Hec Forum最新文献_第10页

Academic During a Pandemic: Reflections from a Medical Student on Learning During SARS-CoVid-2. 大流行时期的学术:一位医学生对SARS-CoVid-2期间学习的思考。

IF 1.5 4区哲学

Hec Forum Pub Date : 2021-06-01 Epub Date: 2021-01-13 DOI: 10.1007/s10730-021-09439-7

Vivian Anderson

引用次数: 1

Oral Health Matters: The Ethics of Providing Oral Health During COVID-19. 口腔健康问题：在 COVID-19 期间提供口腔保健服务的道德规范。

IF 1.5 4区哲学

Hec Forum Pub Date : 2021-06-01 Epub Date: 2021-01-15 DOI: 10.1007/s10730-020-09435-3

Nanette Elster, Kayhan Parsi

引用次数: 0

A Tale of Two Crises: Addressing Covid-19 Vaccine Hesitancy as Promoting Racial Justice. 两个危机的故事:解决Covid-19疫苗犹豫作为促进种族正义。

IF 1.5 4区哲学

Hec Forum Pub Date : 2021-06-01 Epub Date: 2021-01-19 DOI: 10.1007/s10730-021-09440-0

Lauren Bunch

引用次数: 69

Getting Real: The Maryland Healthcare Ethics Committee Network's COVID-19 Working Group Debriefs Lessons Learned. 实事求是：马里兰州医疗伦理委员会网络 COVID-19 工作组总结经验教训。

IF 1.5 4区哲学

Hec Forum Pub Date : 2021-06-01 Epub Date: 2021-02-13 DOI: 10.1007/s10730-021-09442-y

Norton Elson, Howard Gwon, Diane E Hoffmann, Adam M Kelmenson, Ahmed Khan, Joanne F Kraus, Casmir C Onyegwara, Gail Povar, Fatima Sheikh, Anita J Tarzian

{"title":"Getting Real: The Maryland Healthcare Ethics Committee Network's COVID-19 Working Group Debriefs Lessons Learned.","authors":"Norton Elson, Howard Gwon, Diane E Hoffmann, Adam M Kelmenson, Ahmed Khan, Joanne F Kraus, Casmir C Onyegwara, Gail Povar, Fatima Sheikh, Anita J Tarzian","doi":"10.1007/s10730-021-09442-y","DOIUrl":"10.1007/s10730-021-09442-y","url":null,"abstract":"Responding to a major pandemic and planning for allocation of scarce resources (ASR) under crisis standards of care requires coordination and cooperation across federal, state and local governments in tandem with the larger societal infrastructure. Maryland remains one of the few states with no state-endorsed ASR plan, despite having a plan published in 2017 that was informed by public forums across the state. In this article, we review strengths and weaknesses of Maryland's response to COVID-19 and the role of the Maryland Healthcare Ethics Committee Network (MHECN) in bridging gaps in the state's response to prepare health care facilities for potential implementation of ASR plans. Identified \"lessons learned\" include: Deliberative Democracy Provided a Strong Foundation for Maryland's ASR Framework; Community Consensus is Informative, Not Normative; Hearing Community Voices Has Inherent Value; Lack of Transparency & Political Leadership Gaps Generate a Fragmented Response; Pandemic Politics Requires Diplomacy & Persistence; Strong Leadership is Needed to Avoid Implementing ASR … And to Plan for ASR; An Effective Pandemic Response Requires Coordination and Information-Sharing Beyond the Acute Care Hospital; and The Ability to Correct Course is Crucial: Reconsidering No-visitor Policies.","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":"33 1-2","pages":"91-107"},"PeriodicalIF":1.5,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7882050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25370005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Acknowledging the Burdens of 'Blackness'. 承认“黑人”的负担。

IF 1.5 4区哲学

Hec Forum Pub Date : 2021-06-01 Epub Date: 2021-03-05 DOI: 10.1007/s10730-021-09444-w

Nneka O Sederstrom, Jada Wiggleton-Little

引用次数: 4

Guidance for Medical Ethicists to Enhance Social Cooperation to Mitigate the Pandemic. 医学伦理学家加强社会合作以缓解大流行的指南。

IF 1.5 4区哲学

Hec Forum Pub Date : 2021-06-01 Epub Date: 2021-02-15 DOI: 10.1007/s10730-021-09445-9

Kevin Powell, Christopher Meyers

{"title":"Guidance for Medical Ethicists to Enhance Social Cooperation to Mitigate the Pandemic.","authors":"Kevin Powell, Christopher Meyers","doi":"10.1007/s10730-021-09445-9","DOIUrl":"https://doi.org/10.1007/s10730-021-09445-9","url":null,"abstract":"The Covid-19 pandemic has presented major challenges to society, exposing preexisting ethical weaknesses in the modern social fabric's ability to respond. Distrust in government and a lessened authority of science to determine facts have both been exacerbated by the polarization and disinformation enhanced by social media. These have impaired society's willingness to comply with and persevere with social distancing, which has been the most powerful initial response to mitigate the pandemic. These preexisting weaknesses also threaten the future acceptance of vaccination and contact tracing, two other tools needed to combat epidemics. Medical ethicists might best help in this situation by promoting truth-telling, encouraging the rational adjudication of facts, providing transparent decision-making and advocating the virtue of cooperation to maximize the common good. Those interventions should be aimed at the social level. The same elements of emphasizing cooperation and beneficence also apply to the design of triage protocols for when resources are overwhelmed. A life-stages approach increases beneficence and reduces harms. Triage should be kept as simple and straightforward as reasonably possible to avoid unwieldly application during a pandemic.","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":"33 1-2","pages":"73-90"},"PeriodicalIF":1.5,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10730-021-09445-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25369053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Viral Heroism: What the Rhetoric of Heroes in the COVID-19 Pandemic Tells Us About Medicine and Professional Identity. 病毒英雄主义:COVID-19大流行中的英雄修辞告诉我们关于医学和职业身份的什么。

IF 1.5 4区哲学

Hec Forum Pub Date : 2021-06-01 Epub Date: 2021-02-07 DOI: 10.1007/s10730-020-09434-4

Patrick D Hopkins

{"title":"Viral Heroism: What the Rhetoric of Heroes in the COVID-19 Pandemic Tells Us About Medicine and Professional Identity.","authors":"Patrick D Hopkins","doi":"10.1007/s10730-020-09434-4","DOIUrl":"https://doi.org/10.1007/s10730-020-09434-4","url":null,"abstract":"Throughout the COVID-19 pandemic the use of the term \"hero\" has been widespread. This is especially common in the context of healthcare workers and it is now unremarkable to see large banners on hospital exteriors that say \"heroes work here\". There is more to be gleaned from the rhetoric of heroism than just awareness of public appreciation, however. Calling physicians and nurses heroes for treating sick people indicates something about the concept of medicine and medical professionals. In this essay, I will examine three aspects of the social role of medicine exposed by the language of heroism. One, if a hero is someone who goes above and the call of duty, then does that mean exposing oneself to risk of infection is no longer a duty of physicians (as it used to be)? If so, does that mean the \"profession\" of medicine is much like any other business? Two, physicians and nurses are not the only \"heroes\" this go-around. Anyone deemed essential to the US \"infrastructure\" is designated by the US government as having \"special responsibilities\" to remain at their posts for the public good, which explicitly puts physicians in the same category as sewage workers and grocery store cashiers. Three, what does it mean to belong to a profession that does (or does not) have self-sacrifice and risk-taking as part of its mission-especially a profession that rarely gets called upon to practice these obligations?","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":"33 1-2","pages":"109-124"},"PeriodicalIF":1.5,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10730-020-09434-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25341679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 11

Utilitarian Principlism as a Framework for Crisis Healthcare Ethics. 功利主义作为危机医疗伦理的框架。

IF 1.5 4区哲学

Hec Forum Pub Date : 2021-06-01 Epub Date: 2021-01-15 DOI: 10.1007/s10730-020-09431-7

Laura Vearrier, Carrie M Henderson

{"title":"Utilitarian Principlism as a Framework for Crisis Healthcare Ethics.","authors":"Laura Vearrier, Carrie M Henderson","doi":"10.1007/s10730-020-09431-7","DOIUrl":"https://doi.org/10.1007/s10730-020-09431-7","url":null,"abstract":"This paper introduces the model of Utilitarian Principlism as a framework for crisis healthcare ethics. In modern Western medicine, during non-crisis times, principlism provides the four guiding principles in biomedical ethics-autonomy, nonmaleficence, beneficence, and justice; autonomy typically emerges as the decisive principle. The physician-patient relationship is a deontological construct in which the physician's primary duty is to the individual patient and the individual patient is paramount. For this reason, we term the non-crisis ethical framework that guides modern medicine Deontological Principlism. During times of crisis, resources become scarce, standards of care become dynamic, and public health ethics move to the forefront. Healthcare providers are forced to work in non-ideal conditions, and interactions with individual patients must be considered in the context of the crisis. The COVID-19 pandemic has forced healthcare to shift to a more utilitarian framework with a greater focus on promoting the health of communities and populations. This paper puts forth the notion of Utilitarian Principlism as a framework for crisis healthcare ethics. We discuss each of the four principles from a utilitarian perspective and use clinical vignettes, based on real cases from the COVID-19 pandemic, for illustrative purposes. We explore how Deontological Principlism and Utilitarian Principlism are two ends of a spectrum, and the implications to healthcare as we emerge from the pandemic.","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":"33 1-2","pages":"45-60"},"PeriodicalIF":1.5,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10730-020-09431-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38822522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 11

COVID 19: A Cause for Pause in Undergraduate Medical Education and Catalyst for Innovation. COVID 19：本科医学教育的停顿与创新的催化剂。

IF 1.5 4区哲学

Hec Forum Pub Date : 2021-06-01 Epub Date: 2021-01-22 DOI: 10.1007/s10730-020-09433-5

Elizabeth Southworth, Sara H Gleason

{"title":"COVID 19: A Cause for Pause in Undergraduate Medical Education and Catalyst for Innovation.","authors":"Elizabeth Southworth, Sara H Gleason","doi":"10.1007/s10730-020-09433-5","DOIUrl":"10.1007/s10730-020-09433-5","url":null,"abstract":"As the world held its breath for news surrounding COVID-19 and hunkered down amidst stay-at-home orders, medical students across the U.S. wondered if they would be called to serve on the front lines of the pandemic. Medical school administrators faced the challenge of protecting learners while also minimizing harm to their medical education. This balancing act raised critical questions in medical education as institutions reacted to changing guidelines. COVID-19 has punctuated already contentious areas of medical education and has forced institutions and organizations to take quick action. From the perspectives of a recent medical school graduate and current resident (ES) and a practicing clinician-educator (SHG), we examine the pandemic's impact on undergraduate medical education through an ethical lens. First, we explore the value of medical education, what drives this value, and how COVID-19 may alter it. We next consider student choice and how shifts toward utilitarianism in healthcare during a pandemic may affect learning and career exploration. Then, we inquire how access to technology may impact the experience of medical students from diverse backgrounds and varied institutions during a rapid shift to socially distanced learning. We identify vulnerabilities for students at several phases of the journey: premedical, preclinical, clinical, and preparation for residency. Finally, we address the hidden curriculum of COVID-19, its potential erosion of empathy among current medical students, and possible long-term consequences for future physicians and patients.","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":"33 1-2","pages":"125-142"},"PeriodicalIF":1.5,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7821447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38849392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Covid-19 in Historical Context: Creating a Practical Past. 历史背景下的 Covid-19：创造实用的过去

IF 1.5 4区哲学

Hec Forum Pub Date : 2021-06-01 Epub Date: 2021-01-30 DOI: 10.1007/s10730-021-09443-x

Amy W Forbes

{"title":"Covid-19 in Historical Context: Creating a Practical Past.","authors":"Amy W Forbes","doi":"10.1007/s10730-021-09443-x","DOIUrl":"10.1007/s10730-021-09443-x","url":null,"abstract":"Decades ago, in his foundational essay on the early days of the AIDS crisis, medical historian Charles Rosenberg wrote, \"epidemics start at a moment in time, proceed on a stage limited in space and duration, following a plot line of increasing revelatory tension, move to a crisis of individual and collective character, then drift toward closure.\" In the course of epidemics, societies grappled with sudden and unexpected mortality and also returned to fundamental questions about core social values. \"Epidemics,\" Rosenberg wrote, \"have always provided occasion for retrospective moral judgment\" (Rosenberg 1989, pp. 2, 9). Following Rosenberg's observations, this essay places COVID-19 in the context of epidemic history to examine common issues faced during health crises-moral, political, social, and individual. Each disease crisis unfolds in its own time and place. Yet, despite specific contexts, we can see patterns and recurring concerns in the history of pandemics: (1) pandemics and disease crises in the past, along with public health responses to them, have had implications for civil liberties and government authority; (2) disease crises have acted as a sort of stress test on society, revealing, amplifying or widening existing social fissures and health disparities; (3) pandemics have forced people to cope with uncertain knowledge about the origin and nature of disease, the best sources of therapies, and what the future will hold after the crisis. While historians are not prognosticators, understanding past experience offers new perspectives for the present. The essay concludes by identifying aspects of history relevant to the road ahead.","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":"33 1-2","pages":"7-18"},"PeriodicalIF":1.5,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7846493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25311618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0