In a recent article, C.O. Akpan argues that it is “unnatural for a man to sleep with a man as with a woman, and the idea of marriage in this sense is an abomination” (“The morality of same-sex marriage: How not to globalize a cultural anomie,” Online Journal of Health Ethics, 13(1), 2017, p. 9). Arguments in favor of same sex marriage, he claims, are “driven and motivated by the human right fad” (p. 9) that is inappropriate for African countries. We argue that the specific arguments Akpan employs against the morality of homosexuality and same-sex marriage are flawed. Our paper also presents evidence that human rights are not simply a fad, nor are they of concern and appropriate only to the West. Finally, we examine the case in South Africa, the only African nation to include LGBTQ+ rights in its constitution. In particular, we show that by doing so, South Africa has increased the health and safety not only the LGBTQ+ community, but of the nation’s citizens at large.
{"title":"Sexual Minority Rights Are Not Just for the West: Health and Safety Considerations in Africa","authors":"R. S. Stewart, Dionne van Reenen, Richard Watuwa","doi":"10.18785/jhe.1701.06","DOIUrl":"https://doi.org/10.18785/jhe.1701.06","url":null,"abstract":"In a recent article, C.O. Akpan argues that it is “unnatural for a man to sleep with a man as with a woman, and the idea of marriage in this sense is an abomination” (“The morality of same-sex marriage: How not to globalize a cultural anomie,” Online Journal of Health Ethics, 13(1), 2017, p. 9). Arguments in favor of same sex marriage, he claims, are “driven and motivated by the human right fad” (p. 9) that is inappropriate for African countries. We argue that the specific arguments Akpan employs against the morality of homosexuality and same-sex marriage are flawed. Our paper also presents evidence that human rights are not simply a fad, nor are they of concern and appropriate only to the West. Finally, we examine the case in South Africa, the only African nation to include LGBTQ+ rights in its constitution. In particular, we show that by doing so, South Africa has increased the health and safety not only the LGBTQ+ community, but of the nation’s citizens at large.","PeriodicalId":89828,"journal":{"name":"Online journal of health ethics","volume":"638 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80267100","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}
Brought to light by COVID-19, and the Black Lives Matter and Twitter #BlackBioethics movements, bioethics as a discipline has not intentionally accounted for distributive justice in its scholarship. Modern society exhibits gross disparities that affect marginalized populations who suffer amid social, financial, physical and emotional stressors. While marginalized groups that are underserved are not monoliths, disparity persists in disadvantaged communities regardless of social and economic strata. Disparity is the epitome of injustice. The overemphasis on proximal determinants demonstrates ill placed overemphasis on personal culpability whilst ignoring systemic factors that result in structural injustice. The sciences of complexity and systems thinking move healthcare beyond historically ingrained heuristics that more often than not entrench disparities meant to be reversed. This paper sets out the argument that the application of complexity and systems as a groundwork for culturally inclusive bioethics by framing health disparities as structurally and morally complex.
{"title":"Health Inequality as a Socially Created Complex System","authors":"M. Battle-Fisher","doi":"10.18785/jhe.1701.03","DOIUrl":"https://doi.org/10.18785/jhe.1701.03","url":null,"abstract":"Brought to light by COVID-19, and the Black Lives Matter and Twitter #BlackBioethics movements, bioethics as a discipline has not intentionally accounted for distributive justice in its scholarship. Modern society exhibits gross disparities that affect marginalized populations who suffer amid social, financial, physical and emotional stressors. While marginalized groups that are underserved are not monoliths, disparity persists in disadvantaged communities regardless of social and economic strata. Disparity is the epitome of injustice. The overemphasis on proximal determinants demonstrates ill placed overemphasis on personal culpability whilst ignoring systemic factors that result in structural injustice. The sciences of complexity and systems thinking move healthcare beyond historically ingrained heuristics that more often than not entrench disparities meant to be reversed. This paper sets out the argument that the application of complexity and systems as a groundwork for culturally inclusive bioethics by framing health disparities as structurally and morally complex.","PeriodicalId":89828,"journal":{"name":"Online journal of health ethics","volume":"63 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74094432","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}
Editorial by Dr. Sheila Davis, editor-in-chief of the Online Journal of Health Ethics.
《健康伦理学在线杂志》主编Sheila Davis博士的社论。
{"title":"Open letter to all readers, reviewers, and authors","authors":"S. Davis","doi":"10.18785/ojhe.1603.01","DOIUrl":"https://doi.org/10.18785/ojhe.1603.01","url":null,"abstract":"Editorial by Dr. Sheila Davis, editor-in-chief of the Online Journal of Health Ethics.","PeriodicalId":89828,"journal":{"name":"Online journal of health ethics","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44758558","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}
Abbey and George discuss their beliefs regarding abortion in a light hearted manner. Both are aborted fetuses. Abbey was aborted by induction, and George by spontaneous. The pros and cons of abortion, the effects, and the use of fetal cells in research are presented in play format. Abbey is a devout Christian, and George is an atheist. The play allows the reader to hear both sides of the topic.
{"title":"Abbey and George","authors":"Jennie A. Gunn","doi":"10.18785/ojhe.1603.04","DOIUrl":"https://doi.org/10.18785/ojhe.1603.04","url":null,"abstract":"Abbey and George discuss their beliefs regarding abortion in a light hearted manner. Both are aborted fetuses. Abbey was aborted by induction, and George by spontaneous. The pros and cons of abortion, the effects, and the use of fetal cells in research are presented in play format. Abbey is a devout Christian, and George is an atheist. The play allows the reader to hear both sides of the topic.","PeriodicalId":89828,"journal":{"name":"Online journal of health ethics","volume":"16 1","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67709833","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 third and final issue of the Online Journal of Health Ethics for 2020 presents two poignant articles that are rankled with current health ethics and moral issues as the world races to a resolve for the COVID pandemic. There appears to be no easy, quick-fix solutions to the pandemic that has claimed over 1.11 million lives worldwide in this first wave. The Gellert article addresses his view of the U.S. government’s political response and the Gunn article presents an ethical perspective of the emerging promised vaccine to halt the virus.
{"title":"Winners and Losers in the American Political Debates of the Nation’s Health: An Ethical and Moral Dilemma","authors":"S. Davis","doi":"10.18785/ojhe.1603.02","DOIUrl":"https://doi.org/10.18785/ojhe.1603.02","url":null,"abstract":"The third and final issue of the Online Journal of Health Ethics for 2020 presents two poignant articles that are rankled with current health ethics and moral issues as the world races to a resolve for the COVID pandemic. There appears to be no easy, quick-fix solutions to the pandemic that has claimed over 1.11 million lives worldwide in this first wave. The Gellert article addresses his view of the U.S. government’s political response and the Gunn article presents an ethical perspective of the emerging promised vaccine to halt the virus.","PeriodicalId":89828,"journal":{"name":"Online journal of health ethics","volume":" ","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47220032","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}
COVID-19 is exploiting U.S. political and cultural polarization in the first presidential election to be driven by epidemiology and public health. Medical science is on the ballot as Americans’ views on economic re-opening fracture according to party affiliation. The difference between pro aggressive versus incremental re-opening, mask wearing and social distancing is rooted in respect for, or denial of, the science of epidemiological pandemic disease control. Political leaders at multiple levels, and in particular the president, have politicized the wearing of face masks and so intentionally obscured and misinformed the public regarding the objectively and scientifically proven value of these protective measures. The presidential election rests at a fundamental level upon an individual choice of whether to accept or “believe” value-neutral, evidence-based science or an unethical decision to be swayed by political disinformation. The persistent and highly dysfunctional political and cultural polarization of the U.S. is now enabling and reinforcing the ethics of science denial, while driving the nation’s public health fate and near- to medium-term economic outcomes. However, mask wearing, social distance and sheltering are not political expressions, and the right to freedom of expression does not include behaviors that produce or could produce serious, and in the case of this pandemic, deadly impact on other citizens. One does not have the right to forms of political or other expression that kill or make ill other individuals.
{"title":"An Epidemiological View of the 2020 U.S. Presidential Election: COVID-19 and the Ethics of Science Denial","authors":"Gellert, A. George","doi":"10.18785/ojhe.1603.03","DOIUrl":"https://doi.org/10.18785/ojhe.1603.03","url":null,"abstract":"COVID-19 is exploiting U.S. political and cultural polarization in the first presidential election to be driven by epidemiology and public health. Medical science is on the ballot as Americans’ views on economic re-opening fracture according to party affiliation. The difference between pro aggressive versus incremental re-opening, mask wearing and social distancing is rooted in respect for, or denial of, the science of epidemiological pandemic disease control. Political leaders at multiple levels, and in particular the president, have politicized the wearing of face masks and so intentionally obscured and misinformed the public regarding the objectively and scientifically proven value of these protective measures. The presidential election rests at a fundamental level upon an individual choice of whether to accept or “believe” value-neutral, evidence-based science or an unethical decision to be swayed by political disinformation. The persistent and highly dysfunctional political and cultural polarization of the U.S. is now enabling and reinforcing the ethics of science denial, while driving the nation’s public health fate and near- to medium-term economic outcomes. However, mask wearing, social distance and sheltering are not political expressions, and the right to freedom of expression does not include behaviors that produce or could produce serious, and in the case of this pandemic, deadly impact on other citizens. One does not have the right to forms of political or other expression that kill or make ill other individuals.","PeriodicalId":89828,"journal":{"name":"Online journal of health ethics","volume":" ","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46053015","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}
One of the greatest challenges physicians face is living up to their own ideals, let alone others’ expectations, for high-stakes doctor-patient/family communication, especially at the end of life. From emotional strains to time limitations, a multiplicity of factors obfuscates the pursuit of excellence in this vital endeavor. Evidence suggests that African American patients and families are most likely to get the short end of this physician communication stick. Drawing on the current literature, this piece makes a compelling case for the inclusion of third-party specialists to take some of the communication load off of overworked physicians in end-of-life discussions and earlier difficult healthcare issues. A more team-oriented approach to the interdisciplinary art of shared decision making (SDM) may be a win-win for everyone involved.
{"title":"Including a Chaplain and Culturally Sensitive Notary in End-of-Life and Earlier Difficult Healthcare Issues","authors":"J. Stonestreet","doi":"10.31219/osf.io/bdvpq","DOIUrl":"https://doi.org/10.31219/osf.io/bdvpq","url":null,"abstract":"One of the greatest challenges physicians face is living up to their own ideals, let alone others’ expectations, for high-stakes doctor-patient/family communication, especially at the end of life. From emotional strains to time limitations, a multiplicity of factors obfuscates the pursuit of excellence in this vital endeavor. Evidence suggests that African American patients and families are most likely to get the short end of this physician communication stick. Drawing on the current literature, this piece makes a compelling case for the inclusion of third-party specialists to take some of the communication load off of overworked physicians in end-of-life discussions and earlier difficult healthcare issues. A more team-oriented approach to the interdisciplinary art of shared decision making (SDM) may be a win-win for everyone involved.","PeriodicalId":89828,"journal":{"name":"Online journal of health ethics","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90175634","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}
Pub Date : 2020-09-08DOI: 10.21203/rs.3.rs-68862/v1
Evelyn Arana-Chicas, Brooke D Jones, Francisco Cartujano-Barrera, A. Cupertino
Background: The killing of George Floyd triggered the Black Lives Matter protests against police brutality and social injustices in the midst of the COVID-19 pandemic. No research to date has assessed the COVID-19 prevention practices and beliefs of protesters. The purpose of this study was to assess COVID-19 prevention practices and beliefs of Black Lives Matter protesters in the USA. Methods: A pilot mixed methods study was employed. Participants completed a survey collecting data on their frequency in following COVID-19 recommended guidelines and answered open-ended interview questions to elucidate the results from the survey. Results: Twenty participants completed the study. Participants’ average age was 29 and most participants were female (80%) and black (75%). Most always or almost always properly wore their masks (50% and 25%, respectively) and washed their hands during a protest 2-3 times or more than 3 times (35% and 50%, respectively). Although all believed that COVID-19 testing is important (90%), most had never been tested (85%) and most did not self-quarantine for 14 days after protesting (95%). Moreover, most participants reported never or rarely following social distancing guidelines at a protest (25% and 30%, respectively) and most reported being Not at all or Slightly concerned about COVID-19 while at a protest (25% and 30%, respectively). Qualitative data highlighted the following themes: 1) Fighting for social justice, 2) Protesting being more important than COVID-19, 3) Unable to keep 6 ft distance, 4) Masks worn most of the time, 5) Protests sparked global movement, and 6) Increasing awareness of injustices. Conclusion: Although protesters believe that both the fight for social justice and taking precautions during the COVID-19 pandemic are important, they believe the fight for social justice is more important than the COVID-19 pandemic. However, they understand the importance of COVID-19 and try to practice the recommended guidelines to prevent its spread while protesting. These results make an important contribution for policies for controlling the spread of the disease, and also understanding human behavior of protesting for social justice during a pandemic.
{"title":"\"I felt what was happening in our country [USA] with race was so much scarier than the [COVID-19] virus.\" Black Lives Matter protesters’ beliefs and practices during the COVID-19 pandemic","authors":"Evelyn Arana-Chicas, Brooke D Jones, Francisco Cartujano-Barrera, A. Cupertino","doi":"10.21203/rs.3.rs-68862/v1","DOIUrl":"https://doi.org/10.21203/rs.3.rs-68862/v1","url":null,"abstract":"\u0000 Background: The killing of George Floyd triggered the Black Lives Matter protests against police brutality and social injustices in the midst of the COVID-19 pandemic. No research to date has assessed the COVID-19 prevention practices and beliefs of protesters. The purpose of this study was to assess COVID-19 prevention practices and beliefs of Black Lives Matter protesters in the USA. Methods: A pilot mixed methods study was employed. Participants completed a survey collecting data on their frequency in following COVID-19 recommended guidelines and answered open-ended interview questions to elucidate the results from the survey. Results: Twenty participants completed the study. Participants’ average age was 29 and most participants were female (80%) and black (75%). Most always or almost always properly wore their masks (50% and 25%, respectively) and washed their hands during a protest 2-3 times or more than 3 times (35% and 50%, respectively). Although all believed that COVID-19 testing is important (90%), most had never been tested (85%) and most did not self-quarantine for 14 days after protesting (95%). Moreover, most participants reported never or rarely following social distancing guidelines at a protest (25% and 30%, respectively) and most reported being Not at all or Slightly concerned about COVID-19 while at a protest (25% and 30%, respectively). Qualitative data highlighted the following themes: 1) Fighting for social justice, 2) Protesting being more important than COVID-19, 3) Unable to keep 6 ft distance, 4) Masks worn most of the time, 5) Protests sparked global movement, and 6) Increasing awareness of injustices. Conclusion: Although protesters believe that both the fight for social justice and taking precautions during the COVID-19 pandemic are important, they believe the fight for social justice is more important than the COVID-19 pandemic. However, they understand the importance of COVID-19 and try to practice the recommended guidelines to prevent its spread while protesting. These results make an important contribution for policies for controlling the spread of the disease, and also understanding human behavior of protesting for social justice during a pandemic.","PeriodicalId":89828,"journal":{"name":"Online journal of health ethics","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85932845","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":"Ethical imperatives critical to effective disease control in the coronavirus pandemic: Recognition of global health interdependence as a driver of health and social equity","authors":"G. Gellert","doi":"10.18785/ojhe.1601.03","DOIUrl":"https://doi.org/10.18785/ojhe.1601.03","url":null,"abstract":"","PeriodicalId":89828,"journal":{"name":"Online journal of health ethics","volume":"16 1","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2020-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42783849","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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