Bioethics of Public Policies. Ethical Standards in Crisis Situations

Antonio Sandu

Abstract


Due to the fact that the value of public health and the value of individual health take precedence in health policies that respond to the pandemic created by the SARS-CoV-2 virus, there must be a number of limitations on autonomy and informed consent, equity in access to health, etc., and the limits of these measures must be clear to both decision-makers and the public, so the measures must be taken and implemented from an ethical perspective. This lecture will address a number of ethical features that should be taken into account during the pandemic. Public health measures must take into account a number of ethical principles, namely: the intervention should be based on research and be proportionate to the threat to public health posed by that infection, or that the public health hazard, in general, represents for a particular society in one area or another of the world. The purpose of the intervention must be dimensioned in such a way that the intervention is based on the scientific results and the professional judgment of the public health experts in the respective region. The results and goals of health policies as well as the reasons why the intervention takes place must be clearly communicated to the public and be understood accordingly (Cook, 2020).


Keywords


bioethics; public policies; crisis situations; ethical standards

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References


Ahmad, W., & Moeen Al-Sayed (2018). Human subjects in clinical trials: Ethical considerations and concerns. Journal of Translational Science, 4(6), 1-5. https://doi.org/10.15761/JTS.1000239

Ameneiros-Lago, E., Rico, C. C., & Garrido Sanjuán, J. A.. (2006). Limiting therapeutic obstinacy: Can bioethics help us in decision making?. Medicina Paliativa, 13(4), 174-178.

Andreiana, S. (2020, April 24). Doctorul Vasile Astarastoae atrage atentia asupra unui fenomen ciudat: ”De ce nu se fac necropsii in pandemia COVID-19” [Dr. Vasile Astarastoae draws attention to a strange phenomenon: "Why no autopsies are performed in the COVID-19 pandemic"]. Capital.ro. https://www.capital.ro/doctorul-vasile-astarastoae-atrage-atentia-asupra-unui-fenomen-ciudat-de-ce-nu-se-fac-necropsii-in-pandemia-covid-19.html

Archip, A. (2020, April 24). Controversa Remdesivir: medicamentul prezentat de Alexandru Rafila ca un posibil tratament-minune pentru COVID-19 a picat primele teste clinice in China [Remdesivir controversy: Alexandru Rafila's drug as a possible miracle cure for COVID-19 fails first clinical trials in China]. Libertatea.ro. https://www.libertatea.ro/stiri/remdesivir-picat-teste-clinice-china-alexandru-rafila-2969610

Association of UNESCO Centers, UNESCO's Network of National Bioethics Committees, & Commissions of Latin America (2020, March 26). Ethics in research in times of pandemic COVID-19. Unesco.org. https://en.unesco.org/news/ethics-research-times-pandemic-covid-19

Astarastoae, V. (2020, April 23). De ce nu se fac necropsii in pandemia Covid-19? [Why are necropsies not performed in the Covid-19 pandemic?] Facebook. https://www.facebook.com/notes/vasile-ast%C4%83r%C4%83stoae/de-ce-nu-se-fac-necropsii-%C3%AEn-pandemia-covid-19/981290322266645/

Butler, K. (1993). The moral status of smoking. Social Theory and Practice, 19(1), 1-26. https://doi.org/10.5840/soctheorpract19931915

Casella, C., Graziano, V., Lorenzo, P. D., Capasso, E., & Niola, M. (2018). Unreasonable obstinacy: Ethical, deontological and forensic medical problems. Journal of public health research, 7(3), 1460. https://doi.org/10.4081/jphr.2018.1460

Cook, M. (2020). Nuffield Council on Bioethics publishes coronavirus ethics guide. https://www.bioedge.org/bioethics/nuffield-council-on-bioethics-publishes-coronavirus-ethics-guide/13371?fbclid=IwAR2R_bFUASkWhlWr2jpEegSCCNvhh6VrikI6773j61qakVmWiNZWUMDyVAU

Coronavirus: Is Europe losing Italy? (2020, April 5). Financial Times. https://www.ft.com/content/f21cf708-759e-11ea-ad98-044200cb277f

CROS NT (2018). [INFOGRAPHIC] Guide to clinical trial regulations and guidelines: What to know in 2018. CROS NT. https://www.crosnt.com/guide-to-clinical-trial-regulations-and-guidelines/

Did China hide the true extent of the Coronavirus outbreak?. (2020, April 1). Leaders League. https://www.leadersleague.com/en/news/has-china-hidden-the-true-extent-of-the-coronavirus-outbreak

Dunn, A. (2020, April 23). WHO mistakenly posted study results that appeared to show that a leading potential coronavirus treatment failed to help patients. Business Insider. https://www.businessinsider.com/coronavirus-treatment-data-on-gilead-remdesivir-who-2020-4

Duta, M. (2020, March, 25). VIDEO: China, acuzata ca a plagiat schema de vaccin anticoronavirus gandita la Timisoara [VIDEO: China accused of plagiarizing coronavirus vaccine scheme designed for Timisoara]. Newsweek.ro. https://newsweek.ro/sanatate/china-acuzata-de-furtul-intelectual-a-unei-scheme-de-vaccinare-a-cercetatorilor-romani

Ebbs, W. (2020, February 27). China Underreported Coronavirus infections 520% in a day, leaked data show. CCN. https://www.ccn.com/china-underreported-coronavirus-infections-leaked-data-suggests/

European Commission, (2014). Clinical trials - Regulation EU No 536/2014. https://ec.europa.eu/health/human-use/clinical-trials/regulation_en

European Medicines Agency. (2020, April 4). EMA provides recommendations on compassionate use of remdesivir for COVID-19 [Press release]. https://www.ema.europa.eu/en/news/ema-provides-recommendations-compassionate-use-remdesivir-covid-19

Frunza, A. (July 2016). Final report of research project "Informed Consent between Theory and Practice in the North–Eastern Region of Romania Medical Research Field". Initiated within Program supported by NIH Research Grant #5R25TW007085 - funded by the Fogarty International Center, theNational Institute of Environmental Health Sciences, the National Heart Lung and Blood Institute, and the National Institute on Drug Abuse. Developed within & partially funded by LUMEN Research Center in social and Humanistic Sciences.

Frunza, A., & Sandu, A. (2017a). Values grounding the informed consent in medical practice. Theory and practice. SAGE Open, 7(4), 1-14. https://doi.org/10.1177/2158244017740397

Frunza, A., & Sandu, A. (2017b). Formalization of informed consent. From ethical to administrative use. Postmodern Openings, 8(3), 69-95. https://doi.org/10.18662/po/2017.0803.07

Gemene, C., Unguru (Gafton), E., & Sandu, A. (2018). Sociological perspectives on the quality of life correlated with the state of health. Postmodern Openings, 9(3), 76-98. https://doi.org/10.18662/po/37

Hopulele, C. (2015, January 19). Scandalul de la Spitalul de Neurochirurgie din Iasi contiua: doi dintre pacientii care au decedat vor fi exhumati [The scandal at the Neurosurgery Hospital in Iasi continues: two of the patients who died will be exhumed]. Gandul. https://www.gandul.ro/stiri/scandalul-de-la-spitalul-de-neurochirurgie-din-iasi-contiua-doi-dintre-pacientii-care-au-decedat-vor-fi-exhumati-13773270

Ilyushina, M. (2020, March 26). The Kremlin sends mixed messages on coronavirus as Russian cases spiral. CNN. https://edition.cnn.com/2020/03/26/europe/coronavirus-russia-kremlin-intl/index.html

Is Covid-19 a game-changer for Russia? (2020, April 10). Institut Montaigne. https://www.institutmontaigne.org/en/blog/covid-19-game-changer-russia

Lepadatu, F. (2020, March 27). In Franta s-a autorizat tratamentul cu hidroxiclorochina [Hydroxychloroquine treatment has been authorized in France]. Radio Romania Actualitati. http://www.romania-actualitati.ro/in_franta_s_a_autorizat_tratamentul_cu_hidroxiclorochina-136731

Malik, K. (2020, April 26). We're desperate for a coronavirus cure, but at what cost to the human guinea pigs?. The Guardian. https://www.theguardian.com/commentisfree/2020/apr/26/were-desperate-for-a-coronavirus-cure-but-at-what-cost-to-the-human-guinea-pigs-kenan-malik

Mandal, S., & Abrol, D. (2015, March). Clinical trials industry in India: A systematic review, Working Paper 179. Institute for Studies in Industrial Development. http://isid.org.in/pdf/WP179.pdf

Mill, S. (2014). Utilitarismul [Utilitarianism]. All.

Ministry of Internal Affairs (2020a). Ordonanta militara nr. 2/2020 privind masuri de prevenire a raspandirii COVID-19 [Military Ordinance no. 2/2020 on measures to prevent the spread of COVID-19]. Monitorul Oficial al Romaniei [Official Gazette of Romania], 232, 2020, March 21.

Ministry of Internal Affairs (2020b). Ordonanta Militara nr. 3 din 24 martie 2020 privind masuri de prevenire a raspandirii COVID-19 [Military Ordinance no. 3 of March 24, 2020 on measures to prevent the spread of COVID-19]. Monitorul Oficial al Romaniei [Official Gazette of Romania], 242, 2020, March 24.

Moritsugu, K. (2020, April 1). Virus data: What’s known and not known about China’s numbers. AP News. https://apnews.com/4725c6a8cbab86719baee4ce2a0fd04b

Nardini C. (2014). The ethics of clinical trials. Ecancermedicalscience, 8, 387. https://doi.org/10.3332/ecancer.2014.387

National Agency for Medicines and Medical Devices of Romania (2020). Clinical trials specific legislation. ANM.ro. https://www.anm.ro/en/medicamente-de-uz-uman/studii-clinice/legislatie-specifica-pentru-studii-clinice/

Oprea, L., Gavrilovici, C., Manea, T., & Astarastoae, V. (Eds.), (2013). La drum cu Hipocrate: migratia medicilor din Romania [On the road with Hippocrates: the migration of doctors from Romania]. Polirom.

Palombarini, S. (2020, April 10). Italy is discovering that European solidarity doesn’t exist. Jacobin. https://www.jacobinmag.com/2020/04/italy-coronavirus-crisis-european-union-euro .

Raoult, D. (2020, April 6). Hydroxychloroquine-COVID-19 study did not meet publishing society’s “expected standard”. Retraction Watch. https://retractionwatch.com/2020/04/06/hydroxychlorine-covid-19-study-did-not-meet-publishing-societys-expected-standard/

Raus, K. (2016). An analysis of common ethical justifications for compassionate use programs for experimental drugs. BMC Medical Ethics, 17(1). https://doi.org/10.1186/s12910-016-0145-x

Sandu, A. (2013). Kantian ethics vs. Utilitarian and Consequentialist ethics in the kidney transplant. In A. Sandu & A. Caras (Eds.), Tradition an reform social reconstruction of Europe (pp. 335-339). Medimond-Monduzzi Editore International Proceedings Division.

Spinney, L. (2020, April 6). When will a coronavirus vaccine be ready? The Guardian. https://www.theguardian.com/world/2020/apr/06/when-will-coronavirus-vaccine-be-ready

Thiers, F. A., Sinskey, A. J., & Berndt, E. R. (2008). Trends in the globalization of clinical trials. Nature Reviews Drug Discovery, 7(1), 13–14. https://doi.org/10.1038/nrd2441

Thirlway, F. (2019). Nicotine addiction as a moral problem: Barriers to e-cigarette use for smoking cessation in two working-class areas in Northern England. Social Science and Medicine, 238, 112498. https://doi.org/10.1016/j.socscimed.2019.112498

Turnnidge, S. (2020, April 26). No, the first volunteer in the UK's vaccine trials hasn't died. Huffpost.co.uk. https://www.huffingtonpost.co.uk/entry/coronavirus-vaccine-uk-fake-news-volunteer-died_uk_5ea59155c5b6f9639816a17b?guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAACQkc2Te4zDZs3682N2tra9KK8pNhGein8DniA-wgHGAJ_niILG5X8GY57vd7fw1pR4M65YTmI4_loWrbc3Ua-c62XiXJurTCHaCSPg0OVPXNusczQJ2p06BoFTSPKgejn11Q0yOSFnM6im9dxApuhGDtZlBTDCFPCvWUt9a1emm&guccounter=2

Zikuan, L., Dongfei, Y., Zhe, Z., Miaoheng, Y., Yanlei, Y., Xijing, H., Chunhua Zhao, R., & Hongjian, L. (2020). A survey of 434 clinical trials about coronavirus disease 2019 in China (letter to the editor). Journal of Medical Virology. https://doi.org/10.1002/jmv.25779




DOI: http://dx.doi.org/10.18662/po/11.1sup2/147

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