“Guidance for managing ethical issues in infectious disease outbreaks” [OMS, 2016]

oms-2016
World Health Organization 2016
Forewords:
“Infectious disease outbreaks are periods of great uncertainty. Events unfold, resources and capacities that are often limited are stretched yet further, and decisions for a public health response must be made quickly, even though the evidence for decision-making may be scant. In such a situation, public health officials, policy-makers, funders, researchers, field epidemiologists, first responders, national ethics boards, health-care workers, and public health practitioners need a moral compass to guide them in their decision-making. Bioethics puts people at the heart of the problem, emphasizes the principles that should guide health systems, and provides the moral rationale for making choices, particularly in a crisis.”
Introduction:
“This guidance grew out of concern at the World Health Organization (WHO) about ethical issues raised by the Ebola outbreak in West Africa in 2014–2016. The WHO Global Health Ethics Unit’s response to Ebola began in August 2014, immediately after it was declared a “public health emergency of international concern” pursuant to the International Health Regulations (2005). That declaration led to the formation of an Ethics Panel, and later an Ethics Working Group, which was charged with developing ethics guidance on issues and concerns as they arose in the course of the epidemic. It became increasingly apparent that the ethical issues raised by Ebola mirrored concerns that had arisen in other global infectious disease outbreaks, including severe acute respiratory syndrome (SARS), pandemic influenza, and multidrug-resistant tuberculosis. However, while WHO has issued ethical guidance on some of these outbreaks, prior guidance has only focused on the specific pathogen in isolation. The purpose of this document is to look beyond issues specific to particular epidemic pathogens and instead focus on the cross-cutting ethical

issues that apply to infectious disease outbreaks generally. In addition to setting forth general principles, it examines how these principles can be adapted to different epidemiological and social circumstances.”
Relevant ethical principles
Ethics involves judgements about “the way we ought to live our lives, including our actions, intentions, and our habitual behaviour.” The process of ethical analysis involves identifying relevant principles, applying them to a particular situation, and making judgements about how to weigh competing principles when it is not possible to satisfy them all. This guidance document draws on a variety of ethical principles, which are grouped below into seven general categories. These categories are presented merely for the convenience of the reader; other ways of grouping them are equally legitimate.”
Justice
Beneficence
 Utility

Respect for persons
 Liberty
Reciprocity
Solidarity

Table of Contents

Guidelines
1. Obligations of governments and the international community

2. Involving the local community

3. Situations of particular vulnerability
4. Allocating scarce resources

5. Public health surveillance

6. Restrictions on freedom of movement

7. Obligations related to medical interventions for the diagnosis, treatment, and prevention of infectious disease

8. Research during infectious disease outbreaks

9. Emergency use of unproven interventions outside of research

10. Rapid data sharing
11. Long-term storage of biological specimens collected during infectious disease outbreaks

12. Addressing sex- and gender-based differences

13. Frontline response workers’ rights and obligations

14. Ethical issues in deploying foreign humanitarian aid workers

“Os limites do agir ético no dia-a-dia do enfermeiro”

capa servir jun2016

Artigo «Os limites do agir ético no dia-a-dia do enfermeiro».

Resumo

Abordamos o tema em cinco etapas.

Na primeira, Questionamento em torno dos limites aborda o campo semântico, algumas perspetivas teóricas e é sintetizável como a identificação do que caracteriza os limites e o o questionamento sobre os limites com alguns autores.

Na segunda, Da tripla fórmula do plano ético aos limites partimos da formulação de Ricoeur para alicerçar as perspetivas ética, ontológica e existencial dos limites humanos.

Na terceira, Ética de Enfermagem foca-se na fundamentação da dimensão ética da práxis, com centro na dignidade da pessoa, a sua autonomia, o seu contexto situado e associando responsabilidade e respeito pelo Outro, compromisso de cuidado e processo transpessoal e intersubjectivo da acção do enfermeiro.

Na quarta, Limites do agir ético, enunciamos um conjunto de elementos, a partir do sentido (ou finalidade) da autoregulação e dos contornos da ação profissional, incluindo a expressão de vontade da pessoa cuidada, o quadro normativo de expressão deontológica, as leges artis, as regras da arte e do cuidado humano, na transição para a responsabilidade profissional e reconhecendo a relação com a cidadania e direitos humanos.

Na quinta, A consciência e a gestão dos limites no agir profissional consideramos os territórios da ação,  com diversas geografias e geometrias variáveis, com enfoque nas escolhas difíceis e recusas, limites provenientes dos intervenientes e dos contextos, conferindo espaço à solicitude a aos dilemas, a uma “moral da medida”, à reflexão sobre a gestão dos depois (as questões da falibilidade e da falta, sentimento de culpabilidade, do arrependimento e do remorso, assim como da satisfação e da alegria, da estima de Si).

No global, procuramos os limites do agir ético no dia-a-dia do enfermeiro,  com o sentido de agregação das dimensões ética, deontológica, práxica do exercício profissional. Que, pela própria natureza da profissão, estreita laços com questões antropológicas e existenciais.

Palavras Chave: Limites, Ética de Enfermagem, Ação do Enfermeiro

Limites agir enfermeiro_ Rev Servir_2016

e-book do CEJ: “Ética e Redes Sociais”

cej nov 2015

Uso as palavras de João Pires da Rosa, para deixar nota deste ebook que, em boa hora, o CEJ colocou ao dispor.

“Afinal, como escreve o poeta brasileiro Carlos Drummond de Andrade, «ninguém é igual a ninguém. Todo o ser humano é um estranho ímpar» e o caminho em busca da Harmonia
não pode deixar ninguém para trás, a menos que se imponha o sacrifício desse alguém para não sacrificar em excesso um qualquer outro.
E assim caímos na rede, assim somos apanhados na rede – “vemos, ouvimos e lemos, não podemos ignorar”.
Que ninguém me diga que lhe escapa. Se bem que dizer isto é imediatamente alertar para um dos primeiros e principais problemas da(s) rede(s).
É que não é nunca unívoca a comunicação que nos chega fora do contacto olhos nos olhos, orelha a orelha, o contacto imediato e … radicalmente humano entre uma pessoa e
outra pessoa.”

o e-book pode ser descarregado aqui 

A quem possa interessar

5th Edition of the Intensive Course on Foundational Approaches, Contemporary and Educational Issues in Nursing Ethics

(Leuven, Belgium, 1-4 December 2015)

The Centre for Biomedical Ethics and Law of the KU Leuven is organizing the 5th edition of the Intensive Course on Nursing Ethics. The objective of the course is to foster exchanges on foundational and methodological approaches as well as on contemporary and educational issues in nursing ethics. This course works from an interdisciplinary – philosophical, theological, nursing, clinical-ethical – perspective.

During the course, national and international experts will give presentations on various topics in the domain of nursing ethics. There will be time for intensive discussions. The language of instruction will be English.

The course is of interest to participants from diverse professional backgrounds, such as nursing, medicine, philosophy and theology, health care administration, and is open to health care workers, people from universities and university colleges, members of ethics committees or ethics consultation services, and PhD students undertaking courses of study in these areas.

The intensive Course on Nursing Ethics is part of the Erasmus Mundus Master of Bioethics program. Detailed information on funding opportunities, registration and payment can be found at our website www.masterbioethics.org under Intensive Courses.

Course Coordinator – Chris GASTMANS

After virtue. A study in moral theory. Alasdair MacIntyre

after virtue

“Imagine that the natural sciences were to suffer the effects of a catastrophe. A series of environmental disasters are blamed by the general public on the scientists. Widespread riots occur, laboratories are burnt down, physicists are lynched, books and instruments are destroyed. Finally a KnowNothing political movement takes power and successfully abolishes science teaching in schools and universities, imprisoning and executing the remaining scientists. Later still there is a reaction against this destructive movement and enlightened people seek to revive science, although they have largely forgotten what it was. But all that they possess are fragments: a
knowledge of experiments detached from any knowledge of the theoretical context which gave them significance; pans of theories unrelated either to the other bits and pieces of theory which they possess or to experiment; instruments whose use has been forgotten; half-chapters from books, single pages from anicles, not always fully legible because torn and charred.
Nonetheless all these fragments are reembodied in a set of practices which go under the revived names of physics, chemistry and biology. Adults argue with each other about the respective merits of relativity theory, evolutionary theory and phlogiston theory, although they possess only a very panial knowledge of each. Children learn by hean the surviving portions of the periodic table and recite as incantations some of the theorems of Euclid. Nobody, or almost nobody, realizes that what they are doing
is not natural science in any proper sense at all. For everything that they do and say conforms to cenain canons of consistency and coherence and those contexts which would be needed to make sense of what they are doing have been lost, perhaps irretrievably.
In such a culture men would use expressions such as ‘neutrino’, ‘mass’, ‘specific gravity’, ‘atomic weight’ in systematic and often interrelated ways which would resemble in lesser or greater degrees the ways in which such expressions had been used in earlier times before scientific knowledge had been so largely lost. But many of the beliefs presupposed by the use of these expressions would have been lost and there would appear to be an element of arbitrariness and even of choice in their application which
would appear very surprising to us. What would appear to be rival and competing premises for which no further argument could be given would abound. Subjectivist theories of science would appear and would be criticized by those who held that the notion of truth embodied in what they took to be science was incompatible with subjectivism.
This imaginary possible world is very like one that some science fiction writers have constructed. We may describe it as a world in which the language of natural science, or pans of it at least, continues to be used but is in a grave state of disorder. We may notice that if in this imaginary world analytical philosophy were to flourish, it would never reveal the fact of this disorder. For the techniques of analytical philosophy are essentially descriptive and descriptive of the language of the present at that. The
analytical philosopher would be able to elucidate the conceptual structures of what was taken to be scientific thinking and discourse in the imaginary world in precisely the way that he elucidates the conceptual structures of natural science as it is.”

continuar a ler

After Virtue, MacIntyre

Intensive Course Nursing Ethics 2-5 December 2014, Leuven

Uma experiência enriquecedora (pelo menos, em 2013 foi 🙂

The Centre for Biomedical Ethics and Law of the KU Leuven is organizing an intensive course on Nursing Ethics. The objective of the course is to foster exchanges on foundational and methodological approaches as well as on contemporary and educational issues in nursing ethics. This course works from an interdisciplinary – philosophical, theological, nursing, clinical-ethical – perspective.

During the course, national and international experts will give presentations on various topics in the domain of nursing ethics. There will be time for intensive discussions. The language of instruction will be English.

The course is of interest to participants from diverse professional backgrounds, such as nursing, medicine, philosophy and theology, health care administration, and PhD students undertaking courses of study in these areas. The intensive course Nursing Ethics is part of the Erasmus Mundus Master of Bioethics programme.

Nursing Ethics Booklet 2014