In March 2020, the rapid increase in severe COVID‐19 cases overwhelmed the healthcare systems in several European countries. The capacities for artificial ventilation in intensive care units were too scarce to care for patients with acute respiratory disorder connected to the disease. Several professional associations published COVID‐19 triage recommendations in an extremely short time: in 21 days between March 6 and March 27. In this article, we compare recommendations from five European countries, which combine medical and ethical reflections on this (...) situation in some detail. Our aim is to provide a detailed overview on the ethical elements of the recommendations, the differences between them and their coherence. In more general terms we want to identify shortcomings in regard to a common European response to the current situation. (shrink)

The ongoing Coronavirus disease 2019 (COVID-19) pandemic is disrupting most specialized healthcare services worldwide, including those for high-risk newborns and their families. Due to the risk of contagion, critically ill infants, relatives and professionals attending neonatal intensive care units (NICUs) are undergoing a profound remodeling of the organization and quality of care. In particular, mitigation strategies adopted to combat the COVID-19 pandemic may hinder the implementation of family-centered care within the NICU. This may put newborns at risk for several adverse (...) effects, e.g., less weight gain, more nosocomial infections, increased length of NICU stay as well as long-term worse cognitive, emotional, and social development. This article aims to contribute to deepening the knowledge on the psychological impact of COVID-19 on parents and NICU staff members based on empirical data from the literature. We also provided evidence-based indications on how to safely empower families and support NICU staff facing such a threatening emergency, while preserving the crucial role of family-centered developmental care practices. (shrink)

The COVID-19 pandemic has intensified the extent to which economies in the developed and developing world rely on gig workers to perform essential tasks such as health care, personal transport, food and package delivery, and ad hoc tasking services. As a result, workers who provide such services are no longer perceived as mere low-skilled laborers, but as essential workers who fulfill a crucial role in society. The newly elevated moral and economic status of these workers increases consumer demand for corporate (...) social responsibility regarding this stakeholder group – specifically for practices that increase worker freedom and rewards. We provide algorithmic tools for online labor platforms to meet this demand, thereby bolstering their social purpose and ethical branding while better protecting themselves from future reputational crises. To do so, we advance a managerial strategy rooted in moral self-awareness theory in order to leverage customers’ virtuous self-perception and increase gig-worker freedom. (shrink)

Nursing staff plays a key role in the public health response to the COVID-19 pandemic, being in the front line of care. This study sought to synthesise the qualitative literature on care experiences of frontline nurses during the COVID-19 pandemic. A search was conducted on five databases in January 2021. Fifteen qualitative studies met the inclusion criteria and were included in the research, being submitted to interpretive meta-synthesis according to the eMERGe guide. The final synthesis included a line of argument (...) that shows the experiences of frontline nurses during the COVID-19 pandemic, divided into three major themes: ‘Instability on the edge of a cliff: unpredictable and unknown context,’ ‘The price of walking the tightrope: the uncertainty surrounding care,’ and ‘Finding the balance to reach the other side: dealing with the emotional demands of care.’ Although essential in the health response to the COVID-19 pandemic, nurses experienced an emotional impact arising from the hampered care provision. Our results point to need for strengthening the training of nurses and future nurses, creating and promoting measures that contribute to their psycho-emotional well-being, ensuring a safe environment for their clinical practice, and promoting their participation in decision-making processes. (shrink)

COVID-19 severity and mortality risk are greater for older adults whereas economic impact is deeper for younger adults. Using the Health Belief Model as a framework, this study used a web-based survey to examine how perceived COVID-19 susceptibility and severity and perceived efficacy of recommended health behaviors varied by age group and were related to the adoption of health behaviors. Proportional odds logistic regression was used to examine the relationship between age group and perceived COVID-19 susceptibility, severity, impact, and health (...) behavior efficacy and adoption. Structural equation modeling based on HBM constructs examined the relationships between health beliefs and behaviors. Data from 820 participants were analyzed. Middle-aged and older adults reported greater concerns about the personal risk of hospitalization and mortality, economic impact, and social impact of COVID-19 than young adults. Middle-aged adults also reported greatest concern for other age groups. Adoption and perceived efficacy of health behaviors was similar across age groups with few exceptions. Both middle-aged and older-adults were more likely to perceive their own and each other's age groups as responding adequately to COVID-19 compared to young adults. Structural equation modeling indicated perceived benefits of health behaviors were the primary driver of behavior uptake, with socioeconomic factors and perceived severity and susceptibility indirectly associated with uptake through their influence on perceived benefits. Overall, these results suggest adoption of health behaviors is very high with few differences between age groups, despite differences in perceived impact of COVID-19. Public health communications should focus on the benefits of health behaviors to drive adoption. (shrink)

The COVID-19 pandemic swept through New York City swiftly and with devastating effect. The crisis put enormous pressure on all hospital services, including the clinical ethics consultation team. This report describes the recent experience of the ethics consultants and Columbia University Irving Medical Center during the COVID-19 surge and compares the case load and characteristics to the corresponding period in 2019. By reporting this experience, we hope to supplement the growing body of COVID-19 scientific literature and provide details of the (...) human toll the virus took on our hospitals and communities. We also aim to highlight the role of the clinical ethics consultant as well as areas of policy and law that may need to be addressed in order to be better prepared for a future public health crisis. (shrink)

Volume 20, Issue 7, July 2020, Page 103-106.

A discussion of lessons learned in the first months of the COVID-19 pandemic which allowed data safety monitoring boards (DSMBs) to continue their work protecting the interests of human research participants while preserving research studies.

A comprehensive understanding of the ethics of the COVID-19 pandemic priorities must be sensitive to the influence of social inequality. We distinguish between ex-ante and ex-post relevance of social inequality for COVID-19 disadvantage. Ex-ante relevance refers to the distribution of risks of exposure. Ex-post relevance refers to the effect of inequality on how patients respond to infection. In the case of COVID-19, both ex-ante and ex-post effects suggest a distribution which is sensitive to the prevalence social inequality. On this basis, (...) we provide a generic fairness argument for the claim that welfare states ought to favour a healthcare priority scheme that gives particular weight to protecting the socially disadvantaged. (shrink)

Se define la Biocracia -poder político fundado en el cuidado y protección de la vida- y se describe su relación con el derecho fundamental a un nuevo orden mundial (NOM), consagrado en el artículo 28 de la Declaración Universal de los Derechos Humanos (DUDH, 1948) que imperativamente obliga a los Estados a hacer plenamente efectivos todos los derechos humanos (DDHH) de todas las personas - inherentes a la dignidad humana- para que logren felicidad personal, concretando en libertad y autonomía, su (...) proyecto de vida valioso, sin daños ni arbitrariedades, cumpliendo el deber estatal de respetar, proteger y garantizar los DDHH, como reto de la comunidad internacional a favor de la familia humana en la postpandemia de la COVID-19, descrita como la primera guerra “biológica” mundial. -/- Palabras clave: Biocracia, postpandemia, derechos humanos, nuevo orden mundial, proyecto de vida valioso, democracia integral. (shrink)

This study examines whether character strengths predict resilience (operationalized as stable or higher mental health and subjective well-being despite an adverse event) over a period of approximately one month during the COVID-19 pandemic lockdown in Spain. Using a longitudinal design, participants (N = 348 adults) completed online measures of sociodemographic data, information regarding their situation in relation to the COVID-19, character strengths, general mental health, life satisfaction, positive affect and negative affect. All variables were measured at Time 1 and Time (...) 2, except for sociodemographic and most COVID-related information (Time 1 only). Time 1 data collection was conducted between March 21, 2020 and April 2, 2020, i.e., approximately the second week of lockdown in Spain. Time 2 data collection was conducted between April 24, 2020 and May 18, 2020, after the Spanish government announced ita intention to progressively release the lockdown. A principal component analysis of character strengths was conducted. Five character strength factors were extracted: fortitude, goodness, intellectual, interpersonal, and restraint. Factor structures at Times 1 and 2 were highly consistent. All character strength factors at Time 1 correlated positively with life satisfaction and positive affect, and negatively with negative affect and mental health at T2 (higher scores in the mental health measure indicate poorer mental health). Fortitude strengths showed the highest correlations. We conducted a series of regression analyses with strength factors at Time 1 as predictors, and mental health, life satisfaction, and positive and negative affect as dependent variables, controlling for their baseline levels. To test the directionality of the relationship between strengths and the dependent variables, all analyses were reversed. All character strength factors predicted an increase in mental health. They also predicted positive affect, with the exception of strengths of restraint. Fortitude, intellectual and interpersonal strengths predicted an increase in life satisfaction. Finally, fortitude strengths, interpersonal strengths, and strengths of restraint, predicted a decrease in negative affect. None of the reversed analyses yielded significant effects. Limitations, implications, and possible character strengths-based interventions aimed at promoting mental health in the COVID-19 pandemic are discussed. (shrink)

The COVID-19 pandemic and its related policies (e.g., stay at home and social distancing orders) have increased people’s use of digital technology, such as social media. Researchers have, in turn, utilized artificial intelligence to analyze social media data for public health surveillance. For example, through machine learning and natural language processing, they have monitored social media data to examine public knowledge and behavior. This paper explores the ethical considerations of using artificial intelligence to monitor social media to understand the public’s (...) perspectives and behaviors surrounding COVID-19, including potential risks and benefits of an AI-driven approach. Importantly, investigators and ethics committees have a role in ensuring that researchers adhere to ethical principles of respect for persons, beneficence, and justice in a way that moves science forward while ensuring public safety and confidence in the process. (shrink)

Research on the challenges facing African women entrepreneurship and the impact of the coronavirus disease 2019 (COVID-19) pandemic is scant. This article explored the challenges and the impact of COVID-19 on African women-owned businesses and the effect thereof on the 17th goal of the African Union (AU) Agenda 2063. African women entrepreneurs experience many social inequalities, ranging from cultural norms to family to legal and regulatory measures to accessing finance. The COVID-19 pandemic exacerbated these challenges as many African women entrepreneurs (...) have been forced out of business because of measures taken by African governments to halt the spread of the disease. The article reviewed current literature on African women entrepreneurs and the impact of the COVID-19 pandemic using two databases and is based on a total of 104 published articles. The article provided a foundation for post-COVID-19 policy directives in Africa. The authors recommend measures to mitigate these challenges and discuss strategies for policymakers to re-position African women entrepreneurs for the post-COVID-19 era towards achieving AU Agenda 2063 and realising the Africa we all want. Contribution: The study aligns with the United Nations Sustainable Development Goal of ending poverty in Africa and the AU Agenda 2063 goal of achieving gender equality and empowerment of all women and girls to achieve the Africa we all want. (shrink)

This article discusses the changing role of women in the family household to take full control and responsibility as a single parent due to the death of their husbands in the post-Covid-19 pandemic in Indonesia. Based on the Covid-19 pandemic data, the death of husbands is so high in East Java that raised new problems in the family household when a wife must switch her position to take role as the head of the family as a single parent. This article (...) strives to answer the questions of what roles do the women play as the head of the household due to the death of their husbands? How are these roles perceived based on Maqashid Al-Syari’ah, a contemporary Islamic law? These questions aim to understand the transformation of roles between husband and wife in Javanese Muslim family households to portray the gender equality and the construction of the family resilience. The data of this study are collecter through ethnographic fieldwork with participatory observation and in-depth interviews to several married women in eastern parts of Java. This article suggests that mainstreaming the method of Islamic law, Maqashid Al-Syari’ah to build the resilience of single-parent families in East Java is realized by the awareness of single-parent women in meeting the family needs. This awareness is employed through various practices by women in East Java who cover all domestic and public activities for the benefit of the family. (shrink)

The COVID-19 pandemic has helped to clarify the fair and equitable allocation of scarce medical resources, both within and among countries. The ethical allocation of such resources entails a three-step process: (1) elucidating the fundamental ethical values for allocation, (2) using these values to delineate priority tiers for scarce resources, and (3) implementing the prioritisation to faithfully realise the fundamental values. Myriad reports and assessments have elucidated five core substantive values for ethical allocation: maximising benefits and minimising harms, mitigating unfair (...) disadvantage, equal moral concern, reciprocity, and instrumental value. These values are universal. None of the values are sufficient alone, and their relative weight and application will vary by context. In addition, there are procedural principles such as transparency, engagement, and evidence-responsiveness. Prioritising instrumental value and minimising harms during the COVID-19 pandemic led to widespread agreement on priority tiers to include health-care workers, first responders, people living in congregate housing, and people with an increased risk of death, such as older adults and individuals with medical conditions. However, the pandemic also revealed problems with the implementation of these values and priority tiers, such as allocation on the basis of population rather than COVID-19 burden, and passive allocation that exacerbated disparities by requiring recipients to spend time booking and travelling to appointments. This ethical framework should be the starting point for the allocation of scarce medical resources in future pandemics and other public health conditions. For instance, allocation of the new malaria vaccine among sub-Saharan African countries should be based not on reciprocity to countries that participated in research, but on maximally reducing serious illness and deaths, especially among infants and children. (shrink)

The COVID-19 outbreak has seen people in many countries asked to radically modify their way of life in compliance with sweeping safety measures. During the current crisis, technology is turning out to be key, in that it allows practitioners to deliver psychological services to people who would otherwise be unreachable. However, professionals cannot solely rely on their traditional modes of practice, in that different methods are required to bring to light the needs of those affected by the emergency. People are (...) being overwhelmed by a cascade of unusual and unexpected events that are putting a strain on their everyday routines and usual meaning-making systems; ongoing challenges to their employment and financial status will likely divert personal resources away from psychological well-being. We therefore argue that psychologists should also consider the needs of the general population. Among those who may require help – aside from the main targets of psychological intervention, such as healthcare personnel and COVID-19 patients and their relatives – specific attention should be paid to those who are not at the center of the crisis. We suggest that this large segment of potential users may benefit from a non-medical approach focused on the promotion of meaning-making processes. Indeed, the disruptive nature of the current situation hinders sense-making and threatens to undermine psychological balance and well-being, at an individual as well as at a societal level. The present article proposes a methodological perspective based on the reconstruction of meaning-making processes (sense of coherence, predictability, metaphors, narratives). Specifically, psychological interventions should promote personal and collective resources with a view to: “normalizing” current distressful experiences (i.e., acknowledging that such reactions are normal in light of the present situation); widening the observational field, taking relational contexts into account, and promoting an understanding of distressful experiences as coping strategies; fostering meaning-making/reconstruction processes through the use of appropriate metaphors and narratives; promoting a sense of coherence. We present two clinical vignettes to illustrate how these principles might be applied in practice. In conclusion, the exceptional psychological challenges posed by the COVID-19 pandemic require practitioners to adopt a broad and flexible perspective on clinical intervention. (shrink)

Being compassionate and empathic while making rational decisions is expected from healthcare workers across different contexts. But the daily challenges that these workers face, aggravated by the recent COVID-19 crisis, can give rise to compassion and decision fatigue, which affects not only their ability to meet these expectations but has a significant negative impact on their wellbeing. Hence, it is vital to identify factors associated to their exhaustion. Here, we sought to describe levels of compassion and decision fatigue during the (...) pandemic, and to identify factors related to these forms of exhaustion. We collected data using self-reported questionnaires to measure compassion fatigue, decision fatigue, and grit in five intervals from April to November, 2020 (N = 856). Our results showed a negative correlation between grit and compassion and decision fatigue. We also found that under the circumstances studied grit tends to be higher in technicians, nurses, other professionals (psychologists, social workers), and workers at the Emergency Room (ER), and lower in general practitioners. Compassion fatigue tend to be higher for technicians, whereas decision fatigue was lower for specialists, general practitioners, and technicians, and higher for those working at private hospitals. (shrink)

Ruth Macklin argued that dignity is nothing more than respect for persons or their autonomy. During the COVID-19 pandemic, difficult decisions are being made about the allocation of scarce resources. Respect for autonomy cannot justify rationing decisions. Justice can be invoked to justify rationing. However, this leaves an uncomfortable tension between the principles. Dignity is not a useless concept because it is able to account for why we respect autonomy and for why it can be legitimate to override autonomy in (...) times of critical care resource shortages. Dignity affirms the worth of the human individual as a meaning-making embodied subject, who is always in relationship to others, the world, time, and transcendence, and who realizes their dignity through their moral behaviour. Such an understanding means people should be helped to make morally right decisions about their own treatment, which may include forgoing potentially beneficial treatment for the good of others. Respect for dignity does not require fulfilling the morally wrong choices of one who insists on treatment at the expense of others. Dignity also protects the discretion of clinicians to make decisions appropriate to their competence by prohibiting the application of broad-based criteria such as age. (shrink)

During the COVID-19 pandemic people were increasingly obliged to wear facial masks and to reduce the number of people they met in person. In this study, we asked how these changes in social interactions are associated with young children's emotional development, specifically their emotion recognition via the labeling of emotions. Preschoolers labeled emotional facial expressions of adults and children in fully visible faces. In addition, we assessed children's COVID-19-related experiences and recorded children's gaze behavior during emotion labeling. We compared different (...) samples of preschoolers : The data for the no-COVID-19-experience sample were taken from studies conducted before the pandemic. The data for the with-COVID-19-experience sample were collected during the COVID-19 pandemic in Switzerland between June and November 2021. The results did not indicate differences in children's labeling behavior between the two samples except for fearful adult faces. Children with COVID-19-experience more often labeled fearful faces correctly compared to children with no COVID-19 experience. Furthermore, we found no relations between children's labeling behavior, their individual COVID-19-related experiences, and their gaze behavior. These results suggest that, even though the children had experienced differences in the amount and variability of facial input due to the pandemic, they still received enough input from visible faces to be able to recognize and label different emotions. (shrink)

Vietnam, with a geographical proximity and a high volume of trade with China, was the first country to record an outbreak of the new Coronavirus disease (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus 2 or SARS-CoV-2. While the country was expected to have a high risk of transmission, as of April 4, 2020—in comparison to attempts to contain the disease around the world—responses from Vietnam are being seen as prompt and effective in protecting the interests of its citizens, (...) with 239 confirmed cases and no fatalities. This study analyzes the situation in terms of Vietnam’s policy response, social media and science journalism. A self-made web crawl engine was used to scan and collect official media news related to COVID-19 between the beginning of January and April 4, yielding a comprehensive dataset of 14,952 news items. The findings shed light on how Vietnam—despite being under-resourced—has demonstrated political readiness to combat the emerging pandemic since the earliest days. Timely communication on any developments of the outbreak from the government and the media, combined with up-to-date research on the new virus by the Vietnamese science community, have altogether provided reliable sources of information. By emphasizing the need for immediate and genuine cooperation between government, civil society and private individuals, the case study offers valuable lessons for other nations concerning not only the concurrent fight against the COVID-19 pandemic but also the overall responses to a public health crisis. (shrink)

The COVID-19 pandemic has impacted medical care in many ways; previously, a patient would enter a hospital and had an approximate idea of what would happen upon his admission, the physician informed them about it, but in the last two years this scenario has changed. Therefore, our aim was to identify if bioethical principles are present in the physician–patient relationship and the effect of these in the health care provided, through an observational and descriptive study where patients answered the validated (...) ReMePaB questionnaire that measures the presence of bioethical principles in the physician–patient relationship, on the seventh day of their hospital stay and 24 h after discharge, during the period from 1 August to 5 November 2020. In autonomy, an improvement in the score was observed in the second application compared to the first measurement; in the principle of non-vulnerability, the same scenario was observed for the first and second measurements, respectively. In the principles of beneficence, dignity, and justice, no statistically significant differences were observed. Considering the presence or absence of bioethical aspects in health care in this pandemic creates an area of opportunity to know the feelings of the patient during the care received and to maintain what is done well and improve those aspects that can be improved. (shrink)

In times of crises, public health leaders may claim that trials of public health interventions are unethical. One reason for this claim can be that equipoise—i.e. a situation of uncertainty and/or disagreement among experts about the evidence regarding an intervention—has been disturbed by a change of collective expert views. Some might claim that equipoise is disturbed if the majority of experts believe that emergency public health interventions are likely to be more beneficial than harmful. However, such beliefs are not always (...) justified: where high quality research has not been conducted, there is often considerable residual uncertainty about whether interventions offer net benefits. In this essay we argue that high-quality research, namely by means of well-designed randomized trials, is ethically obligatory before, during, and after implementing policies in public health emergencies (PHEs). We contend that this standard applies to both pharmaceutical and non-pharmaceutical interventions, and we elaborate an account of equipoise that captures key features of debates in the recent pandemic. We build our case by analyzing research strategies employed during the COVID-19 pandemic regarding drugs, vaccines, and non-pharmaceutical interventions; and by providing responses to possible objections. Finally, we propose a public health policy reform: whenever a policy implemented during a PHE is not grounded in high-quality evidence that expected benefits outweigh harms, there should be a planned approach to generate high-quality evidence, with review of emerging data at preset time points. These preset timepoints guarantee that policymakers pause to review emerging evidence and consider ceasing ineffective or even harmful policies, thereby improving transparency and accountability, as well as permitting the redirection of resources to more effective or beneficial interventions. (shrink)

COVID-19 has precipitated an increase in political homophobia in Turkey. This article focuses on the interlocking processes of LGBTQ marginalization and exclusion in Turkey with the purpose of uncovering how political homophobia is enforced, experienced, and navigated by LGBTQ people in Turkey during the COVID-19 pandemic. With the help of two critical conceptual tools, pink line and queer strategies, I first propose a multi-layered conceptualization of political homophobia that is drawn through anti-LGBTQ boundary regimes that shape the everyday lives of (...) LGBTQ people and sexualized bordering processes that filter and block digital LGBTQ representation and visibility in Turkey’s digital publics. I then analyze the everyday strategic uses of digital platfroms by LGBTQ activists and community organizers in Turkey. Invested in this complexity, this article draws from the ethnographic data of 20 interviews with LGBTQ people whose lives have crossed paths in several digital LGBTQ groups during the pandemic. Henceforth I argue that these digital LGBTQ groups have facilitated ways of connectivity among LGBTQ people in Turkey which limit exposure to the COVID-19 virus while partially freeing them from the restrictive limits of the nation-state and its political homophobia. (shrink)

Since the outbreak of the Covid-19 pandemic, there has been an increase in religious conspiracy theories in Africa, ranging from outright denial, partial acceptance to spreading misinformation about the Coronavirus. This essay will argue that RCTs pose serious challenges to Covid-19 prevention by encouraging non-compliance to Covid-19 preventive measures and refusal to take Covid-19 vaccination. It will then formulate a personhood-based theory of right action. This new theory will be teased out of Ifeanyi Menkiti's account of the normative conception of (...) personhood and deployed here as a veritable tool for overcoming the challenges posed by RCTs in the fight against the COVID-19 Pandemic in Africa. (shrink)

We revisit the flight-to-quality and flight-from-quality occurrences vis-à-vis the stock-bond nexus across differing investment time scales in the COVID-19 era, using a novel technique hinged on a denoised frequency-domain transfer entropy. Our findings divulge that flights, both FTQ and FFQ, could be attained during stress periods. Generally, in the intermediate term of the COVID-19 pandemic, both Islamic and conventional bonds could act as safe havens, diversifiers, and hedges for international equities, and the same could be observed for international equities. We (...) reiterate empirically that flights may improve the financial system’s stability and robustness by allowing diversity to be effective when it is most required. The findings have financial and portfolio implications for investors considering how to deploy their investments in the COVID-19 era. Our findings may impact policymakers’ responses to changes in various asset classes, allowing them to better monitor financial markets and adjust macroeconomic policies. (shrink)

In the middle of 2020, Buddhism in Thailand looked quite different than it had just prior to the COVID-19 pandemic. Monasteries had closed their doors to the public, and monastic ordinations ceased. The institution of Thai Buddhism stayed relevant, however, largely by promoting a quite unusual practice. In addition to the typical religious activity of lay followers offering food to monks, and receiving merit from the monks in return, the path that food traveled during the pandemic also turned the other (...) way around. In a curious series of events, monks at monasteries throughout the country began to hand out food to lay Buddhist followers. In a religious landscape with a very codified system of exchange, this was spiritually precarious: if monks give out food, where does the merit lie, and what are the karmic results? To answer this, I examine attitudes about monks’ activities, drawing on interviews conducted in Chiang Mai in 2021, and relationships to textual accounts of nutrients and healing across Buddhist history. Rather than signifying a break from spiritual relationships, I argue that this a-typical movement during the pandemic helps to highlight the continuing importance of monastic hope within interpersonal affective economies of Thai Buddhist practice. (shrink)

In the context of the global COVID-19 pandemic, the fast and equitable distribution of effective vaccines worldwide is one of the challenges faced by international institutions in charge, as global equity in vaccine supply has not yet been achieved. Our paper explains the current state of ethical research on equity in global COVID-19 vaccine allocation, focusing on the COVAX Facility established by the WHO, acting as the global vaccine distributor. The article presents a detailed analysis of the first year of (...) COVAX allocation in 2021 identifying problematic aspects of its allocation framework regarding the implementation of COVAX’s fundamental allocation principles. We argue that the COVAX Facility has developed a proper concept to deal with global vaccine allocation—but to address uncovered defaults, we introduce the ‘Prioritized Distribution of Equal Shares’ model—a both ethical and practically feasible alternative allocation framework to protect the value of human lives in both high- and low-income countries through fair and fast global vaccine distribution in health emergencies. Nonetheless, we argue that the COVAX Facility remains the main organization to provide equitable access to vaccines. Yet, the global community has to consider further aspects such as patent protection, vaccine production and the lack of power of global structures to address the inequities that have arisen. Since new wars and further crises have arisen, a shift in public global attention endangers the processing of COVID-19-related issues. That is why now more than ever extensive efforts to achieve vaccine equity are needed. (shrink)

The COVID-19 crisis has not only ontological roots but also epistemic ones too; its cause lies in the main evolutionary trends in the development of science as a social institution. And only then the epistemic factors were transformed into existential-ontological ones, connected with the very existence of civilization and our biosocial nature. The way out of the crisis is the unalterable development of all sectors of technologies of controlled evolution. As a result, biopolitics extends the sphere of competence to interstate (...) and interethnic relations, becomes transbiopolitics, ie a global geopolitical factor responsible for the preservation of humanity and its self-identity. The coronavirus pandemic, like other manifestations of the civilization crisis, is politically generated by globalization. The same consequences of globalization contribute to the fragmentation of the geopolitical space and the inhibition of the actual globalization process. the pandemic scale of the crisis immediately brought biopolitics to the level of a systemic factor in interstate relations in both formal and substantive aspects. (shrink)

The sudden emergence of the COVID-19 pandemic brought global disruption to every aspect of society including healthcare, supply chain, the economy, and social interaction. Among the many emergent considerations were the safety and public health of the public, patients, essential workers, and healthcare professionals. In certain locations, clinical research was halted—or terminated—in deference to the immediate needs of patient care, and clinical trials focusing on the treatment and prevention of coronavirus infection were prioritized over studies focusing on other diseases. Difficult (...) decisions were made rapidly; flexibility and reconsideration were necessary not only because the intensity and severity of infection varied over time and by locale but also because knowledge of the disease and understanding of its treatment grew. Here we discuss the ethical challenges in decision-making and competing ethical tensions during the pandemic in an effort to advance future preparedness. (shrink)

In the years following the COVID‐19 pandemic, issues such as high job demands, burnout, and turnover continue to influence the nursing workforce, with heavier impacts to marginalized groups. Understanding the work and life contexts of nurses of color can help guide strategies for workplace equity and meaningful support. This qualitative study explored the experiences of nurses of color in the United States during the pandemic, focusing on feelings about the profession and job decisions. The overarching theme was “answering the call,” (...) with subthemes of “COVID shone a light,” “being consumed by COVID,” and “is it worth it?” Participants shared how their racial identities shaped their perceptions and job decisions in positive and negative ways, noting how racism impacted many facets of their work and added to the stressors felt in the workplace and the community. Findings provide insight into the underrepresented perspectives of nurses of color and suggest strategies to eliminate racism in nursing. (shrink)

During the COVID-19 pandemic, investigational treatments have been made available to seriously ill patients through so-called expanded access programmes, such as compassionate use and named-patient programmes. Many countries have legal, ethical and professional frameworks in place to promote safe and responsible use of investigational treatments outside of clinical trial settings. However, these frameworks leave room for ambiguities regarding the roles and responsibilities of treating physicians, hospital-based pharmacists, pharmaceutical companies, and other stakeholders, and for practices to differ, not only between countries, (...) but also within countries, between hospitals and individual healthcare providers. Current ambiguities with regard to physicians’ moral duties, for instance, allow physicians to withhold information from patients about options for expanded access, and to forego pursuing such options for their patients. This chapter describes the experiences with the use of Remdesivir and hydroxychloroquine in COVID-19-infected patients in the Netherlands during the first wave of the pandemic, and discusses an open question in relation to treating physicians’ duties, namely vis-à-vis information provision. This chapter proposes a prima facie obligation for healthcare professionals to inform eligible patients about relevant options for expanded access. (shrink)

The COVID‐19 pandemic has reinforced the critical role of ethics and community engagement in designing and conducting clinical research during infectious disease outbreaks where no vaccine or treatment already exists. In reviewing current practices across Africa, we distinguish between three distinct roles for community engagement in clinical research that are often conflated: 1) the importance of community engagement for identifying and honouring cultural sensitivities; 2) the importance of recognising the socio‐political context in which the research is proposed; and 3) the (...) importance of understanding what is in the interest of communities recruited to research according to their own views and values. By making these distinctions, we show that current practice of clinical research could draw on anthropology in ways which are sometimes unnecessary to solicit local cultural values, overlook the importance of socio‐political contexts and wider societal structures within which it works, potentially serving to reinforce unjust political or social regimes, and threaten to cast doubt on the trustworthiness of the research. We argue that more discerning anthropological engagement as well as wider collaboration with other social scientists and those working in the humanities is urgently needed to improve the ethics of current biomedical and pharmaceutical research practice in Africa. (shrink)

The presented study raises the issue of contribution payers in the field of social insurance, in particular based on the Covid-19 pandemic. Searching for ways of supporting was determined by the deterioration of the financial condition of entrepreneurs as payers of contributions. In 2020, there were no instruments or mechanisms to support entrepreneurs in a lockdown situation, which implied the need to build such tools and the legal environment for SMEs practically from the beginning. The Social Insurance Institution (ZUS) was (...) entrusted with the role of a stabilizer, consisting in servicing entrepreneurs as part of subsequent editions of the Anti-Crisis Shield. During the announcement of the COVID-19 pandemic, ZUS used the following forms of support for contribution payers: exemption from the obligation to pay contributions, postponement of the payment of contributions and payment of contributions in installments. The research question concerned the enforcement of the law and respect for the basic rights of entrepreneurs in the scope of the support used. In order to solve the research task legal interpretation were used in the work. The author’s considerations lead to the conclusion that forms of support used in connection with the Covid-19 pandemic turned out to be effective and may be used in the future in emergency situations. An important science contribution of the article results from the combination of the selected legal and economic aspects. (shrink)

The previous general update of acquisitions appeared in Russell n.s. 37 (winter 2017–18): 342–7. The new listing covers numbers 1,797 to 1,823 with the latest items arriving in November 2019.

Individual differences in effortful control, a component of temperament, reflecting the ability to use attention and other cognitive processes to self-regulate emotion and behavior, contribute to child academic adjustment, social competence, and wellbeing. Research has linked excessive screen time in early childhood to reduced self-regulation ability. Furthermore, research suggests that parents are more likely to use screens with children who have more challenging temperaments, such as low levels of effortful control. Since screen time by children between the ages of 0 (...) and 18 has increased during the COVID-19 pandemic, it remains timely to investigate the developmental pattern of association between child screen media use and effortful control. We hypothesize that higher levels of screen media intake at age 3.5 will be associated with lower effortful control at age 4.5 and that lower effortful control at 3.5 will contribute to more screen media intake at age 4.5. This study draws on participants followed longitudinally over the span of 2-years for an investigation of Canadian preschoolers’ screen media use during the pandemic. A follow-up with this sample was completed in 2021. Analyses using a cross-lagged panel model revealed stability in child screen time and effortful control between the ages of 3.5 and 4.5. Child screen time at age 3.5 significantly contributed to decreased effortful control scores at the age of 4.5, whereas effortful control at age 3.5 did not contribute to screen time at age 4.5. Our results partially confirmed our hypothesis and indicated that higher levels of screen time intake were detrimental to the development of effortful control. These results suggest that screen media use, an exceedingly frequent activity, may play an enduring role in development by shaping young children’s temperaments. (shrink)

Oxford Studies in Metaethics is the only publication devoted exclusively to original philosophical work in the foundations of ethics. It provides an annual selection of much of the best new scholarship being done in the field. Its broad purview includes work being done at the intersections of ethical theory with metaphysics, epistemology, philosophy of language, and philosophy of mind. The essays included in the series provide an excellent basis for understanding recent developments in the field; those who would like to (...) acquaint themselves with the current state of play in metaethics would do well to start here. (shrink)

COVID-19 lockdown presented a novel opportunity to study the experiences of people attempting to maintain friendships in the context of worldwide, government-enforced physical distancing and lockdown. Here we report on an experiential, idiographic qualitative project with a purposive sample of Scottish students. Data was collected via one-to-one on-line interviews with nine student participants. Data was transcribed and analyzed using Interpretative Phenomenological Analysis. Analysis highlighted three group-level experiential themes and associated subthemes. Participants’ shared experiences of maintaining friendships were reflected in a (...) dynamic process by which ‘changes to communication’ were associated with experiences of ‘effort and balance’ across friendships. Participants reported becoming particularly aware of the psychological processes involved in maintaining friendships, in turn, this was associated with ‘reflection and growth.’ These experiential findings resonate well with several longstanding classic theories; however, they also speak to the particularities of the context in which the study was conducted. They suggest the need for a pandemic psychology that moves beyond the typical focus on the direct impacts of infectious disease to address the wider psychosocial impacts with equal vigor. (shrink)

Shortages of new therapeutics to treat coronavirus disease (COVID-19) have forced clinicians, public health officials, and health systems to grapple with difficult questions about how to fairly allocate potentially life-saving treatments when there are not enough for all patients in need (1). Shortages have occurred with remdesivir, tocilizumab, monoclonal antibodies, and the oral antiviral Paxlovid (2) -/- Ensuring equitable allocation is especially important in light of the disproportionate burden experienced during the COVID-19 pandemic by disadvantaged groups, including Black, Hispanic/Latino and (...) Indigenous communities, individuals with certain disabilities, and low-income persons. However, many health systems have resorted to first-come, first-served approaches to allocation, which tend to disadvantage individuals with barriers in access to care (3). There is mounting evidence of racial, ethnic, and socioeconomic disparities in access to medications for COVID-19 (4, 5). -/- One potential method to promote equitable allocation is to use a weighted lottery, which is an allocation strategy that gives all eligible patients a chance to receive the scarce treatment while also allowing the assignment of higher or lower chances according to other ethical considerations (6). We sought to assess the feasibility of implementing a weighted lottery to allocate scarce COVID-19 medications in a large U.S. health system and to determine whether the weighted lottery promotes equitable allocation. (shrink)

IntroductionLittle is known about risk factors for both Long COVID and somatic symptoms that develop in individuals without a history of COVID-19 in response to the pandemic. There is reason to assume an interplay between pathophysiological mechanisms and psychosocial factors in the etiology of symptom persistence.ObjectiveTherefore, this study investigates specific risk factors for somatic symptom deterioration in a cohort of German adults with and without prior SARS-CoV-2 infection.MethodsGerman healthcare professionals underwent SARS-CoV-2 IgG antibody testing and completed self-rating questionnaires at baseline (...) and 21 months later between April 2020 and February 2022. Differences in variables between the time points were analyzed and a regression analysis was performed to predict somatic symptom deterioration at follow-up.ResultsSeven hundred fifty-one adults completed both assessments. Until follow-up, n = 58 had contracted SARS-CoV-2 confirmed by serology. Between baseline and follow-up, signs of mental and physical strain increased significantly in the sample. Symptom expectations associated with COVID-19 and a self-reported history of COVID-19, but not serologically confirmed SARS-CoV-2 infection, significantly predicted somatic symptom deterioration at follow-up. A further predictor was baseline psychological symptom burden.ConclusionsThis study supports a disease-overarching biopsychosocial model for the development of burdensome somatic symptoms during the COVID-19 pandemic and supports research findings that symptom burden may be more related to the psychosocial effects of the pandemic than to infection itself. Future studies on Long COVID should include SARS-CoV-2 negative control groups and consider symptom burden prior to infection in order to avoid an overestimation of prevalence rates. (shrink)

The COVID-19 pandemic provided the opportunity to determine whether age-related differences in utilitarian moral decision-making during sacrificial moral dilemmas extend to non-sacrificial dilemmas in real-world settings. As affect and emotional memory are associated with moral and prosocial behaviors, we also sought to understand how these were associated with moral behaviors during the 2020 spring phase of the COVID-19 pandemic in the United States. Older age, higher negative affect, and greater reports of reflecting on negative aspects of the pandemic were associated (...) with higher reported purchase of hard-to-find goods, while older age and higher negative affect alone were associated with higher reported purchase of hard-to-find medical supplies. Older age was associated with what appeared at first to be non-utilitarian moral behaviors with regard to the purchasing of these supplies; However, they also reported distributing these goods to family members rather than engaging in hoarding behaviors. These findings suggest that advancing age may be associated with engagement in utilitarian moral decision-making in real-world settings more than the sacrificial moral decision-making literature would suggest. (shrink)

Purpose The purpose of this study is to examine the primary sources and methods of Web-based messaging during the early stages of the coronavirus pandemic. The authors use ethical lens to develop a conceptual framework to inform and reduce conflicts of Web-based messaging associated with COVID-19. Design/methodology/approach This paper provides a comprehensive review of three different ethical schools and identifies the cohesive theme of common good across them. Common good leading to a greater good serves as the overarching ethical construct (...) for Web-based messages that focus on society and not the singular individual, business or political ideology. Findings The findings suggest that the ethical construct of common good focuses on prioritizing the society over the individual and draws upon utilitarian principles focused on consequences, Kantian principles focused on intentions and Aristotelian principles focused on the definition of good. Web-based messaging on COVID-19 originates from diverse public and private sources and ethically can be governed by adherence to achieving the greatest good for society. Pervasive conflicts with COVID-19 messaging can be mitigated by pursuing a more ethical agenda with messages. Originality/value This manuscript provides a conceptual framework, based on ethical principles, to serve as a blueprint for Web-based messaging during a pandemic. This work offers an ethical perspective for communication during a pandemic and it is original in conceptualizing the components of Web-based messaging and decomposing them into the different levels where conflicts can occur. This article can serve as a template for Web-based communication pertaining to future pandemics and other events that benefit from prioritizing the impact on society over the impact on the individual. (shrink)