By Arthur L. Caplan and Jerrold L. Abraham. We responded to the review in JME by Monrad about ethical issues in vaccine trials, in which the discussion was limited to secondary vaccine trials (i.e. testing additional vaccines after one or more vaccines have been approved). We are concerned that the ethics of ongoing primary vaccine […]
Category: Journal of Medical Ethics
The problem in nursing homes is not Covid-19 – it is nursing homes
By Tania Moerenhout A couple of weeks ago, the New York Times published a scathing article on how the pandemic was handled in Belgian nursing homes, focusing on instances where elderly were declined hospitalisation despite the fact that intensive care beds remained available. Refusing hospital care to nursing home residents was never the official policy, […]
Immunity passports, fundamental rights and public health hazards: A reply to Brown et al.
By Iñigo de Miguel Beriain and Jon Rueda Etxebarria In a recent article published by the Journal of Medical Ethics, Brown et al. analysed several ethical aspects around immunity passports and put forward some recommendations for implementing them. When we first read this paper, we considered that it was an excellent piece of analysis, but […]
Lockdown is not levelling down
By Jonathan A Hughes In their article “Why lockdown of the elderly is not ageist and why levelling down equality is wrong” and their related JME Blog post, Savulescu and Cameron argue for selective isolation of the elderly as preferable to a continuation of general lockdown. Central to their argument is the claim that the […]
Indirect racial discrimination in COVID-19 ethical guidance
By Harleen Kaur Johal, Rachel Prout, Marianne Tinkler. Although the COVID-19 pandemic has challenged all communities, increasing evidence has emerged that certain sectors have been disproportionately affected. A Public Health England report identified individuals from Black ethnic groups as most likely to be diagnosed with COVID-19. The risk of mortality was also estimated as being […]
People with disabilities are worth saving, too: Ensuring healthcare equity during the COVID-19 pandemic
By Molly M. King Before we face another swell of the pandemic, we have the opportunity as a country to take stock of early lessons learned about the vulnerabilities of our nation’s healthcare system. As our nation celebrates the 30th anniversary of the Americans with Disabilities Act, we have other shortcomings to reflect on, as […]
Proving our worth: why clinical ethicists should help discuss treatment allocation decisions
By Trevor M. Bibler. Clinical ethicists across the nation, and throughout the world, have recently devoted their waking hours to developing triage and allocation policies in response to the COVID 19 pandemic. As these policies develop, we find general agreement that shared processes should take the place of ad hoc, bedside allocation decisions, and that […]
We should sit this one out: Why ethicists should not help discuss treatment allocation decisions
By Claire Horner. Ethicists help both health care professionals and patients and their families by working through complex ethical questions or facilitating communication in a conflict. Clinical Ethics Consultation (CEC) is generally defined as “a set of services provided by an individual or group in response to questions from patients, families, surrogates, health care providers […]
PPE in the hospital: ethical decision-making that balances health professional wellbeing and duty to care
By Rosalind McDougall, Lynn Gillam, Danielle Ko, Isabella Holmes, Clare Delany Prior to the COVID-19 pandemic, clinicians in well-resourced healthcare systems usually had the information and resources they needed to appropriately protect themselves while still providing optimal care for patients. However, achieving both staff protection and high quality patient care has now become difficult in […]
Mechanical ventilators: the evidence of effectiveness
By Jonathan J. Darrow and Jing Luo As government leaders move to relax physical distancing requirements related to severe acute respiratory coronavirus 2 (SARS-CoV-2), a central assumption is that mechanical ventilators will form part of the safety net needed to sustain life in those afflicted with the disease it causes, Covid-19. Ventilators have been described as […]