such as by donning a mask—is proportional to your estimation of an increase in the likelihood that your respiratory effluent poses a risk of harmful infection to others. REF includes illustrated decision models that instantiate a framework of proportionality between levels of risk, ethical duty and mitigation that shapes risk mitigation across domains.
2019冠状病毒病大流行提出了建立伦理框架的需要,以解决空气传播传染病带来的独特伦理挑战和问题。例如,我们在道德上有义务戴口罩吗?如果是,为什么?何时?呼吸伦理框架(REF)在此提出了基于道德规范和非伤害、慈善和尊重个人自主权的道德原则的答案途径。REF是一种个人道德,你的道德责任是加强你的呼吸卫生努力——比如戴口罩——与你对你的呼吸流出物对他人造成有害感染的可能性的增加的估计成正比。REF包括说明的决策模型,这些模型实例化了风险水平、道德责任和缓解之间的比例框架,从而形成了跨领域的风险缓解。
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引用次数: 0
Why the West Should Help China Reduce Unrecognized and Preventable COVID-19 Deaths 为什么西方应该帮助中国减少未被识别和可预防的COVID-19死亡
Pub Date : 2023-06-01 DOI: 10.18785/jhe.1901.02
G. Gellert
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引用次数: 0
Ethical Considerations Surrounding Vaccine Development During A Public Health Crisis 公共卫生危机期间疫苗开发的伦理考虑
Pub Date : 2023-06-01 DOI: 10.18785/jhe.1901.03
Sayed Arsalan Akhter Zaidi, Kainat Saleem, Rahul Bollam, Bushra Zaidi
Epidemics and Pandemics have been plaguing mankind since many centuries, and are a cause of major healthcare expense in modern times. The novel coronavirus pandemic of 2019-2020 spread worldwide faster than many previous pandemics, including EBOLA in 2017. Although personal protective equipment, and social distancing slowed the outbreak, a vaccine is needed to ensure global immunization and to stop this deadly outbreak. Developing a vaccine in times of a public health crisis comes with a lot of ethical considerations, including overlooking proper informed consent, the issue of using placebo in control arm of trials, extended timelines of development of vaccines, randomized placebo control trial of secondary vaccine once the first vaccine is approved, and utilizing vulnerable population for trials. These issues are often overlooked due to the urgency of the situation, and the need of developing a cure/vaccine can lead to potential oversight of many regulations. We discuss some of these issues related to vaccine development in a pandemic situation in this commentary paper. We also discuss some of the arguments supporting a secondary vaccine development such as logistical/economic issue, better efficacy, and the conditions of Equipoise.
流行病和流行病已经困扰了人类许多世纪,并且是现代主要医疗费用的原因。2019-2020年的新型冠状病毒大流行在全球范围内的传播速度比之前的许多大流行都要快,包括2017年的埃博拉病毒。虽然个人防护装备和保持社交距离减缓了疫情,但需要一种疫苗来确保全球免疫并阻止这一致命的疫情。在公共卫生危机时期开发疫苗需要考虑许多伦理问题,包括忽视适当的知情同意、在试验的对照组中使用安慰剂的问题、延长疫苗开发的时间表、在第一种疫苗获得批准后对第二种疫苗进行随机安慰剂对照试验,以及利用弱势群体进行试验。由于形势紧迫,这些问题往往被忽视,而开发治疗方法/疫苗的需要可能导致对许多法规的潜在疏忽。我们在这篇评论文章中讨论了在大流行情况下与疫苗开发有关的一些问题。我们还讨论了支持二次疫苗开发的一些论据,如后勤/经济问题、更好的效力和平衡条件。
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引用次数: 0
Discussing the Injustice of the COVID-19 Vaccine Pass Imposed on Medical Consultation in Public Hospitals in Hong Kong 探讨香港公立医院在求诊时须出示新冠肺炎疫苗通行证的不公正
Pub Date : 2022-12-01 DOI: 10.18785/jhe.1802.02
F. Cheng
The COVID-19 pandemic has devastated public health, economy and social life all over the world, especially wherever a vaccine pass scheme has been implemented. Many countries have begun to relax schedules to return to normal activities. In contrast, Hong Kong continues to tighten the utilisation of a vaccine pass for medical services in order to boost vaccination rates. Such a practice not only significantly challenges ethical and operative concerns but also threatens health equity and social justice for healthcare decision-makers and practitioners, consequently hurting public health and community well-being. This discussion analyses the various arguments, reviews vaccine hesitancy and suggests a holistic approach for solutions (aside from vaccination and medications) to strengthen individual immunity and therefore to deal with this disease more effectively, efficiently and ethically, including personal hygiene and lifestyle.
COVID-19大流行在世界各地破坏了公共卫生、经济和社会生活,特别是在实施疫苗通行证计划的地方。许多国家已经开始放松日程安排,恢复正常活动。相比之下,香港继续收紧使用医疗服务的疫苗通行证,以提高疫苗接种率。这种做法不仅严重挑战了伦理和操作问题,而且还威胁到卫生保健决策者和从业人员的卫生公平和社会正义,从而损害公共卫生和社区福祉。本讨论分析了各种论点,审查了疫苗犹豫,并提出了一种全面的解决办法(除了疫苗接种和药物),以加强个人免疫力,从而更有效、高效和合乎道德地应对这种疾病,包括个人卫生和生活方式。
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引用次数: 0
Theory Building as Integrated Reflection: Understanding Physician Reflection Through Human Communication Research, Medical Education, and Ethics 作为综合反思的理论建设:通过人际交往研究、医学教育和伦理学来理解医生的反思
Pub Date : 2022-12-01 DOI: 10.18785/jhe.1802.05
A. Vicini, Ashley Duggan, Allen F. Shaughnessy
Grounded in a presupposition that a single explanatory framework cannot fully account for the expansive learning processes that occur during medical residency, the article examines developing physicians’ reflective writing from three disciplinary lenses. The goal is to understand how the multi-dimensional nature of medical residency translates into assembling educational experiences and constructing meaning that cannot be fully explained through a single discipline. An interdisciplinary research team across medical education, communication, and ethics qualitatively analyzed reflective entries (N=756) completed by family medicine residents (N=33) across an academic year. Results provide evidence for moving toward an integrated thematic explanation across disciplines. The authors suggest that the integration of disciplinary explanations allows for comprehensive understanding of reflection as a cornerstone in the broader formation of the physician. Examples provide evidence for an integrated understanding of a fuller human experience by considering the three thematic explanations as co-occurring, reciprocal processes.
基于一个假设,即单一的解释框架不能完全解释在住院医生期间发生的广泛学习过程,本文从三个学科的角度考察了发展中的医生的反思性写作。我们的目标是了解医疗住院医师的多维性如何转化为整合教育经验和构建无法通过单一学科完全解释的意义。一个跨医学教育、传播和伦理的跨学科研究团队定性分析了家庭医学住院医师(N=33)在一学年完成的反思条目(N=756)。结果为跨学科的综合主题解释提供了证据。作者建议,学科解释的整合允许对反思的全面理解,作为医生更广泛形成的基石。通过将这三种主题解释视为共同发生的、相互作用的过程,实例为对更全面的人类体验的综合理解提供了证据。
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引用次数: 0
Applying lessons learned: nursing facility administrators’ operational and ethical challenges during COVID-19 应用经验教训:2019冠状病毒病期间护理机构管理人员面临的业务和道德挑战
Pub Date : 2022-12-01 DOI: 10.18785/jhe.1802.03
M. Wickersham
Operational and ethical challenges for nursing homes across the United States during the COVID-19 pandemic were daunting, that experience perhaps only a forecast of future epidemics that nursing home administrators and operators may face. This article describes administrator-identified challenges and focuses on how nursing homes might learn from their experiences by increasing flexibility to meet evolving needs, improving quality assurance and disaster planning, using ethics policies and ethical decision-making processes to work through difficult decisions, and leading the way in creating new policies that will make nursing home care safer and more appropriate for patients with ever-changing needs.
在2019冠状病毒病大流行期间,美国各地的养老院面临的运营和道德挑战令人生畏,这种经历可能只是养老院管理人员和运营商可能面临的未来流行病的预测。本文描述了管理员确定的挑战,并重点介绍了养老院如何从经验中学习,通过增加灵活性来满足不断变化的需求,改进质量保证和灾难规划,使用道德政策和道德决策过程来完成困难的决策,并领导制定新政策,使养老院的护理更安全,更适合需求不断变化的患者。
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引用次数: 0
Why Do the Police Reject Counseling? An Examination of Necessary Changes to Police Subculture 为什么警察拒绝心理咨询?论警察亚文化的必要变革
Pub Date : 2022-12-01 DOI: 10.18785/jhe.1802.04
Noel Otu, Ntiense Otu
This paper reviews the concept of police subculture and examines its role in the management and acceptance of treatment for stress-related injury. In particular, we examine the impact of stigma that attaches to treatment within this subculture. The persistence of the dominant police subculture remains a significant obstacle to officers seeking treatment for stress-related illnesses. The subculture has historically resisted acknowledging the need for treatment in response to the occupational and/or organizational stress-related injury that results from frequent exposure to work-related trauma. Many police administrators are still embedded within and resist changes to the subculture, which results in an atmosphere that is unwelcoming to officers seeking or accepting treatment. This study draws on both qualitative and quantitative studies and modifies labeling theory to determine the sources of stigma involved in the police subculture. The paper reviews the reasons why officers refuse treatment, discusses the issue of stigmatization and labeling, and argues for the need to change police subculture, at least in part by ensuring that administrators support treatment and good health for officers. It is revealed that the stigmatization of officers who seek and receive treatment directly results in others’ refusal/rejection of it. The study recommends that departments address the subcultural processes of labeling and stigmatization associated with stress counseling at the individual, management, and organizational levels to bring about a shift in police subculture and improve the level of occupational health and safety for officers on the force.
本文回顾了警察亚文化的概念,并探讨了其在管理和接受治疗的压力相关伤害中的作用。特别是,我们研究了这种亚文化中附着在治疗上的耻辱的影响。占主导地位的警察亚文化的持续存在仍然是警察寻求治疗压力相关疾病的重大障碍。从历史上看,亚文化一直拒绝承认由于频繁暴露于与工作有关的创伤而导致的职业和/或组织压力相关损伤需要治疗。许多警察管理人员仍然沉浸在亚文化中,并抵制改变,这导致了一种不欢迎寻求或接受治疗的警察的氛围。本研究借鉴了定性和定量研究,并修改了标签理论,以确定警察亚文化中耻辱的来源。这篇论文回顾了警察拒绝治疗的原因,讨论了污名化和贴标签的问题,并认为有必要改变警察亚文化,至少在一定程度上要确保行政人员支持治疗和警察的健康。据透露,对寻求和接受治疗的军官的污名化直接导致其他人拒绝/拒绝治疗。该研究建议各部门在个人、管理和组织层面处理与压力咨询相关的标签和污名化亚文化过程,以改变警察亚文化,提高警察的职业健康和安全水平。
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引用次数: 0
Ethical and Moral Imperatives of 2022 2022年的伦理和道德要求
Pub Date : 2022-12-01 DOI: 10.18785/jhe.1802.01
S. Davis
Editor's introduction to the Journal of Health Ethics vol. 18, no. 2
编辑对《健康伦理杂志》第18卷的介绍。2
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引用次数: 0
2022: Global Ethical Think Tank 2022年:全球伦理智库
Pub Date : 2022-08-01 DOI: 10.18785/jhe.1801.01
S. Davis
Editor's introduction to Volume 18, Number 1 of the Journal of Health Ethics.
编辑对《健康伦理学杂志》第18卷第1期的介绍。
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Online journal of health ethics
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