In December 2019 an infectious coronavirus disease, commonly known as COVID-19, was identified in Wuhan, China. The disease spread rapidly and became a global pandemic. New Zealand’s first COVID-19 case was confirmed on 28 February 2020, after which the number of cases began to rise significantly, prompting the New Zealand Government to introduce a nationwide lockdown on 25 March 2020. This factsheet reports early findings from a quantitative study with adult New Zealanders. It explores how prevalent the experiences (...) of unwanted digital communication were in the last 12 months, before, during, and just after the nationwide COVID 19 lockdown. This study found a higher prevalence of unwanted digital communications around the time of the nationwide COVID-19 lockdown. This study’s findings suggest that unexpected health and social events, such as the COVID-19 pandemic and compulsory lockdown, are factors that can trigger changes in people’s experiences of online risk from unwanted digital communications. (shrink)

In this unprecedented time, there are many questions and plenty of speculation surrounding what life will be like after the South African nationwide lockdown. There is concern over the effects that the lockdown will have on worship services when churches are in a position to open their doors to the public once more. As a result of recognising the lockdown as a liminal phase, perspectives are shared when considering how the church will gather again in a (...) post-lockdown context and therefore a post-liminal phase. One prevailing perspective in considering this post-liminal phase involves koinonia and how an undiscriminating virus can remind those to further practise inclusivity and ubuntu, by embracing sameness and difference when ‘being church’. In contrast, another important perspective focuses on ritualising certain measures in the worship service to prevent the spread of coronavirus disease 2019 (COVID-19), when gathering in church buildings is permissible in a post-lockdown context. This is concluded by echoing the spirit of ubuntu, namely, ‘I am because we are’, in ‘being church’ during and after the crisis of the COVID-19 global pandemic. Contribution: From the perspective of Liturgical and Ritual Studies, this article aims to contribute to the Theological perspectives of COVID-19. (shrink)

This paper conducts a cost–benefit analysis of Australia’s Covid-19 lockdown strategy relative to pursuit of a mitigation strategy in March 2020. The estimated additional deaths from a mitigation strategy are 11,500 to 40,000, implying a Cost per Quality Adjusted Life Year saved by locking down of at least 11 times the generally employed figure of $100,000 for health interventions in Australia. The lockdowns do not then seem to have been justified by reference to the standard benchmark. Consideration of the (...) information available to the Australian government in March 2020 yields a similar ratio and therefore the same conclusion that lockdown was not warranted. If Australia experiences a new outbreak, and cannot contain it without resort to a nationwide lockdown, the death toll from adopting a mitigation strategy at this point would be even less than had it done so in March 2020, due to the vaccination campaign, lessons learned since March 2020, and because the period over which the virus would then inflict casualties would now be much less than the period from March 2020. This would favour a mitigation policy even more strongly than in March 2020. This approach of assessing the savings in quality adjusted life years and comparing them to a standard benchmark figure ensures that all quality adjusted life years saved by various health interventions are treated equally, which accords with the ethical principle of equity across people. (shrink)

On 24th March 2020, the first nationwide complete lockdown was announced by the Prime Minister of India for 21 days which was later extended to 31st May 2020. Consequently, thousands of migrant workers placed in big cities had no other option but to go back to their native villages. Their journeys back to villages- thousands of kilometres on bicycles or foot due to the non-availability of public transport amidst the travel ban- were driven by the compulsions of food (...) and shelter. In one of many heart-wrenching incidents, sixteen laborers were run over by a freight train while they were resting on the railway tracks. The images of the Roti on the railway track strewn across were beamed on the national news channels, as a telling commentary of the unimaginable hardships of these workers. Ironically, in the eyes of law, they were trespassers under the Indian Railways Act, 1989. The Indian Railway did not pay any compensation to the victims. Their act also violated the Indian Disaster Management Act, 2005 and Indian Penal Code, 1860- the law for the breach of lockdown guidelines and the law for disobedience of order by public servants respectively- for having decided to travel amidst a travel ban. The semiotics of law-making acts ‘criminal’ bereft of ‘moral culpability’ are seldom questioned on their supposed amoral foundations. Pandemic exhibited that social fissures not only condition the individual or community actions but also the actions of the State. Minorities especially Muslims were at the receiving end of State’s selective enforcement of lockdown laws in India. The various instances in the wake of the COVID-19 pandemic expose the hollow claims of equality before the law and the equal protection of laws as a constitutional promise to every citizen. This article aims to unravel the ostensible and the actual moral exhibition of such Indian laws through the lens of several incidents during the nationwide lockdown in India. This paper would argue that this constructed positivist amorality needs to be deconstructed to unearth the power imbalance that it seeks to hide. (shrink)

As consequence to the coronavirus outbreak, governments around the world imposed drastic mitigation measures such as nationwide lockdowns. These measures included the closures of schools, hence, putting parents into the position of juggling school and work from home. In the present study, we investigated the well-being of parents with school-aged children and its connection to mitigation measures with particular focus on parental roles “caregiver,” “worker,” and “assistant teacher” as stressors. In addition to direct effects, we expected indirect effects on (...) well-being through changes in household dynamics. Data were collected via an online survey (N= 1313, 85.5% female; 53.2% university degree) conducted during the first wave of school closures in Germany. We observed that during the early COVID-19 pandemic, parental well-being in general was quite positive. Comparing the positive and negative PANAS subscales, parents agreed significantly more with the positive than with the negative items,t(1299) = 28.55,p< 0.001. Parents also reported an increase in positive family activities during the lockdown,t(1272) = 43.96,p< 0.001. Although a significant increase in negative household dynamics, such as disputes, was also observed to a lower extent,t(1295) = 7.78,p< 0.001. Using structural equation modeling, we observed that “homeoffice” was not significantly related to parents’ well-being, but positively affected household dynamics. Taking on the role of “assistant teacher” was negatively related to household dynamics. Additionally, we found a significant direct effect on negative affect for “assistant teacher.” We conclude that parents of school-aged children have mostly been able to establish positive dynamics in their households during the lockdown given the extra time they got to spend with their children by working from home. However, our results identify the role of “assistant teacher” as a potential stressor for parents. Bridging the gap between teachers and parents seems warranted especially if (some) distance-learning continues, in order to avoid long-term consequences for the students. (shrink)

IntroductionIn spring 2020, the first nationwide lockdown in response to the spreading COVID-19 pandemic came into effect in Germany. From March to May, gambling venues, casinos, and betting offices were forced to close. This study explores how land-based gamblers respond to short-term closures of higher-risk forms of gambling. Which gamblers are particularly susceptible to switching to online gambling? Which are more likely to use the lockdown as an opportunity to quit or pause gambling? Potential parameters for these (...) switching or cessation processes are identified using multivariate multinomial logistic regression analysis.MethodsThe research questions are analyzed on the basis of quantitative data. For this purpose, a survey was conducted among members of a comparatively large German online access panel. The sample of analysis consisted of 612 gamblers who had participated in at least one higher-risk form of gambling and had done so exclusively offline before the first lockdown.ResultsA total of 37.1% of sports bettors ceased participation in higher-risk forms of gambling, compared to 64.1% of casino gamblers. Switching to online gambling, on the other hand, was a rather rare event, regardless of the form of gambling: the proportions differ between 7.7% and 10.9%. In the multivariate model female gender, younger age, and a lower frequency of gambling before the first lockdown were found to be significant factors for quitting higher-risk offline gambling forms. Secondly, the analysis revealed that individuals with more pronounced cognitive distortions had an increased risk of switching to online gambling rather than staying offline.DiscussionA key finding of this study is that the temporary closure of offline venues does not result in a significant shift towards the online market. Instead, the results of this study show that these short, temporary closures of gambling venues were an appropriate opportunity to give individual groups of gamblers the opportunity to reflect, reduce or quit gambling. It is worth considering implementing such temporary closures as a preventive measure in the future – this should be investigated in advance in further evaluation studies. (shrink)

In March 2020, the World Health Organization announced the Covid-19 outbreak a pandemic and restrictive measures were enacted by the Governments to fight the spread of the virus. In Italy, these measures included a nationwide lockdown, with limited exceptions including grocery shopping, certain work activities, and healthcare. Consistently with findings from previous studies investigating the psychological impact of similar pandemics [e.g., Severe Acute Respiratory Syndrome ], there is evidence that Covid-19 is associated with negative mental health outcomes. Given (...) this background, we conducted a cross-sectional study aimed at investigating the impact of the Covid-19 pandemic and the subsequent restrictive measures imposed by the Government on the psychological health of Italian men and women aged = 18 years and living in Lombardy, one of the worst-hit regions. The study also aimed at identifying what factors are associated with specific psychological outcomes. Thus, we developed an online survey that included a researcher-made questionnaire to collect sociodemographic, household, general health, and pandemic-related information. The Generalized Anxiety Disorder-7, the Patient Health Questionnaire-9 and the Perceived Stress Scale were used to assess anxiety, depression, and perceived stress, respectively. We found that younger age, greater concerns about the pandemic, female gender, being unmarried, not having children, and being a student were associated with worse psychological health. These findings may provide further insight into the risk factors associated with negative psychological outcomes during the current pandemic, with identification of vulnerable groups. This body of evidence may help professionals implement targeted psychosocial treatment and prevention programs. (shrink)

This article describes how the COVID-19 pandemic has forced the higher education institutes in developing nations like India to relook at pedagogical approaches. Due to government imposing nationwide lockdown, higher educational institutes were quickly adopting to imbibe online learning medium. This research takes a qualitative thematic analytical approach to explore the facilitators and challenges to online learning from the perspectives of both learners and educators in higher education institutes. We have specifically explored the ethical and social concerns related (...) to online learning and the possible solution for the same. (shrink)

The COVID-19 pandemic has undoubtedly become an era-defining challenge for the entire world. It has implications not only in the public health sector but also in the global economy and political landscape. The prevention strategy that has been followed in Sri Lanka is unique. Early action taken by the government and the ministry of health, being one of pre-emptive quarantining and isolation of suspected contacts even before they developed symptoms, was vital to contain the spread of the disease. During the (...) early phase, a nationwide lockdown in the form of a curfew was imposed which helped mitigate the spread of the virus. However, due to several lapses, there was a threat of community transmission; this was swiftly brought under control through ongoing government interventions. Thus, strict social/physical distancing measures enforced by the government, together with an increase in testing capacity, prevented widespread community transmission. Strictly containing the outbreaks as and when they were identified made it easier to bring the spread under control through contact tracing. In this article, we give an account of the strategy taken by Sri Lanka to mitigate the pandemic and comment on the lessons learned concerning the ethical responses to the COVID-19 crisis. (shrink)

Considering the high impact strain that the severe acute respiratory syndrome coronavirus 2 pandemic has put on medical personnel worldwide, identifying means to alleviate stress on healthcare professionals and to boost their subjective and psychological wellbeing is more relevant than ever. This study investigates the extent to which the relationships between the status of working in healthcare and the subjective and psychological wellbeing are serially mediated by work recovery experiences and the need for recovery. Data were collected from 217 Romanian (...) employees using a cross-sectional design with self-report instruments, during the first stage of the nationwide lockdown. The results of the serial mediation analyses revealed that working in the medical field is indirectly related to subjective and psychological wellbeing through the following: mastery experiences and mastery experiences as an antecedent of the need for recovery. As such, our findings indicate that working in the medical field is, in fact, linked to healthcare professionals’ subjective and psychological wellbeing, and they provide some input on how recovery experiences and the need for recovery intervene in these relationships. Based on these findings, theoretical, methodological, and practical implications were suggested, and future research directions were proposed to maximize healthcare professionals’ wellbeing. (shrink)

The COVID-19 pandemic forced German universities to adjust their established operations quickly during the first nationwide lockdown in spring 2020. Lecturers and students were confronted with a sudden transition to remote teaching and learning. The present study examined students’ preparedness for and perspective on this new situation. In March and April 2020, we surveyed n = 584 students about the status quo of their perceived digital literacy and corresponding formal learning opportunities they had experienced in the past. Additionally, (...) the students reported the direction of changes in key study characteristics they expected from this new situation. Moreover, they reported the extent to which they believe they will be able to master this new study situation successfully. Two categories of independent variables were considered: context-related variables and person-related variables. Our results show that students did not have many learning opportunities to promote their digital literacy, suggesting that they were not appropriately prepared for this new situation. Results for digital literacy vary by competence area. However, there is a positive correlation between past formal learning opportunities and corresponding digital competences. Master students reported more learning opportunities and higher digital literacy only in one competence area compared to bachelor students. Regarding the expected change of key study characteristics, some characteristics were expected to worsen and fewer to improve. A multiple regression analysis explained 54% of the estimated probability of successful remote learning. Students’ age, state anxiety, positive state affect, general self-efficacy, the availability of an own workplace, past learning opportunities in digital content creation, and the estimated preparedness of lecturers for remote teaching were significant explaining factors. Our results provide valuable insights into the perspective of students on studying during the COVID-19 pandemic and beyond. We discuss important factors that should be addressed by educational measures in the future. (shrink)

Nation-wide community quarantines and social distancing are part of the new normal because of the global COVID-19 pandemic. Since extensive and prolonged lockdowns are relatively novel experiences, not much is known about the well-being of individuals in such extreme situations. This research effort investigated the relationship between well-being elements and resiliency of 533 Filipino adults who were placed under the nationwide enhanced community quarantine during the COVID-19 pandemic. Participants comprised of 376 females and 157 males. The median and mode (...) ages of the participants is 23 years, while 25 is the mean age. PERMA Profiler was used to measure participants’ well-being elements, while Connor-Davidson Resiliency Scale-10 was used to measure their resiliency. Collected data were analyzed using the regression model and necessary condition analysis. This study corroborated that all the five pillars of well-being are significant positive correlates of resiliency in quarantined adults. The results shown accomplishment positively predicts resiliency, while negative emotions negatively predict resiliency. Lastly, the five pillars of well-being are necessary-but-not-sufficient conditions of resiliency. Our results cast a new light on well-being elements as constraints rather than enablers of resiliency. This novel result shows that optimum resiliency is only possible when all the five pillars of well-being are taken care of and when a person is at least minimally contented with their physical health. The present findings underscore the importance of a holistic as against an atomistic approach to maintaining good mental health, which suggests that deficiencies in certain areas of well-being may not be fully addressed by overcompensating on other areas, as all five pillars of well-being are necessary-but-not-sufficient conditions of resiliency. The study ends with the recommendation for the use of necessary condition analysis to study both classical and novel psychological research problems. (shrink)

Although numerous media literacy training sessions on internet safety for children and adolescents have been conducted, their number contrasts sharply with the few systematic studies on their effectiveness. In this study, we describe the evaluation of nationwide-implemented training sessions on internet safety in Luxembourg, which included perceptions of learning outcomes and evaluations of implementation and effectiveness. Training data from 2011 to 2018 were analyzed, including 28,060 students and 5,031 teachers. Students reported pronounced learning effects, especially for younger students and (...) for repeated training participation. Teachers greatly appreciated the implementation and effectiveness, which generally increased over the years. The perceived effectiveness of the training was significantly related to teachers’ planning to cover internet safety topics in future lessons. The present study shows that carefully planned and continuously evaluated training sessions on internet safety successfully support children’s understanding and teachers’ willingness to implement internet safety in their curriculum. (shrink)

The Spellings Commission recommends widespread critical-thinking testing to help determine the “value added” by higher education institutions—with the data banked and made available (“transparent”) in order to enable parents, students, and policy makers to compare institutions and hold them accountable. Because of the likely and desirable promotion of critical thinking that would result from the Commission’s program, I recommend cooperation by critical-thinking faculty and administrators, but only if there is much less comparability and considerably deeper transparency of the tests and (...) their justification than the Commission recommends, and only if vigilance in handling the many problems and dangers elaborated herein is successful. (shrink)

Background: The knowledge of scientific dishonesty is scarce and heterogeneous. Therefore this study investigates the experiences with and the attitudes towards various forms of scientific dishonesty among PhD-students at the medical faculties of all Norwegian universities.MethodAnonymous questionnaire distributed to all post graduate students attending introductory PhD-courses at all medical faculties in Norway in 2010/2011. Descriptive statistics. Results: 189 of 262 questionnaires were returned (72.1%). 65% of the respondents had not, during the last year, heard or read about researchers who committed (...) scientific dishonesty. One respondent had experienced pressure to fabricate and to falsify data, and one had experienced pressure to plagiarize data. On average 60% of the respondents were uncertain whether their department had a written policy concerning scientific conduct. About 11% of the respondents had experienced unethical pressure concerning the order of authors during the last 12 months. 10% did not find it inappropriate to report experimental data without having conducted the experiment and 38% did not find it inappropriate to try a variety of different methods of analysis to find a statistically significant result. 13% agreed that it is acceptable to selectively omit contradictory results to expedite publication and 10% found it acceptable to falsify or fabricate data to expedite publication, if they were confident of their findings. 79% agreed that they would be willing to report misconduct to a responsible official. Conclusion: Although there is less scientific dishonesty reported in Norway than in other countries, dishonesty is not unknown to doctoral students. Some forms of scientific misconduct are considered to be acceptable by a significant minority. There was little awareness of relevant policies for scientific conduct, but a high level of willingness to report misconduct. (shrink)

Were governments justified in imposing lockdowns to contain the spread of the COVID-19 pandemic? We argue that a convincing answer to this question is to date wanting, by critically analyzing the factual basis of a recent paper, “How Government Leaders Violated Their Epistemic Duties During the SARS-CoV-2 Crisis” (Winsberg et al. 2020). In their paper, Winsberg et al. argue that government leaders did not, at the beginning of the pandemic, meet the epistemic requirements necessitated to impose lockdowns. We focus on (...) Winsberg et al.’s contentions that knowledge about COVID-19 resultant projections were inadequate; that epidemiologists were biased in their estimates of relevant figures; that there was insufficient evidence supporting the efficacy of lockdowns; and that lockdowns cause more harm than good. We argue that none of these claims are sufficiently supported by evidence, thus impairing their case against lockdowns, and leaving open the question of whether lockdowns were justified. (shrink)

With the intensifying shortage of care-providers and mounting financial burden of an aging population in Japan, artificial intelligence (AI) offers a potential solution through AI-driven robots, chatbots, smartphone apps, and other AI medical services. Yet Japanese acceptance of medical AI, especially patient care, largely depends on the degree of ‘humanness’ that can be integrated into intelligent technologies. As empathy is considered a core value in the practice of healthcare workers, artificially intelligent agents must have the ability to perceive human emotions (...) and respond in an affective, human-like manner. This paper presents the results of a nationwide survey in Japan 2023 about the public perception of the use of emotionalized AI (EAI) in healthcare. The sample included 2000 Japanese citizens from 20 to 69 years old with an average age of 45 years. The questionnaire included 65 items in six categories: demographic, perception of the existing healthcare system, attitude towards the use of AI, and EAI in healthcare, trust and privacy concerns and fear of AI, and seeking literacy on new technologies. The analysis of the responses demonstrates that overall, the Japanese population has a limited knowledge of AI, EAI, and smart technologies but trusts the healthcare system, physicians, and staff to use it properly, with little worries over the potential pitfalls related to data security and safety. However, they prefer the use of more human resources and are concerned about privacy and the high cost of new technology, and believe little information is being provided to them through government and media. (shrink)

Nonbelievers represent an understudied population in Greece. This investigation reports on the translation, cultural adaptation, and initial validation of the Nonreligious-Nonspiritual Scale (NRNSS), a measure designed to assess nonbelief. Data from 1754 participants were collected to examine the psychometric properties of the Greek version of the instrument and to assess the nationwide interpretability of the measure. Factor analyses suggested that the 16-item scale retained its bifactor model. Convergent validity was supported through associations with additional measures, namely, the Meaning in (...) Life Questionnaire (MLQ) and the Connor–Davidson Resilience Scale (CD-RISC), which were used as reference criteria. Potential utility of the measure and future directions for ongoing development are discussed. (shrink)

BackgroundWe examine the incidence of medical tribunal decisions and disciplinary actions (DAs) against healthcare professionals (HCPs). In addition, we studied whether an intimate relationship between an HCP and patient as part of the medical tribunal decision is associated with an increased likelihood of disciplinary actions.MethodsWe conducted a nationwide cohort analysis on the downloadable medical tribunal decisions from a medical disciplinary tribunal in the Netherlands from 2010 to 2017.ResultsWe found that 117 (2.8%) of the 4,046 medical tribunal decisions involved an (...) alleged intimate relationship between an HCP and patient. In these medical tribunal decisions the likelihood of a disciplinary action was significantly increased (odds ratio [OR] 12.97, 95% Confidence Interval [95% CI] 7.11–23.64). In addition, we found that nurses and psychiatrists are more frequently accused of and receive disciplinary actions due to intimate relationships than other HCP groups.ConclusionsWe found a limited number of medical tribunal decisions involving an intimate relationship. Especially given the total number of medical tribunal decisions and the number of yearly HCP-patient interactions, the number appears small. Furthermore, an alleged intimate relationship or inappropriate sexual conduct is associated with an increased likelihood of disciplinary action. Future research should obtain statistics on the number of intimate relationships that actually start between HCPs and patients. (shrink)

Lockdowns in Australia have been strict and lengthy. Policy-makers appear to have given the preservation of quantity of lives strong priority over the preservation of quality of lives. But thought-experiments in population ethics suggest that this is not always the right priority. In this paper, I'll discuss both negative impacts on quantity of lives caused by the lockdowns themselves, including an increase in domestic violence, and negative impacts on quality of lives caused by lockdowns, in order to raise the question (...) of whether we each had reason to choose quantity over quality in our own lives in a way that would justify the lockdowns we had. (shrink)

Background: Long working hours and mental health problems among teachers are a concern in Japan. More specifically, it has been reported that junior high school teachers tend to work overtime. In this study, examined the working hours of junior high school teachers in public schools and investigated the association between overtime work and stress responses across job titles.Methods: From June to December 2018, 54,772 teachers in public junior high schools completed a web-based nationwide survey regarding occupational stress and submitted (...) self-evaluated working hours per day of the previous month. Psychological and physical stress responses were assessed using the Brief Job Stress Questionnaire.Results: Results showed that 59.6% of the participants worked 11 h or more per day. Additionally, the length of working hours significantly differed across job titles = 5295.8, p < 0.001, Cramér’s V = 0.14). With respect to tenured teachers, sex, age, taking charge of the class, number of working years in the same school, working hours of 10 to 11 h, 11 to 12 h, 12 to 13 h, and 13 h or more were significantly associated with high stress, compared to those who worked less than 9 h per day. Moreover, for fixed-term teachers, sex, age, working hours of 9 to 10 h, 10 to 11 h, 11 to 12 h, 12 to 13 h, and 13 h or more were related with more stress as compared to those who worked less than 9 h per day. On the other hand, there was no significant relationship between long working hours and stress response among vice-principals, even though they tended to work the longest hours.Conclusion: We verified that Japanese junior high school teachers work long hours. Long working hours were associated with stress responses in both tenured and fixed-term teachers, but not in vice-principals. However, vice-principals work the longest hours among teachers, and we suggest that these long working hours may be a hidden problem that is often overlooked. (shrink)

Aims: To examine the extent of social stigma toward diabetes among Singapore's multi-ethnic general population and determine whether this differs across socio-demographic sub-groups.Methods: Data for this study came from a nationwide cross-sectional study. A diabetes stigma questionnaire comprising Social Distance Scale and Negative Attitudes and Stereotyping Scale was administered to those respondents who had not been diagnosed with diabetes. Exploratory factor analysis was conducted to determine the dimensionality of the instruments and validated using confirmatory factor analysis. Multiple linear regression (...) analysis was conducted to examine associations between socio-demographic factors and measures of diabetes stigma.Results: In all, 2,895 participants were recruited from the general population giving a response rate of 66.2%. Factor analyses found that a one-factor model resulted in an acceptable fit for both stigma scales, which measured social distance and negative attitudes and stereotyping, respectively. Multiple linear regression analyses identified Indian ethnicity, higher personal income and having close friends or family members who had been diagnosed with diabetes to be significantly associated with lower social distance scores while those aged 50–64 years and those with secondary and vocational education were significantly associated with higher social distance scores. Those with a personal income of SG$2,000–3,999 and SGD $6,000 and above, and those with close friends or family members diagnosed with diabetes were significantly associated with lower negative attitudes and stereotyping scores. In contrast those aged 35 years and above, those with primary education and below, and those of Malay ethnicity were significantly associated with higher negative attitudes and stereotyping scores.Conclusions: The study found a relatively low level of stigma toward diabetes in the general population of Singapore, although some stigmatizing beliefs emerged. While greater knowledge of diabetes could reduce stigma, anti-stigma messaging should be incorporated into the “War on Diabetes” programme in Singapore. (shrink)

The doctor-patient relationship has evolved to respect “the autonomy and patients’ rights”. One of the cornerstones in such autonomy is the opportunity for patients to draw living wills, also known as advance directives. However, information about AD available to patients remains scarce largely due to the lack of involvement of General practitioners for several reasons. The aim of our study was to evaluate current general practitioner residents’ behavior concerning their role in informing their patients about AD. We built a French (...) nationwide survey from GPR class of 2012 to 2014. Two thousand three hundred ten residents completed our survey. 89.8% declared their willingness to offer patients the opportunity of writing AD. When asked about the usefulness of AD, 73.6% of residents responded that these are a suitable help for patients, but 19.7% considered that AD are essentially geared towards frail patients. Among residents who want to inform patients about AD, 14.7% wanted to involve all patients. Only 20.5% thought that elderly people should be systematically informed about AD. When the question involves other frail people in various disease areas, information seems relevant for 60.1% of GPR considering patient with cancer or malignant hematologic disease and for 56.2% about patients affected by neurodegenerative disease. When considering the routine use of AD, 20.5% of GPR would take them into account only if they are in agreement with the patient’s decision. The results of the survey indicate that GPR would rather choose to decide who should be informed about AD, and when to take AD into account for ethical concerns. (shrink)

Our aim in this brief essay is not to defend a particular policy or attitude toward lockdown measures in the United States or elsewhere, but to consider the scope and limits of different types of arguments that can be offered for them. Understanding the complexity of these issues will, we hope, go some way to helping us understand each other and our attitudes toward state responses to the pandemic.

BackgroundThe COVID-19 pandemic has created ethical challenges for intensive care unit (ICU) professionals, potentially causing moral distress. This study explored the levels and causes of moral distress and the ethical climate in Dutch ICUs during COVID-19.MethodsAn extended version of the Measurement of Moral Distress for Healthcare Professionals (MMD-HP) and Ethical Decision Making Climate Questionnaire (EDMCQ) were online distributed among all 84 ICUs. Moral distress scores in nurses and intensivists were compared with the historical control group one year before COVID-19. ResultsThree (...) hundred forty-five nurses (70.7%), 40 intensivists (8.2%), and 103 supporting staff (21.1%) completed the survey. Moral distress levels were higher for nurses than supporting staff. Moral distress levels in intensivists did not differ significantly from those of nurses and supporting staff. “Inadequate emotional support for patients and their families” was the highest-ranked cause of moral distress for all groups of professionals. Of all factors, all professions rated the ethical climate most positively regarding the culture of mutual respect, ethical awareness and support. “Culture of not avoiding end-of-life-decisions” and “Self-reflective and empowering leadership” received the lowest mean scores. Moral distress scores during COVID-19 were significantly lower for ICU nurses (p < 0.001) and intensivists (p < 0.05) compared to one year prior.ConclusionLevels and causes of moral distress vary between ICU professionals and differ from the historical control group. Targeted interventions that address moral distress during a crisis are desirable to improve the mental health and retention of ICU professionals and the quality of patient care. (shrink)

[OPEN ACCESS] Commentaries on the ethics of Covid lockdowns nearly all focus on offering substantive guidance to policy‐makers. Lockdowns, however, raise many ethical questions that admit of a range of reasonable answers. In such cases, policy‐making in a liberal democracy ought to be sensitive to which reasonable views the public actually holds—a topic existing bioethical work on lockdowns has not explored in detail. In this essay, I identify several important questions connected to the kind of influence the public ought to (...) have on lockdown decision‐making, including how policy‐makers ought to handle misinformed or morally suspect viewpoints, and how policy‐makers ought to respond to minority viewpoints. I argue that questions like this, concerning the appropriate influence of the public on decision‐making, will be central to the field of bioethics as it increasingly focuses on policy and population‐level issues and therefore ought to be priorities for future work. (shrink)

In order to prevent the rapid spread of COVID-19, governments have placed significant restrictions on liberty, including preventing all non-essential travel. These restrictions were justified on the basis the health system may be overwhelmed by COVID-19 cases and in order to prevent deaths. Governments are now considering how they may de-escalate these restrictions. This article argues that an appropriate approach may be to lift the general lockdown but implement selective isolation of the elderly. While this discriminates against the elderly, (...) there is a morally relevant difference—the elderly are far more likely to require hospitalisation and die than the rest of the population. If the aim is to ensure the health system is not overwhelmed and to reduce the death rate, preventing the elderly from contracting the virus may be an effective means of achieving this. The alternative is to continue to keep everyone in lockdown. It is argued that this is levelling down equality and is unethical. It suggests that in order for the elderly to avoid contracting the virus, the whole population should have their liberty deprived, even though the same result could be achieved by only restricting the liberty of the elderly. Similar arguments may also be applied to all groups at increased risk of COVID-19, such as men and those with comorbidities, the obese and people from ethnic minorities or socially deprived groups. This utilitarian concern must be balanced against other considerations, such as equality and justice, and the benefits gained from discriminating in these ways must be proportionately greater than the negative consequences of doing so. Such selective discrimination will be most justified when the liberty restriction to a group promotes the well-being of that group (apart from its wider social benefits). (shrink)

Lockdowns were a morally and medically appropriate anti-contagion policy to stop the spread of Covid. However, lockdowns came with considerable costs. Specifically, lockdowns imposed harms and losses upon the young in order to benefit the elderly, who were at the highest risk of severe illness and death from Covid. This represented a shifting of the (epidemiological) burden of Covid for the elderly to a systemic burden of lockdown upon the young. This article argues that even if lockdowns were a (...) morally permissible response to Covid, the harms and losses they imposed on the young ground a claim of compensation. I defend an intergenerational compensation argument that defends a claim for an egalitarian intergenerational transfer to compensate the young for the harms of lockdown. (shrink)

Lockdowns were a morally and medically appropriate anti-contagion policy to stop the spread of Covid. However, lockdowns came with considerable costs. Specifically, lockdowns imposed harms and losses upon the young in order to benefit the elderly, who were at the highest risk of severe illness and death from Covid. This represented a shifting of the (epidemiological) burden of Covid for the elderly to a systemic burden of lockdown upon the young. This article argues that even if lockdowns were a (...) morally permissible response to Covid, the harms and losses they imposed on the young ground a claim of compensation. I defend an intergenerational compensation argument that defends a claim for an egalitarian intergenerational transfer to compensate the young for the harms of lockdown. (shrink)

The lifting of lockdown is a typical case of the tragedy of the commons, and as such should be regulated by public authority, instead of being left to the ethics and responsibility of single individuals. I would therefore argue that we should think about an intermediate phase between the lockdown and the opening of shops (which in the Italian case is the transition from the red zone to the orange zone): diversified access to commercial activities, on an hourly (...) basis, for different population groups. This can be achieved either by creating different opening hours for different commercial activities and offices, or by opening them all at the same time but introducing free entrance hours based on age groups of clients. Both solutions would imply an extension of business and office hours, contrary to what has happened in most countries, where an attempt has been made to shorten the days and in some cases, such as in Italy, a curfew has even been introduced at a certain time of the day (in Italy, at 10 pm). (shrink)

The spread of COVID-19 in Italy resulted in the implementation of a lockdown that obligated the first time the general populace to remain at home for approximately two months. This lockdown interrupted citizens’ professional and educational activities, in addition to closing shops, offices and educational institutions. The resulting changes in people’s daily routines and activities induced unexpected changes in their thoughts, feelings and attitudes, in addition to altering their life perceptions. Consequently, the present study explores how young adults (...) perceived their lives under lockdown during the final week of March 2020, when the reported number of daily coronavirus infections reached its peak in Italy. The research was carried out among 293 university students (234 women and 59 men) with an average age of 20.85 years old (SD = 3.23). The researchers asked participants to describe the emotions, thoughts and experiences that characterized their time under lockdown. The study analyzed specific narratives related to time and space using grounded theory methodology, which was applied using Atlas 8 software, leading to the creation of 68 codes. The study organized these codes into three specific categories: confined in the present, confined in the past, and striving toward one’s goals. Finally, the researchers also created a core-category labeled “continuity of being.” The results showed that the closure of open spaces caused a division in participants’ perceptions of time continuity, with many viewing themselves as feeling fragmented and as living the present in a static and fixed way. Additionally, participants also saw the present as being discontinuous from the past, while, simultaneously, projecting toward the future and the changes it might bring. Finally, this study examined further implications surrounding individual projecting among young people in greater depth. (shrink)

Background Psychiatric electroceutical interventions (PEIs) use electrical or magnetic stimulation to treat mental disorders and may raise different ethical concerns than other therapies such as medications or talk therapy. Yet little is known about stakeholders’ perceptions of, and ethical concerns related to, these interventions. We aimed to better understand the ethical concerns of a variety of stakeholder groups (patients with depression, caregivers of patients, members of the public, and psychiatrists) regarding four PEIs: electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS), (...) deep brain stimulation (DBS), and adaptive brain implants (ABI). Methods We conducted a national survey of these four stakeholder groups, using an embedded video vignette experiment depicting a patient with treatment-resistant depression and her psychiatrist discussing the possibility of treatment with one of the four PEIs. Results Participants’ ethical concerns varied by stakeholder group, by PEI, and by the interaction of the two. The three non-clinician groups tended to have similar ethical concerns, but to differ from psychiatrists. Similar concerns were raised with regard to the two implantable technologies, DBS and ABI. Overall, there was relatively little concern about the involuntary use of PEIs, though some expressed concern about the adequacy of information provided during the consent process. There was also significant concern that patients may not receive helpful therapies. Conclusions To our knowledge, this is the first national survey that includes multiple stakeholder groups and multiple PEI modalities. A better understanding of the ethical concerns of stakeholders can help to shape clinical practice and health care policy regarding PEIs. (shrink)

BackgroundDecision-making in out-of-hospital cardiac arrest should ideally include clinical and ethical factors. Little is known about the extent of ethical considerations and their influence on prehospital resuscitation. We aimed to determine the transparency in medical records regarding decision-making in prehospital resuscitation with a specific focus on ethically relevant information and consideration in resuscitation providers’ documentation.MethodsThis was a Danish nationwide retrospective observational study of out-of-hospital cardiac arrests from 2016 through 2018. After an initial screening using broadly defined inclusion criteria, two (...) experienced philosophers performed a qualitative content analysis of the included medical records according to a preliminary codebook. We identified ethically relevant content in free-text fields and categorised the information according to Beauchamp and Childress’ four basic bioethical principles: autonomy, non-maleficence, beneficence, and justice. ResultsOf 16,495 medical records, we identified 759 (4.6%) with potentially relevant information; 710 records (4.3%) contained ethically relevant information, whereas 49 did not. In general, the documentation was vague and unclear. We identified four kinds of ethically relevant information: patients’ wishes and perspectives on life; relatives’ wishes and perspectives on patients’ life; healthcare professionals’ opinions and perspectives on resuscitation; and do-not-resuscitate orders. We identified some “best practice” examples that included all perspectives of decision-making. ConclusionsThere is sparse and unclear evidence on ethically relevant information in the medical records documenting resuscitation after out-of-hospital cardiac arrests. However, the “best practice” examples show that providing sufficient documentation of decision-making is, in fact, feasible. To ensure transparency surrounding prehospital decisions in cardiac arrests, we believe that it is necessary to ensure more systematic documentation of decision-making in prehospital resuscitation. (shrink)

Governments around the world have faced the challenge of how to respond to the recent outbreak of a novel coronavirus disease. Some have reacted by greatly restricting the freedom of citizens, while others have opted for less drastic policies. In this paper, I draw a parallel with vaccination ethics to conceptualize two distinct approaches to COVID-19 that I call altruistic and lockdown. Given that the individual measures necessary to limit the spread of the virus can in principle be achieved (...) voluntarily as well as through enforcement, the question arises of how much freedom governments ought to give citizens to adopt the required measures. I argue that an altruistic approach is preferable on moral grounds: it preserves important citizen freedoms, avoids a number of potential injustices, and gives people a much-needed sense of meaning in precarious times. (shrink)

The magnitude of public concerns about agricultural innovations has often been underestimated, as past examples, such as pesticides, nanotechnology, and cloning, demonstrate. Indeed, studies have proven that the agricultural sector presents an area of tension and often attracts skepticism concerning new technologies. Digital technologies have become increasingly popular in agriculture. Yet there are almost no investigations on the public acceptance of digitalization in agriculture so far. Our online survey provides initial insights to reduce this knowledge gap. The sample represents the (...) German population in terms of gender, age, education and size of place of residence. Results showed that if the potential of digital farming technologies regarding animal welfare and environmental protection was described, respondents reacted positively. Thus, the general attitudes of respondents toward the benefits of DFT were mostly positive. The approval to increasing adoption rates of particular DFT by providing subsidies was also high. Linear regression models showed that the dominant positive influences on respondents’ attitudes toward the benefits of DFT were a generally positive attitude toward farming and a strong trust in farmers in Germany. Confronting respondents with pictures showing DFT resulted in many spontaneous negative associations and general criticism of agricultural production. The latter holds true for DFT in animal husbandry in particular. However, as agriculture as a whole is criticized by many groups in Germany, it is unlikely that benefits from digitalization will significantly increase the public acceptance of agriculture as a whole. (shrink)

How could the initial, drastic decisions to implement “lockdowns” to control the spread of COVID-19 infections be justifiable, when they were made on the basis of such uncertain evidence? We defend the imposition of lockdowns in some countries by first, and focusing on the UK, looking at the evidence that undergirded the decision, second, arguing that this provided us with sufficient grounds to restrict liberty given the circumstances, and third, defending the use of poorly-empirically-constrained epidemiological models as tools that can (...) legitimately guide public policy. (shrink)

In their recent article, ‘Why lockdown of the elderly is not ageist and why levelling down equality is wrong’, Savulescu and Cameron argue for selective isolation of the elderly as an alternative to general lockdown. An important part of their argument is the claim that the latter amounts to ‘levelling down equality’ and that this is ‘unethical’ or even ‘morally repugnant’. This response argues that they fail to justify either part of this claim: the claim that levelling down (...) is always morally wrong is subject to challenges that Savulescu and Cameron do not consider; and a policy of maintaining general lockdown does not constitute levelling down, as it provides absolute benefits to those who would be worse off under selective isolation. (shrink)

Focusing on the United Kingdom, this paper examines the mechanisms of 2020’s ‘lockdown’ strategy from a governmental perspective, with ‘governmentality’ being defined as the art of, or rationale behind, governing populations at a given time. By investigating a series of recent imperatives given to the population by the UK government, and comparing these with the previously dominant form of governmentality (neoliberalism), I hope to shed light on some new features of the current art of government. Indeed, the paper argues (...) that neoliberalism is no longer the dominant form of governmentality in the UK, although some important legacies remain. I therefore argue that new forms of governmentality have risen to prominence. In particular, I use the concept of ‘algorithmic governmentality’ to address features of lockdown subjectivity and economy, such as the ‘doppelgänger logic’ of consumption and production, as well as the government’s attempts to continuously manage and re-manage the population based on biometric data. However, I also show that this concept does not adequately encompass contemporary realities of surveillance, exposition and coercion. As such, I introduce ‘instrumentarian governmentality’ to denote the use of digital surveillance instruments to control the behaviour of the population. Additionally, the term is intended to denote an ‘authoritarian’ turn in the ways in which people are governed. Overall, what it means to govern in 2020 is posited as a fluctuating composite of three key forms of governmentality: neoliberal, algorithmic, and instrumentarian. (shrink)

In the last years of its history, the Ukrainian ethnic group faced numerous external and internal challenges, which, to a large extent, were the result of its previous genesis and profound transformations in public consciousness. At the same time, one of the central stereotypes of the domestic political and legal mentality is the idea of truth and justice as a basic social ideal and the basis of the legal order. Analysis of research and publications. The problem of mentality and the (...) formation of behavioral stereotypes has been of interest to domestic and foreign scientists for a long time. The concept of «mentality» is most widespread in the writings of the French historical school «Annals». The scientific work of M. Blok, F. Braudel, M. Vovel, J. Le Hoff, J. Lefebvre, L. Fevre, R. Mandr and other scientists reveals the content of mentality and its structures, as well as the peculiarities of their influence on everyday life and activities of individuals who lived in different historical eras. The purpose and objectives of the article. In this article, the authors aim to analyze the idea of truth-justice as a tool for transforming the legal mentality of the Ukrainian ethnic group and to show its influence on the content of its behavioral stereotypes. Research methodology. The methodology of this research has a complex nature and is based on a socio-philosophical and philosophical-legal analysis of the behavioral guidelines of Ukrainians in the field of legal understanding. The results. The social ideology, developed on the basis of ancient social ideas and stereotypes of the national legal mentality, should become a tool for correcting such destructive phenomena in the state-building discourse as legal nihilism, anarchism, civic passivity, corruption, nepotism, etc. At the same time, the concepts of truth-justice, will-freedom and fraternity-equality are key in Ukrainian legal culture. Discussion. The interpretation of this idea in scientific opinion is not unambiguous. This idea clearly manifests itself in the context of the opposition between Truth and Evil in the national culture. Truth is inseparable from human existence and daily activities. The idea of truth is closely related to the idea of justice, which, according to many researchers, is a later, more rational and clearly defined phenomenon derived from truth. Justice as a socio-philosophical phenomenon is intended to act as a kind of moral measure of relations between individuals in society. It is considered as an authoritative criterion for establishing the correspondence between the nature of human activity and its assessment by the social community. Conclusions. Destructive behavioral stereotypes of the Ukrainian ethnic group that were formed, among other things, under the influence of factors of stressogenesis can be corrected with the help of the legal ideology of state building, which should be based on the content of the idea of truth and justice. The developed ideology should be based on the most stable constructive guidelines of the national legal mentality, organically complementing and ideologically justifying them. (shrink)

This article explores the role of language and ideology in Soviet philosophy and education. The author argues that the Soviet regime deliberately used philosophy as a tool for manipulation, with the aim of creating a common understanding that Marxism and Leninism are the only true doctrines of philosophy. The course of philosophy was mandatory at all levels of education and was fully standardized, with a focus on scientific grounds that only Marxist philosophy was valid. The article also highlights the role (...) of language in the Soviet language lockdown policy, where the Russian language was prioritized as the primary language of education and science, suppressing national languages and cultures of member countries. Furthermore, translations of key philosophical texts were selectively done, presenting only those texts that did not touch upon political or religious issues. The article concludes that the oppressive language and ideology practices in Soviet philosophy had a significant impact on the intellectual and cultural development of the Soviet Union and its member countries. (shrink)

The Hannover qualifying programme ‘ethics consultation in hospitals’, conducted by a four-institution cooperation partnership, is an interdisciplinary, scientifically based programme for healthcare professionals interested in ethics consultation services and is widely acknowledged by hospital managements and healthcare professionals. It is unique concerning its content, scope and teaching format. With its basic and advanced modules it has provided training and education for 367 healthcare professionals with 570 participations since 2003 (until February 2010). One characteristic feature is its attractiveness for health professionals (...) from different backgrounds. Internationally, the Hannover programme is one of the few schedules with both academics and non-academics as target groups and a high participation rate of physicians. The concept of the Hannover programme is in great demand, and its schedule is continuously optimised through evaluation. The goals of enabling healthcare professionals from different professional backgrounds to define and reflect ethical problems, to facilitate and support the process of decision-making and to work out structures for their own institutions seem to have been achieved. However, in order to obtain effective and sustainable results, participation in the programme should be supplemented regularly by in-house training sessions or individual expert consultations. Future challenges include new thematic courses and providing a network for former participants, especially when they come from non-academic hospitals. The network is a reasonable platform to discuss participants' experiences, successes and pitfalls. A further task will be research on how the programme's concept can support the sustainability of ethics structures in the various institutions. (shrink)

When the city of Wuhan was severely locked down on January 23, 2020 for 76 days due to the coronavirus outbreak, many residents started writing “lockdown diaries.” This article argues these diaries constitute a kind of performance art for their authors, specifically, an 'art of endurance' as described by Shalson (2018). Keeping a diary requires a plan, but the following through of the plan is a contingent process requiring efforts and endurance. The challenges become particularly daunting for authors of (...) online diaries in pandemic times. The article analyzes multiple types of endurance associated with the Wuhan lockdown diarists, showing that in digitally-driven environments, where potential collective responses are a key context, the lockdown diaries of Wuhan, like works of endurance art, engage with meanings that reach far beyond their original experience and context. Their stories of endurance are an allegory of the endurance of the entire city of Wuhan. (shrink)

The coronavirus disease 2019 pandemic is influencing our lives in an enormous and unprecedented way. Here, we explore COVID-19-lockdown's consequences for creative activity. To this end, we relied on two extensive diary studies. The first, held on March 2019, involved 78 students who reported their emotions and creativity over 2 weeks. The second, conducted on March 2020, involved 235 students who reported on their emotions, creativity, and the intensity of thinking and talking about COVID-19 over a month. We found (...) that compared with 2019, during the lockdown, students engaged slightly yet statistically significantly more in creative activities. An analysis of diaries collected during the pandemic also showed that the days when students spent more time discussing or searching for information about COVID-19 were characterized by a higher creative activity yet also mixed emotions. We discuss potential explanations of these unexpected results along with future study directions. (shrink)

At this stage of the COVID-19 pandemic, two policy aims are imperative: avoiding the need for a general lockdown of the population, with all its economic, social and health costs, and preventing the healthcare system from being overwhelmed by the unchecked spread of infection. Achieving these two aims requires the consideration of unpalatable measures. Julian Savulescu and James Cameron argue that mandatory isolation of the elderly is justified under these circumstances, as they are at increased risk of becoming severely (...) ill from COVID-19, and are thus likely to put disproportionate strain on limited healthcare resources. However, their arguments for this strategy are contingent on the lack of viable alternatives. We suggest that there is a possible alternative: a mandatory, centralised contact-tracing app. We argue that this strategy is ethically preferable to the selective isolation of the elderly, because it does not target members of a certain group, relying instead on the movements of each individual, and because it avoids the extended isolation of certain members of the society. Although this type of contact-tracing app has its drawbacks, we contend that this measure warrants serious consideration. (shrink)

Lockdown measures in response to the COVID-19 pandemic involve placing huge burdens on some members of society for the sake of benefiting other members of society. How should we decide when these policies are permissible? Many writers propose we should address this question using cost-benefit analysis, a broadly consequentialist approach. We argue for an alternative non-consequentialist approach, grounded in contractualist moral theorising. The first section sets up key issues in the ethics of lockdown, and sketches the apparent appeal (...) of addressing these problems in a CBA frame. The second section argues that CBA fundamentally distorts the normative landscape in two ways: first, in principle, it allows very many morally trivial preferences—say, for a coffee—might outweigh morally weighty life-and-death concerns; second, it is insensitive to the core moral distinction between victims and vectors of disease. The third section sketches our non-consequentialist alternative, grounded in Thomas Scanlon’s contractualist moral theory. On this account, the ethics of self-defence implies a strong default presumption in favour of a highly restrictive, universal lockdown policy: we then ask whether there are alternatives to such a policy which are justifiable to all affected parties, paying particular attention to the complaints of those most burdened by policy. In the fourth section, we defend our contractualist approach against the charge that it is impractical or counterintuitive, noting that actual CBAs face similar, or worse, challenges. (shrink)