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Commentary: Special Issue on Conscientious Objection. 评论:良心拒服兵役特刊。
IF 1.5 4区 哲学
Hec Forum Pub Date : 2021-09-01 Epub Date: 2021-08-20 DOI: 10.1007/s10730-021-09458-4
Mark R Wicclair
{"title":"Commentary: Special Issue on Conscientious Objection.","authors":"Mark R Wicclair","doi":"10.1007/s10730-021-09458-4","DOIUrl":"https://doi.org/10.1007/s10730-021-09458-4","url":null,"abstract":"<p><p>This special issue of HEC Forum includes articles on a wide range of specific topics that make significant contributions to conscientious objection scholarship. In this commentary, it is not feasible to provide a comprehensive analysis of each of the articles; and I have not attempted to do so. Instead, for each article, I have selected specific issues and arguments on which to comment.</p>","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":"33 3","pages":"307-324"},"PeriodicalIF":1.5,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10730-021-09458-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39331776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Conscience Dissenters and Disagreement: Professions are Only as Good as Their Practitioners. 良心异议和分歧:职业的好坏取决于从业人员。
IF 1.5 4区 哲学
Hec Forum Pub Date : 2021-09-01 DOI: 10.1007/s10730-020-09395-8
Bryan C Pilkington
{"title":"Conscience Dissenters and Disagreement: Professions are Only as Good as Their Practitioners.","authors":"Bryan C Pilkington","doi":"10.1007/s10730-020-09395-8","DOIUrl":"https://doi.org/10.1007/s10730-020-09395-8","url":null,"abstract":"<p><p>In this paper, I consider the role of conscience in medical practice. If the conscientious practice of individual practitioners cannot be defended or is incoherent or unreasonable on its own merits, then there is little reason to support conscience protection and to argue about its place in the current medical landscape. If this is the case, conscience protection should be abandoned. To the contrary, I argue that conscience protection should not be abandoned. My argument takes the form of an analysis of an essential feature of the conscience dissenter's argument, the role of disagreement within \"the medical profession.\" Conscience dissenters make certain assumptions within their arguments about the profession, disagreements within the professions, and how such disagreement should be adjudicated. If it is the case that these assumptions are accurate reflections of the current medical landscape, then the advocate of conscience protection has one less leg to stand on. I aim to show that this is not the case and that the assumptions of the conscience dissenter are not only mistaken but are mistakes of significant magnitude, so significant as to raise serious questions about the merit of their position. If the argument in this paper is sound, then, at the very least, the conversation over conscience protection in medicine, in particular, and health care, in general, must continue.</p>","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":"33 3","pages":"233-245"},"PeriodicalIF":1.5,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10730-020-09395-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37689496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
The Cost of Safety During a Pandemic. 大流行期间的安全成本。
IF 1.5 4区 哲学
Hec Forum Pub Date : 2021-06-01 Epub Date: 2021-03-06 DOI: 10.1007/s10730-020-09438-0
Rachel M B Greiner
{"title":"The Cost of Safety During a Pandemic.","authors":"Rachel M B Greiner","doi":"10.1007/s10730-020-09438-0","DOIUrl":"https://doi.org/10.1007/s10730-020-09438-0","url":null,"abstract":"<p><p>A first-person account of some victims of the virus, the author puts faces and circumstances to the tragedy of the Covid-19 pandemic. Told from a chaplain's point of view, these narratives will take the reader beyond the numbers and ask questions like: What is the cost of keeping families separated at the end of life, and, if patient/family centered care is so central to healthcare these days, why was it immediately discarded? Is potentially saving human lives worth the risk of damaging them beyond repair?</p>","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":"33 1-2","pages":"61-72"},"PeriodicalIF":1.5,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10730-020-09438-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25451694","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: 1
A Journal of the COVID-19 (Plague) Year. 2019冠状病毒病(鼠疫)年杂志
IF 1.5 4区 哲学
Hec Forum Pub Date : 2021-06-01 Epub Date: 2021-03-23 DOI: 10.1007/s10730-021-09448-6
Brian H Childs, Laura Vearrier
{"title":"A Journal of the COVID-19 (Plague) Year.","authors":"Brian H Childs,&nbsp;Laura Vearrier","doi":"10.1007/s10730-021-09448-6","DOIUrl":"https://doi.org/10.1007/s10730-021-09448-6","url":null,"abstract":"<p><p>The essays in this special issue of HEC Forum provide reflections that make explicit the implicit anthropology that our current pandemic has brought but which in the medical ethics literature around COVID-19 has to a great extent ignored. Three of the essays are clearly \"journalistic\" as a literary genre: one by a hospital chaplain, one by a medical student in her pre-clinical years, and one by a fourth-year medical student who reports her experience as she completed her undergraduate clerkships and applied for positions in graduate medical education. Other essays explore the pandemic from historical, sociological, and economic perspectives, particularly how triage policies have been found to be largely blind to structural healthcare disparities, while simultaneously unable to appropriately address those disparities. Central issues that need to be addressed in triage are not just whether a utilitarian response is the most just response, but what exactly is the greatest good for the greatest number? Together, the essays in this special issue of HEC Forum create a call for a more anthropological approach to understanding health and healthcare. The narrow approach of viewing health as resulting primarily from healthcare will continue to hinder advances and perpetuate disparities. Health outcomes result from a complex interaction of various social, economic, cultural, historical, and political factors. Advancing healthcare requires contextualizing the health of populations amongst these factors. The COVID-19 pandemic has made us keenly aware of how interdependent our health as a society can be.</p>","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":"33 1-2","pages":"1-6"},"PeriodicalIF":1.5,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10730-021-09448-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25507984","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
Correction to: A Tale of Two Crises: Addressing Covid‑19 Vaccine Hesitancy as Promoting Racial Justice. 更正: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 DOI: 10.1007/s10730-021-09446-8
Lauren Bunch
{"title":"Correction to: A Tale of Two Crises: Addressing Covid‑19 Vaccine Hesitancy as Promoting Racial Justice.","authors":"Lauren Bunch","doi":"10.1007/s10730-021-09446-8","DOIUrl":"https://doi.org/10.1007/s10730-021-09446-8","url":null,"abstract":"","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":"33 1-2","pages":"155"},"PeriodicalIF":1.5,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10730-021-09446-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25451695","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: 1
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
{"title":"Academic During a Pandemic: Reflections from a Medical Student on Learning During SARS-CoVid-2.","authors":"Vivian Anderson","doi":"10.1007/s10730-021-09439-7","DOIUrl":"https://doi.org/10.1007/s10730-021-09439-7","url":null,"abstract":"<p><p>The current pandemic represents unprecedented times in medical education. In addition to the already strenuous demands of medical school, the SARS-CoVid-2 pandemic introduced a new source of ethical and moral pressure on students. Medical students navigated finishing their didactic years in isolation and initiated their clinical rotations in a pandemic environment. Many medical students found themselves in the frustrating position of being non-essential healthcare workers but still wanting to help. This paper follows the personal and shared experiences of a second-year medical student transitioning to their third year. In particular, this paper examines the author's personal ties to the disability community through their family, and how this impacted their approach in striving to aid in the pandemic.</p>","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":"33 1-2","pages":"35-43"},"PeriodicalIF":1.5,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10730-021-09439-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38818510","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: 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
{"title":"Oral Health Matters: The Ethics of Providing Oral Health During COVID-19.","authors":"Nanette Elster, Kayhan Parsi","doi":"10.1007/s10730-020-09435-3","DOIUrl":"10.1007/s10730-020-09435-3","url":null,"abstract":"<p><p>Oral health is a critical part of overall health. The current COVID-19 pandemic has highlighted the importance of oral health. In this article, we describe how dental practice has been impacted by COVID-19, identify the public health response to COVID-19, and explain the gradual resumption of dental care after the initial disruption due to the pandemic. Finally, we discuss how long-standing health disparities in oral health have been exacerbated by the current pandemic.</p>","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":"33 1-2","pages":"157-164"},"PeriodicalIF":1.5,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7809093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38822138","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
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
{"title":"A Tale of Two Crises: Addressing Covid-19 Vaccine Hesitancy as Promoting Racial Justice.","authors":"Lauren Bunch","doi":"10.1007/s10730-021-09440-0","DOIUrl":"https://doi.org/10.1007/s10730-021-09440-0","url":null,"abstract":"<p><p>The year 2020 has yielded twin crises in the United States: a global pandemic and a public reckoning with racism brought about by a series of publicized instances of police violence toward Black men and women. Current data indicate that nationally, Black Americans are three times more likely than White Americans to contract Covid-19 (with further variance by state), a pattern that underscores the more general phenomenon of health disparity among Black and White Americans (Oppel et al. in The New York Times 2020; APM Research Lab Staff in APM Research Lab 2020). Once exposed, Black Americans are twice as likely to die of the virus. Unsurprisingly, Black Americans report higher levels of fear of Covid-19 than their White peers, but they also report higher levels of hesitancy toward a Covid-19 vaccine. This paper explores why this apparent discrepancy exists. It also provides practical recommendations for how government and public health leaders might address vaccine hesitancy in the context of the twin crises of 2020.</p>","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":"33 1-2","pages":"143-154"},"PeriodicalIF":1.5,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10730-021-09440-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38834244","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: 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":"<p><p>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.</p>","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
{"title":"Acknowledging the Burdens of 'Blackness'.","authors":"Nneka O Sederstrom,&nbsp;Jada Wiggleton-Little","doi":"10.1007/s10730-021-09444-w","DOIUrl":"https://doi.org/10.1007/s10730-021-09444-w","url":null,"abstract":"<p><p>The novel coronavirus of 2019 exposed, in an undeniable way, the severity of racial inequities in America's healthcare system. As the urgency of the pandemic grew, administrators, clinicians, and ethicists became concerned with upholding the ethical principle of \"most lives saved\" by re-visiting crisis standards of care and triage protocols. Yet a colorblind, race-neutral approach to \"most lives saved\" is inherently inequitable because it reflects the normality and invisibility of 'whiteness' while simultaneously disregarding the burdens of 'Blackness'. As written, the crisis standards of care (CSC) adopted by States are racist policies because they contribute to a history that treats Black Americans are inherently less than. This paper will unpack the idealized fairness and equity pursued by CSC, while also considering the use of modified Sequential Organ Failure Assessment (mSOFA) as a measure of objective equality in the context of a healthcare system that is built on systemic racism and the potential dangers this can have on Black Americans with COVID-19.</p>","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":"33 1-2","pages":"19-33"},"PeriodicalIF":1.5,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10730-021-09444-w","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25441925","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: 4
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