J Bioethic Inq
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In today's pandemic, many countries have experienced shortages of medical resources and many healthcare providers have often been faced with dramatic decisions about how to allocate beds, intensive care, or ventilators. Despite recognizing the need for triage, responses are not the same everywhere, and opinions and practices differ around what guidelines should be used, how they should be implemented, and who should ultimately decide. To some extent, triage issues reflect community values, revealing a given society's moral standards and ideals. Our goal is to study two countries which share many common features-Italy and France-as they deal with the pandemic, revealing the moral organization of medicine and healthcare, the power structures, and the nature of the disruptions in each context.
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When infectious disease outbreaks strike, health facilities acquire labels such as "war zones" and "battlefields" and healthcare professionals become "heroes" on the "front line." But unlike soldiers, healthcare professionals often take on these dangerous roles without any prior intention or explicit expectation that their work will place them in grave personal danger. This inevitably raises questions about their role-related obligations and whether they should be free to choose not to endanger themselves. In this article, I argue that it is helpful to view this situation not only through the lens of "professional duty" but also through the lens of "role-related conflicts." Doing so has the advantage of avoiding exceptionalism and allowing us to draw lessons not only from previous epidemics but also from a wide range of far more common role-related dilemmas in healthcare.
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Recent weeks have seen an increased focus on the ethical response to the COVID-19 pandemic. Ethics guidance has proliferated across Britain, with ethicists and those with a keen interest in ethics in their professions working to produce advice and support for the National Health Service. The guiding principles of the pandemic have emerged, in one form or another, to favour fairness, especially with regard to allocating resources and prioritizing care. ⋯ Drawing on early criticisms of existing clinical guidance (for example, the frailty decision tool) and ethical guidance in Britain, this essay will discuss the importance of including sociology, specifically the relationship between ethnicity and health, in any ethical and clinical guidance for care during the pandemic in the United Kingdom. To do otherwise, I will argue, would be actively choosing to allow a proportion of the British population to die for no other reason than their ethnic background. Finally, I will end by arguing why sociology must be a key component in any guidance, outlining how sociology was incorporated into the cross-college guidance produced by the Royal College of Physicians.
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COVID-19 has truly affected most of the world over the past many months, perhaps more than any other event in recent history. In the wake of this pandemic are patients, family members, and various types of care providers, all of whom share different levels of moral distress. Moral conflict occurs in disputes when individuals or groups have differences over, or are unable to translate to each other, deeply held beliefs, knowledge, and values. ⋯ In the current pandemic, most hospitals and healthcare institutions in the United States have not allowed visitors to come to the hospitals to see their family or loved ones, even when the patient is dying. The moral conflict and moral distress (being constrained from doing what you think is right) among care providers when they see their patients dying alone can be unbearable and lead to ongoing grief and sadness. This paper will explore the concepts of moral distress and conflict among hospital staff and how a system-wide provider wellness programme can make a difference in healing and health.
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The Rejuvenation of the Withering Nation State and Bio-power: The New Dynamics of Human Interaction.
The outbreak of COVID-19 comes at the time when a shrinking public sector healthcare is an acknowledged fact in post-colonial societies. The policies adopted by the apparatus of most nation states for the past thirty years or more reveal that providing healthcare to all sections of societies is not a priority. The gradual process of economic liberalization has established "market" as the only legitimate mechanism of the distribution of goods/services as per the efficiency principle. ⋯ But the spread of COVID-19 on a global scale has provided an opportunity to the nation state. With the help of healthcare systems, the State has reasserted itself as the ultimate archangel to define human beings and their respective status in the newly emerging nomenclature of the public sphere. In this paper, the rejuvenation of the nation state with respect to bio-power will be discussed in the postcolonial context.