The COVID-19 Pandemic a stress test for clinical medicine and medical ethics, with a confluence over questions of the proportionality of resuscitation. Drawing upon his experience as a clinical ethicist during the surge in New York City during the Spring of 2020, the author considers how attitudes regarding resuscitation have evolved since the inception of do-not-resuscitate orders decades ago. Sharing a personal narrative about a DNR quandry he encountered as a medical intern, the author considers the balance of (...) patient rights versus clinical discretion, warning about the risk of resurgent physician paternalism dressed up in the guise of a public health crisis. (shrink)

Due to the COVID-19 pandemic, the academe was introduced to online education, which is complicated. The sudden shift of traditional face-to-face classes to digital learning impacted every student's self-efficacy and motivation towards their studies. This study investigates the relationship between the self-efficacy and academic motivation of the 304 freshmen college students from private higher education institutions in the Philippines. Based on the data gathered, the participants' level of self-efficacy (x̄ = 3.27) and academic motivation (x̄ = 5.93) is (...) high. Further, the statistical analysis concluded a relationship between self-efficacy and academic motivation (r=.002, at 0.05 level) among the graduating college students. Implications of the study were discussed, and recommendations for future research were suggested. (shrink)

This paper uses the example of the COVID-19 pandemic to analyse the danger associated with insufficient epistemic pluralism in evidence-based public health policy. Drawing on certain elements in Paul Feyerabend’s political philosophy of science, it discusses reasons for implementing more pluralism as well as challenges to be tackled on the way forward.

Governmental reactions to crises like the COVID-19 pandemic can be seen as ethics communication. Governments can contain the disease and thereby mitigate the detrimental public health impact; allow the virus to spread to reach herd immunity; test, track, isolate, and treat; and suppress the disease regionally. An observation of Sweden and Finland showed a difference in feasible ways to communicate the chosen policy to the citizenry. Sweden assumed the herd immunity strategy and backed it up with health utilitarian (...) arguments. This was easy to communicate to the Swedish people, who appreciated the voluntary restrictions approach and trusted their decision makers. Finland chose the contain and mitigate strategy and was towards the end of the observation period apparently hesitating between suppression and the test, track, isolate, and treat approach. Both are difficult to communicate to the general public accurately, truthfully, and acceptably. Apart from health utilitarian argumentation, something like the republican political philosophy or selective truth telling are needed. The application of republicanism to the issue, however, is problematic, and hiding the truth seems to go against the basic tenets of liberal democracy. (shrink)

This paper investigates the COVID-19 pandemic, and its impact on pro-environmental behaviour of individuals travelling internationally for leisure and recreational purposes. The aim of this manuscript is to investigate a conceptual framework created through the examination of current existing literature in the field of tourism science. The conceptual framework, consisting of certain constructs of the health belief model, and the theory of planned behaviour, is applied and tested using a partial least-squares-structural equation modelling. Data were collected from participants (...) who have travelled internationally before and during the outbreak of the COVID-19 pandemic, and those who plan to travel post-COVID-19 pandemic. Results revealed that the conceptual framework tested positively against existing theory, highlighting the key influencing factors in which COVID-19 is likely to have on future pro-environmental behaviour of individuals travelling internationally for leisure and recreational purposes. Moreover, perceived safety threat and outcome expectations have a positive impact on attitude; attitude has a positive impact on behavioural intentions; subjective norm has a positive impact on behavioural intentions, and perceived behavioural control has a positive impact on behavioural intentions. The study results identify practical and theoretical implications for global and travel companies and organisations, presenting opportunities to adjust environmental policies and procedures accordingly, whilst identifying the most effective marketing and management strategies to rebuild a collapsed global travel industry. (shrink)

ABSTRACTThis article addresses the question of whether certain experiences that originate in causes other than bereavement are properly termed ‘grief’. To do so, we focus on widespread experiences of grief that have been reported during the Covid-19 pandemic. We consider two potential objections to a more permissive use of the term: grief is, by definition, a response to a death; grief is subject to certain norms that apply only to the case of bereavement. Having shown that these objections (...) are unconvincing, we sketch a positive case for a conception of grief that is not specific to bereavement, by noting some features that grief following bereavement shares with other experiences of loss. (shrink)

Increasing evidence indicates that the coronavirus disease 2019 pandemic is associated with adverse psychological effects, including heightened levels of anxiety. This study examined whether COVID-19-related anxiety levels during the early stage of the pandemic predicted demanding working memory updating performance. Altogether, 201 healthy adults mostly from North America and the British Isles were recruited to this study via the crowdsourcing site www.prolific.co. The results showed that higher levels of COVID-19-related anxiety during the first weeks of the (...) pandemic outbreak were associated with poorer WM performance as measured by the n-back paradigm. Critically, the unique role of COVID-19-related anxiety on WM could not be explained by demographic factors, or other psychological factors such as state and trait anxiety or fluid intelligence. Moreover, across three assessment points spanning 5–6 weeks, COVID-19-related anxiety levels tended to decrease over time. This pattern of results may reflect an initial psychological “shock wave” of the pandemic, the cognitive effects of which may linger for some time, albeit the initial anxiety associated with the pandemic would change with habituation and increasing information. Our results contribute to the understanding of cognitive–affective reactions to a major disaster. (shrink)

It has been quite a year so far(!) and as the wenches we are, we have been taking our time to collect our thoughts and reflections before sharing them at the start of this issue of the journal. In this editorial we think through the COVID-19 pandemic and its devastating effects on the world, on our lives and on our editorial processes. We renew our commitment to improving our operations as a journal and its health along with our (...) own as we deploy wench tactics to restore, sustain and slow down to negotiate this new reality, this new world. We conclude with an introduction to the fascinating contents of this issue along with a collaborative statement of values on open access as part of a collective of intersectional feminist and social justice editors. Through all of the pain and suffering we focus our gaze on hope: hope that we can come through this global crisis together engaging in critical conversations about how we can be better and do better as editors, academics and individuals for ourselves, our colleagues and our journal. (shrink)

When considering our own death, we normally weigh its impact on the people we love and care about, as well as worrying about the way in which our life might end, hoping that not too much suffering precedes it. However, such view, despite necessary, is a passive understanding of death, interpreted as something that merely happens to us, where we would have some control over timing if physician-assisted dying were legal in our countries. But what if our relation to death (...) would not end there? What if special medical needs, such as the emergency situation resulting from the Covid-19 pandemic, could have a direct impact on us creating a moral duty to end our lives? That is the thesis that will be advocated for in this paper: a moral duty to die will arise in some people to save resources that will help others get through Covid-19. It is important to indicate that the duty to die is personally acknowledged and self-imposed, thus nobody can be coerced to carry it out; for autonomy would be lost and such action should be considered an instance of incitement to die, therefore being morally blameworthy. (shrink)

This monograph evaluates public policy responses to the Covid-19 pandemic through a public choice lens. The book compares two prominent, albeit mutually exclusive, theories in social sciences—public interest theory and public choice theory—and explores how their predictions perform within the framework of the Covid-19 pandemic. The chapters present different pandemic policies alongside empirical data in order to draw conclusions about their efficacy, and, in turn, draw conclusions about the veracity of each theory. By the end (...) of the volume, the reader will be able to draw their own conclusions about whether the pandemic policy responses served the public interest, as public interest theory suggests, or the personal interests of the politicians who implemented them, as public choice theory holds. (shrink)

Ageism has unfortunately become a salient phenomenon during the COVID-19 pandemic. In particular, triage decisions based on age have been hotly discussed. In this article, I first defend that, although there are ethical reasons (founded on the principles of benefit and fairness) to consider the age of patients in triage dilemmas, using age as a categorical exclusion is an unjustifiable ageist practice. Then, I argue that ageism during the pandemic has been fueled by media narratives and unfair (...) assumptions which have led to an ethically problematic group homogenization of the older population. Finally, I conclude that an intersectional perspective can shed light on further controversies on ageism and triage in the post-pandemic future. (shrink)

Humans have been using fire for hundreds of millennia, creating an ancestral expansion toward the nocturnal niche. The new adaptive challenges faced at night were recurrent enough to amplify existing psychological variation in our species. Night-time is dangerous and mysterious, so it selects for individuals with higher tendencies for paranoia, risk-taking, and sociability. During night-time, individuals are generally tired and show decreased self-control and increased impulsive behaviors. The lower visibility during night-time favors the partial concealment of identity and opens more (...) opportunities for disinhibition of self-interested behaviors. Indeed, individuals with an evening-oriented chronotype are more paranoid, risk-taking, extraverted, impulsive, promiscuous, and have higher antisocial personality traits. However, under some circumstances, such as respiratory pandemics, the psychobehavioral traits favored by the nocturnal niche might be counter-productive, increasing contagion rates of a disease that can evade the behavioral immune system because its disease cues are often nonexistent or mild. The eveningness epidemiological liability hypothesis presented here suggests that during the COVID-19 pandemic, the evening-oriented psychobehavioral profile can have collectively harmful consequences: there is a clash of core tendencies between the nocturnal chronotype and the recent viral transmission-mitigating safety guidelines and rules. The pandemic safety protocols disrupt much normal social activity, particularly at night when making new social contacts is desired. The SARS-CoV-2 virus is contagious even in presymptomatic and asymptomatic individuals, which enables it to mostly evade our evolved contagious disease avoidance mechanisms. A growing body of research has indirectly shown that individual traits interfering with social distancing and anti-contagion measures are related to those of the nocturnal chronotype. Indeed, some of the social contexts that have been identified as superspreading events occur at night, such as in restaurants, bars, and nightclubs. Furthermore, nocturnal environmental conditions favor the survival of the SARS-CoV-2 virus much longer than daytime conditions. We compare the eveningness epidemiological liability hypothesis with other factors related to non-compliance with pandemic safety protocols, namely sex, age, and life history. Although there is not yet a direct link between the nocturnal chronotype and non-compliance with pandemic safety protocols, security measures and future empirical research should take this crucial evolutionary mismatch and adaptive metaproblem into account, and focus on how to avoid nocturnal individuals becoming superspreaders, offering secure alternatives for nocturnal social activities. (shrink)

The COVID-19 pandemic has foregrounded the significance of time to everyday life, as the routines, pace, and speed of social relations were widely reconfigured. This article uses rhythm as an object and tool of inquiry to make sense of spatio-temporal change. We analyse the Mass Observation (MO) directive we co-commissioned on ‘COVID-19 and Time’, where volunteer writers reflect on whether and how time was made, experienced, and imagined differently during the early stages of the pandemic in (...) the UK. We draw on Henri Lefebvre and Catherine Régulier's ‘rhythmanalysis’, taking up their theorisation of rhythm as linear and cyclical and their concepts of arrhythmia (discordant rhythms) and eurhythmia (harmonious rhythms). Our analysis highlights how MO writers articulate (a) the ruptures to their everyday rhythms across time and space, (b) their experience of ‘blurred’ or ‘merged’ time as everyday rhythms are dissolved and the pace of time is intensified or slowed, and (c) the remaking of rhythms through new practices or devices and attunements to nature. We show how rhythm enables a consideration of the spatio-temporal textures of everyday life, including their unevenness, variation, and difference. The article thus contributes to and expands recent scholarship on the social life of time, rhythm and rhythmanalysis, everyday life, and MO. (shrink)

Grounded in a will to adapt to dangers, and espouse both responsibility and resilience, voluntary measures have largely replaced one of the oldest public health strategies, quarantine. The Covid-19 pandemic, however, elicited a broad sweep of tactics from the archive of public health armoury. On a general level, this review essay addresses the common measures rolled out by various authorities against the pandemic - the lock-downs, reopening process, financial support and vaccination. By relating these measures to 1) (...) the “plague-stricken town”, deployed during the seventeenth and eighteenth centuries in Europe by the Polizeistaat; 2) the “self-regulation strategy” that emerged with liberal ideas at the end of the eighteenth century; and 3) the “minimum security” programmed by neoliberal governmentality in the second half of the twentieth century, it is suggested that tensions between freedom and security during, and after, the pandemic can be better understood. To end, the essay noticed that the pandemic has enforced tensions in the administration and calibration of individual wishes and collective wellbeing, creating a fragile “freedom-security relationship” and new problem space for self-regulation. (shrink)

ObjectiveThis study aims to analyze sociohistorically how the normative patterns of hegemonic masculinity produced impacts on men’s health/mental health in the context of the COVID-19 pandemic.MethodsA qualitative study from a socio-historical perspective was conducted with 50 men based on an online survey. A semistructured form was applied. The data were analyzed by the Collective Subject Discourse method, interpreted in the light of the context of epidemic disease and hegemonic masculinity.ResultsThe experience of the pandemic exposed the normative patterns (...) of masculinities from the consummation of acts representative of the pandemic context, which incited men to deny the existence of COVID-19 disease and to delay the understanding and adoption of measures to protect and control COVID-19. As a repercussion, men presented conflicts in the regulation of emotions; presented emotional suppression; were more reactive; felt threatened regarding the loss of the role of family provider, virility; and revealed a sense of invulnerability, added to the weakening of self-care.ConclusionThe discourse revealed that the men’s behaviors are consistent with the characteristics of hegemonic masculinity, but express signs of recognition that this behavior causes harm to themselves and their health. (shrink)

In this article, I consider the interoperation of twin contemporary governmental imperatives, fostering economic growth and ensuring biopolitical security, in the face of the COVID-19 pandemic. At a theoretical level, I thereby consider the question of the applicability of a Marxist analysis vis-à-vis a Foucauldian one in understanding state responses to the pandemic. Despite the apparent prioritization of preserving life over economic activity by governments around the world in this context, I will argue that the basic problem (...) that COVID-19 posed for the state was one of sheer unknowability and that the fundamental motive for the governmental response was a concern for security in Foucault’s sense, that is, ensuring a baseline predictability in the social field, upon which economic activity, like myriad other social activity, is premised. I argue that this drive for security motivated states to appeal to medical experts to determine the direction of their response, who in turn applied a default model of quarantine. While we cannot be certain that the medically-guided response was optimal in terms either of health outcomes or economically, I argue it served its essential purpose by providing a structured framework for social action in the face of the unknown. While this is vital for the maintenance of the basic coordinates of capitalist society, I argue it nonetheless cannot entirely be explained simply by an appeal to Marxist categories and instead requires Foucault’s insights into the medicalization of society. (shrink)

The impact of this pandemic is not only through COVID-19 itself: the care for non-COVID-19 related conditions has been dramatically curtailed, shaking entire healthcare services around the world. Amongst the non-COVID-19 related conditions, oncology has been disproportionally affected. We discuss how oncology has changed since the acute phase of the pandemic; its impact on clinicians, trainees, and patients; and offer some medical and historical perspectives to reflect on how this impact could be reduced.

This paper describes an innovative just-in-time health humanities programme to educate and provide support to COVID-19 frontline doctors-in-training. The programme incorporates small-group screening of the Netflix documentary, The Next Pandemic from the Explained series, followed by a one-hour facilitated discussion to explore themes surrounding the current pandemic and its impact on frontline doctors in a tertiary paediatric hospital in Singapore. Themes derived from the film included preparedness, blame, and the impact on healthcare workers and public, which were (...) further discussed to include concerns regarding current local readiness levels given global connectivity, the need for international cooperation, and the effects of blame such as racism and prejudice. The association with culture; the current impact on healthcare workers, physician-patient relationships, and the public including the role of social media, the government and associated public reactions were also explored. These rich discussions demonstrate the pivotal role health humanities has in times of uncertainty such as an emerging infectious disease outbreak by providing timely pandemic education and supporting reflective learning. (shrink)

The COVID-19 pandemic brings up unprecedented challenges. Healthcare practitioners find themselves in an extraordinary, wartime-like situation and are obliged to apply triage on a daily basis. In this context, routine procedures prove insufficient and the redefinition of ethical practice guidelines becomes a necessity – leading not only to a shift in procedures, but also reshaping the very value of human life. This, in turn, triggers an axiological crisis, which exacerbates the tension between paradigms of sanctity and quality of (...) life and the conflicting principles of egalitarianism and utilitarianism. Triage should not be limited to healthcare practice only: the concept can be extended to a macro-level where policymakers decide whether to prioritize human lives over livelihoods and economic health, impacting healthcare system capacity. The complexity of the challenges arising from the pandemic uncovers the urgent need to seek solutions from an integrated approach. In this paper, we offer a transdisciplinary view: we first define technical aspects of triage from the perspective of a healthcare professional. In the second part, we further analyze the problem of medical prioritization in the light of doctrinal findings related to the value of human life, and we show how and to what extent this philosophical debate is reflected in the emerging ethical guidelines in France, Spain, Italy, Belgium, Germany and Austria. Finally, we broaden the concept of triage, adding the “macro-economic” ingredient in our analysis and we present the results for selected European countries with special emphasis on the case of Poland. (shrink)

The COVID-19 pandemic has increased demand for physicians, leading to widespread redeployment of specialty physicians to care for patients with COVID-19. These redeployments highlight an important question: How do physicians balance competing obligations to their own health, their own patients, and society during a public health crisis? How can physicians, specifically subspecialists, navigate this tension? In this article, we analyse a clinical scenario in which an orthopaedic sports surgeon is redeployed to care for patients with COVID-19. (...) This case raises questions about physicians’ obligations to their own patients compared with society at large, the relative value of specialty physicians during a global pandemic, and the ethical permissibility of compulsory redeployment. Using the orthopaedic surgery specialty as a model, we build a redeployment framework for surgical specialists that is both ethical and equitable. We argue that although orthopaedic surgeons have a moral obligation to participate in physician redeployment schemes, the scope of this obligation is limited and contingent on the following conditions: (1) the number of local COVID-19 cases is high; (2) obligations to their own patients or orthopaedic patients requiring urgent or emergency care have been fulfilled; (3) their value as physicians exceeds their value as specialists because of the pandemic climate; (4) voluntary redeployments are exhausted before compulsory redeployments are implemented; and (5) redeployment would not put the physicians at unreasonable risk of harm. (shrink)

Pandemics first and foremost hit those who are most vulnerable, and the COVID-19 pandemic is not different. Although the infection rate in the nation’s poorest neighborhoods is twice as it is in th...

The outbreak of the novel coronavirus disease and the efforts to contain the raging pandemic raise not only health, but also existential concerns. The present work sets out to examine how the pandemic impacts on the African socio-cultural life. The approach is analytical, phenomenological and above all conversational. For the African, the pandemic has two-pronged, positive and negative existential implications. On the one hand, the search for a possible cure and a vaccine for the novel coronavirus disease, (...) when interpreted from the anthropological point of view, present an opportunity for cultural creativity in the areas of medicine and therapeutics. African traditional medicine as a cultural element is, here, referenced.On the other hand, it is discovered that the isolationist tendency of the pandemic, aggravated by another ‘virus of disinformation’ ─ an infodemics, threatens the social relations within the African world that is largely interdependent. The work argues that a fruitful utilization of the good cultural traits the pandemic brings can serve to boost the African self-confidence and cultural pride. The positive cultural traits that trail the pandemic can be absorbed to enrich the African culture whereas the negative traits should be jettisoned. Keywords: COVID-19 pandemic, African identity, equality, anthropology, medicine, and cultural pride. (shrink)

The role of bioethicists amidst crises like the COVID-19 pandemic is not well defined. As professionals in the field, they should respond, but how? The observation of the early days of pandemic confinement in Finland showed that moral philosophers with limited experience in bioethics tended to apply their favorite theories to public decisions, with varying results. Medical ethicists were more likely to lend support to the public authorities by soothing or descriptive accounts of the solutions assumed. These (...) are approaches that Tuija Takala has called the firefighting and window dressing models of bioethics. Human rights lawyers drew attention to the flaws of the government’s regulative thinking. Critical bioethicists offered analyses of the arguments presented and the moral and political theories that could be used as the basis of good and acceptable decisions. (shrink)

The aim of this article is to present the changes referred to as the “fourth industrial revolution” and the role of the crisis caused by the COVID-19 pandemic in accelerating the technological revolution in relation to Polish companies. The ongoing economic downturn has different causes and much broader effects than previous crises. Hence the need to analyze trends (megatrends) in the emergence of innovations initiated or significantly accelerated by the pandemic crisis, and consequently, among other things, the (...) intensification of the digital transformation process. The study has a theoretical and empirical character. For the research, the authors used the descriptive method with elements of statistical data analysis. The analysis was based on reports of such institutions as the World Intellectual Property Organization, the European Commission and the Central Statistical Office. (shrink)

During the COVID‐19 pandemic, healthcare professionals around the world were driven by universal values of solidarity and duty to provide care. However, local societal norms and existing healthcare systems influenced interactions among physicians, and with patients and their families. An exploratory qualitative study design using in‐depth interviews was undertaken with physicians working at two public sector hospitals in Karachi, Pakistan. Using the constant comparison method of data analysis, several key themes were identified highlighting norms of kinship and interdependencies (...) characteristic of collectivistic societies that influenced professional interactions. The role of seniors in the hierarchical society of Pakistan played a major role in provision of care. Physicians reported numerous challenges in dealing with patients and their families amidst public denial fueled due to ill‐formed government policies. This included interruption of funeral rites which undermined public trust. The study provides insights into the local moral world of two healthcare institutions in Pakistan. (shrink)

The pandemic caused by the SARS-CoV2 novel coronavirus is creating a global crisis. There is a global ambience of uncertainty and anxiety. In addition, nations have imposed strict and restrictive public health measures including lockdowns. In this heightened time of vulnerability, public cooperation to preventive measures depends on trust and confidence in the health system. Trust is the optimistic acceptance of the vulnerability in the belief that the health system has best intentions. On the other hand, confidence is assessed (...) based on previous experiences with the health system. Trust and confidence in the health system motivate people to accept the public health interventions and cooperate with them. Building trust and confidence therefore becomes an ethical imperative. This article analyses the COVID-19 pandemic in the south Indian state of Tamil Nadu and the state’s response to this pandemic. Further, it applies the Trust-Confidence-Cooperation framework of risk management to analyse the influence of public trust and confidence on the Tamil Nadu health system in the context of the preventive strategies adopted by the state. Finally, the article proposes a six-pronged strategy to build trust and confidence in health system functions to improve cooperation to pandemic containment measures. (shrink)

Studies on mental health and academic performance have been conducted throughout the world. Thus, this study aims to assess the students' mental health amidst the new normal of education employing 21-item Depression, Anxiety, and Stress Scale or DASS-21, concerning their academic performance. The study's findings showed that almost more than half of the respondents suffered from moderate to extremely severe levels of depression, stress, and anxiety. Thus, there was no significant relationship between high negative mental health symptoms and academic performance. (...) In conclusion, students that encounter extreme levels of adverse mental health can still maintain high academic achievement. However, the students' mental health should always be managed and helped to cope with their life problems, especially during this pandemic crisis. (shrink)

The novel pandemic called “Coronavirus Disease 2019”, as a global public health emergency and global threat, has affected many countries in unpredictable ways and impacted on physical activity behaviors to various extents. Specific populations including refugees, asylum seekers, and prisoners, are vulnerable groups with multiple complex health needs and worse health outcomes with respect to the general population worldwide and at high risk of death from the “Severe Acute Respiratory Syndrome-related Coronavirus type 2”. Governments around the world have been (...) implementing preventive healthcare policies, including physical and social distancing, isolation, and confinement, to mitigate against the burden imposed by the COVID-19 outbreak. This pandemic period is characterized by reduced or lack of movement. During this period of lockdown, PA can represent an immunotherapy and a preventative approach to avoid the harmful effects of inactivity due to the pandemic. Moreover, PA could be prescribed to improve the immune system of specific populations, which particularly experience the condition of being confined. The present narrative review discusses the potential impacts of COVID-19 pandemic on these specific populations’ health status and the importance of performing PA/exercise to reduce the deleterious effects of COVID-19 pandemic. In addition, we aim to provide useful recommendations on PA/exercise for these specific populations to maintain their level of independence, physical, and mental health as well as their wellbeing. (shrink)

Part of the rationale behind public health measures is protecting the vulnerable. One of the groups most vulnerable to COVID-19 are the elderly and, consequently, many countries adopted public health measures that aimed to keep the elderly safe. The effectiveness and the consequences of those measures, however, leaves a lot to be desired. In my article, I will look at the steps that the Nordic countries took to protect their elderly and assess their success. I will further analyze those (...) in the light of standard ethical theories. Public health crises often call for choices between two evils. Selecting patients for intensive care is one such choice, and again, it seems that for the elderly, the outcome was less than favorable. Overall, from the point of view of ethics, many countries failed miserably when it came to the treatment of the elderly. I will end my paper by discussing the lessons we can learn from the COVID-19 pandemic and suggests measures we need to take to offer genuine respect for the rights of the elderly. (shrink)

This critical essay responds to the COVID-19 pandemic and subsequent lockdown in Victoria from the perspective of a retired Aboriginal academic and reflects on personal responsibility, Indigenous history, and resilience.

In many ways, questionable epidemiological measures by which the authorities restricted civic and private life during the COVID-19 pandemic have challenged many implied notions of the inviolability of citizens’ rights and freedoms, as well as obedience to state authority. It is a problem of the incommensurability between freedom and law seen through the conflict between personal rights and the demands of the common good. This article examines how a state of emergency, such as a pandemic, affects the (...) perception of the legitimacy of the State. In this, it relies on some key concepts from Carl Schmitt’s political theology, such as the “exception”, “the sociology of legal concepts”, the “nature of sovereignty”, the formal criterion of the political as a specific way of thinking, and acting and “stasiological” nature of the political. (shrink)

Purpose Telemedicine has been advancing for decades and is more indispensable than ever in this unprecedented time of the COVID-19 pandemic. As shown, eHealth appears to be effective for routine management of chronic conditions that require extensive and repeated interactions with healthcare professionals, as well as the monitoring of symptoms and diagnostics. Yet much needs to be done to alleviate digital inequalities that stand in the way of making the benefits of eHealth accessible to all. The purpose of (...) this paper is to explore the recent shift in healthcare delivery in response to the COVID-19 pandemic towards telemedicine in healthcare delivery and show how this rapid shift is leaving behind those without digital resources and exacerbating inequalities along many axes. Design/methodology/approach Because the digitally disadvantaged are less likely to use eHealth services, they bear greater risks during the pandemic to meet ongoing medical care needs. This holds true for both medical conditions necessitating lifelong care and conditions of particular urgency such as pregnancy. For this reason, the authors examine two case studies that exemplify the implications of differential access to eHealth: the case of chronic care diseases such as diabetes requiring ongoing care and the case of time-sensitive health conditions such as pregnancy that may be compromised by gaps in continuous care. Findings Not only are the digitally disadvantaged more likely to belong to populations experiencing greater risk – including age and economic class – but they are less likely to use eHealth services and thereby bear greater risks during the pandemic to meet ongoing medical care needs during the pandemic. Social implications At the time of writing, almost 20% of Americans have been unable to obtain medical prescriptions or needed medical care unrelated to the virus. In light of the potential of telemedicine, this does not need to be the case. These social inequalities take on particular significance in light of the COVID-19 pandemic. Originality/value In light of the COVID-19 virus, ongoing medical care requires exposure to risks that can be successfully managed by digital communications and eHealth advances. However, the benefits of eHealth are far less likely to accrue to the digitally disadvantaged. (shrink)

Background:The first wave of the COVID-19 pandemic caused a shortage of qualified nurses in Spain. As a result, the government authorized the hiring of senior students.Objectives:To explore the ethical dilemmas and ethical conflicts experienced by final-year nursing students who worked during the first outbreak of the COVID-19 pandemic in Spain.Research design:A qualitative exploratory study was conducted using purposive sampling. Semi-structured interviews were carried out using a question guide. Interviews took place via a private video chat room (...) platform. A thematic, inductive analysis was performed of the information gathered.Participants and research context:Eighteen nursing students were recruited from two universities of Madrid, aged between 18 and 65 years old, enrolled in the fourth year of nursing studies and who were hired under a relief contract for health professionals during the pandemic.Ethical considerations:The present study was carried out in accordance with the Declaration of Helsinki, and the study was approved by the Local Ethics Committee of Universidad Rey Juan Carlos.Results:Three specific themes emerged: (a) coping with patient triage, (b) difficulties in providing end-of-life care, and (c) coping with patient death. Nursing students participated in the process of patient selection for resource allocation and ICU bed occupancy. They were shown how to care for patients who were not admitted to the ICU, in their last moments and were faced with the difficulties of applying end-of-life care. Finally, the nursing students were confronted with the death of their patients, in overwhelming numbers and under adverse conditions.Conclusions:These findings can help shed light on the ethical dilemmas and ethical conflicts faced by novice nursing students, incorporated into the workforce during the COVID-19 pandemic. Moreover, it was described that students may normalize the death due to the exhaustion and overwhelmed routine. (shrink)

The role of bioethicists amidst crises like the COVID-19 pandemic is not well defined. As professionals in the field, they should respond, but how? The observation of the early days of pandemic confinement in Finland showed that moral philosophers with limited experience in bioethics tended to apply their favorite theories to public decisions with varying results. Medical ethicists were more likely to lend support to the public authorities by soothing or descriptive accounts of the solutions assumed. These (...) are approaches that Tuija Takala has called the firefighting and window dressing models of bioethics. Human rights lawyers drew attention to the flaws of the government’s regulative thinking. Critical bioethicists offered analyses of the arguments presented and the moral and political theories that could be used as the basis of good and acceptable decisions. (shrink)

In Mexico, significant ethical and social issues have been raised by the COVID-19 pandemic. Some of the most pressing issues are the extent of restrictive measures, the reciprocal duties to healthcare workers, the allocation of scarce resources, and the need for research. While policy and ethical frameworks are being developed to face these problems, the gender perspective has been largely overlooked in most of the issues at stake. Domestic violence is the most prevalent form of violence against women, (...) which can be exacerbated during a pandemic: stress and economic uncertainty are triggers for abuse, and confinement limits access to support networks. Confinement also exacerbates the unfair distribution of unpaid labor, which is disproportionately assigned to women and girls, and highlights inequality in the overall labor market. Lack of security measures has resulted in attacks towards health workers, particularly female nurses, due to fear of contamination. Finally, resource results in lack of access to other health necessities, including sexual and reproductive health services. Research across all disciplines to face—and to learn from—this crisis should be done through a gender lens, because understanding the realities of women is essential to understand the pandemic’s true effects in Mexico and the world. (shrink)

This research examines the impact of COVID-19 on food security in New York state and the innovative approaches employed by food assistance organizations to help address the changing and increasing demand for their services from March 2020 to May 2021. We examine the case study of New York’s Capital District region through a qualitative approach. We find that there was a sharp increase in utilization of emergency services during spring of 2020, which tapered off in the summer and fall (...) of 2020 but remained above the levels of need seen the previous year. Food assistance organizations quickly adapted to the increased demand for their services and changing conditions to reduce gaps in local food distribution chains: They reorganized and tapped into new sources for volunteers, networked with public and private organizations, and coordinated work with other regional food pantries for maximum impact. The flexibility of food assistance organizations to address the disruptions brought about by the COVID-19 pandemic highlights their critical roles in the U.S. food security environment. While organizations are aware of their shortcomings, constraints, and overall role in the American food system, the majority also expressed that the pandemic presented an opportunity to treat a complex problem together and to enact change. Several stakeholders also shared their hope that strengthening their networks and innovations may facilitate post-pandemic recovery, bring about systemic changes to address root causes of food insecurity, and better serve the communities most vulnerable to hunger and service disruptions. (shrink)

The COVID-19 pandemic has created a unique set of challenges for national governments regarding how to deal with a major international pandemic of almost unprecedented scope. As the pandemic consti...

The aim of the article is to analyse the provisions regulating the organisation and principles of financial management of the COVID-19 Counteracting Fund in the context of progressive debudgetisation of public finances. The first part presents the concept, sources and effects of debudgetisation of public finances, with emphasis on earmarked funds as the basic example of this process. The second part assesses the regulations concerning the organisation and tasks of the COVID-19 Counteracting Fund, and presents the sources of (...) financing and the principles of financial management. Using methods according to contemporary legal, economic and financial principles (in particular, a critical review of the literature on the subject, legal acts, and analysis of statistical data), basic features determining the actual nature and role of the COVID-19 Counteracting Fund in the collection and spending of public money were verified. The hypothesis that this institution (despite not having the status of a state earmarked fund in the normative sense) is a kind of para-budget with typical functions of public finances was confirmed. The creation of the COVID-19 Counteracting Fund resulted in the exclusion of some finances of a public nature from the general pool, intended primarily for tasks related to health care during the COVID-19 pandemic. The adoption of such a solution is part of a trend of increasing deviations from the principle of completeness of the state budget noticeable in recent years, which has led to excessive debudgetisation of the state budget. This, in turn, is not conducive to maintaining transparency and rationality in the collection and spending of public funds, which are prescribed by the doctrine. (shrink)

BackgroundThe COVID-19 pandemic has had a significant impact on the health system worldwide. The organ and tissue donation and transplantation (OTDT) system is no exception and has had to face ethical challenges related to the pandemic, such as risks of infection and resource allocation. In this setting, many Canadian transplant programs halted their activities during the first wave of the pandemic.MethodTo inform future ethical guidelines related to the COVID-19 pandemic or other public health emergencies (...) of international concern, we conducted a literature review to summarize the ethical issues.ResultsThis literature review identified three categories of ethical challenges. The first one describes the general ethical issues and challenges reported by OTDT organizations and transplantation programs, such as risks of COVID-19 transmission and infection to transplant recipients and healthcare professionals during the transplant process, risk of patient waitlist mortality or further resource strain where transplant procedures have been delayed or halted, and resource allocation. The second category describes ethical challenges related to informed consent in the context of uncertainty and virtual consent. Finally, the third category describes ethical issues related to organ allocation, such as social considerations in selecting transplant candidates.ConclusionThis literature review highlights the salient ethical issues related to OTDT during the current COVID-19 pandemic. As medical and scientific knowledge about COVID-19 increases, the uncertainties related to this disease will decrease and the associated ethical issues will continue to evolve. (shrink)

The disability viewpoint is the fundamental for understanding social justice in a given population. Disability rights need to be obeyed in the inclusive preparedness and response to all the disasters or during the crisis period including COVID-19 pandemic. COVID-19 pandemic jeopardized the health and rehabilitation services globally. The impact is much more in low resource developing countries like Bangladesh. In general, people with disability (PWD) suffer from multiple medical and rehabilitation complications and they need frequent rehabilitation (...) consultations or hospital admissions in comparison to people without disability. As a developing country, Bangladesh has poor ratios of doctors, nurses and technologists of 1:0.4:0.24 (WHO: 1:3:5) to face the COVID-19 challenge. Rehabilitation services have been disrupted in almost two-thirds (63%) of countries of the world. Even though rehabilitation is the key to recovery following severe illness from COVID-19. There are many concerns and debates about the preparedness, response and mitigation the process of COVID-19 on the part of the national government. According to recent study reports, the lives of about 100% of PWD have been impacted by the COVID-19 pandemic. COVID-19 National Technical Advisory Committee is working for strategic planning, response and mitigation process but omission of a representative of PWD or a rehabilitation physician in the committee has created much dissatisfaction. The difficult COVID-19 testing process due to country wide shutdown of rehabilitation essential services and central pulling of rehabilitation physicians have side lined the PWD inclusiveness. It is expected that the rehabilitation preparedness, response and mitigation of the pandemic should be based on an ethics driven process. (shrink)

This research aims to examine access to medical treatment during the COVID-19 pandemic for people living with disabilities. During the COVID-19 pandemic, the practical and ethical problems of allocating limited medical resources such as intensive care unit beds and ventilators became critical. Although different countries have proposed different guidelines to manage this emergency, these proposed criteria do not sufficiently consider people living with disabilities. People living with disabilities are therefore at a higher risk of exclusion from (...) medical treatments as physicians tend to assume they have poor quality of life, whereas access to medical treatment should be based on several parameters, including clinical data and prognosis. However, the COVID-19 pandemic shifts the medical paradigm from person-centred medicine to community-centred medicine, challenging the main ethical theories. We reviewed the main guidelines and recommendations for resources allocation and examined their position toward persons with disabilities. Based on our findings, we propose criteria for not discriminating against people with disabilities in allocating resources. The shift from person-centred to community-centred medicine offers opportunities but also risks sacrificing the most vulnerable people. The principle of reasonable accommodation must always be considered to guarantee the rights of persons with disabilities. (shrink)

Given the negative consequences of the ongoing COVID-19 pandemic on public health, his study aimed at investigating: the differences between adults with and without chronic illness in buying behavior, vaccination intention, pandemic worry, and the health belief model components; the HBM components as mediators of the relationship between pandemic worry and vaccination intention. The sample consisted of 864 adults, of which 20.5% reported having a chronic illness. Associations between pandemic worry, vaccination intention, and HBM were (...) ascertained using correlation and mediation analyses. Individuals with chronic illness reported a higher level of pandemic worry, higher levels of perceived threat, greater benefits from vaccination, had lower self-efficacy and bought more medicine and sanitary/hygienic products. No significant differences were observed regarding vaccination intention, barriers against vaccination, and changes in food buying behavior. We found that the relationship between pandemic worry and vaccination intention was partially mediated by the perceived threat of disease and the benefits of vaccination. Pandemic worry predicted vaccination intention directly but also through the contribution of the perceived threat of disease and the benefits of vaccination. These findings suggest that presenting evidence of COVID-19 vaccine efficacy and the benefits of having the vaccine will encourage the population to follow vaccination recommendations. (shrink)

This article examines the development of the Republic of Korea’s strategy to prevent the spread of COVID-19 with particular focus on ethical issues and the problem of politicization of public communication. Using prominent examples of stakeholders who have acted and expressed themselves in highly contradictory ways on the topic of the pandemic, we provide an analysis of how the public health policy discourse has entered into the realm of politicization and elaborate on the danger that this phenomenon poses (...) in terms of rational debate and appropriate policy measures geared toward the public’s safety. Considering the role that the Republic of Korea have had in global media coverage of quarantine policies and epidemic prevention, we believe that our study makes a significant contribution to the literature because it provides a new perspective and insights into the forces at work within and around a prevention strategy that has both been lauded and seen as highly controversial. (shrink)