In 2015, the Israeli Knesset passed the force-feeding act that permits the director of the Israeli prison authority to appeal to the district court with a request to force-feed a prisoner against his expressed will. A recent position paper by top Israeli clinicians and bioethicists, published in Hebrew, advocates for force-feeding by medical professionals and presents several arguments that this would be appropriate. Here, we first posit three interrelated questions: 1. Do prisoners have a right to hunger-strike? 2. Should governing (...) institutions force-feed prisoners and/or is it ethical to force-feed prisoners? 3. Should healthcare professionals force-feed prisoners? We then focus on the first and third questions. We first briefly provide several arguments to support the right of prisoners to refuse treatment. Next, we critically review the arguments presented in the Israeli position paper, demonstrating that they are all misguided at best. Lastly, we briefly present arguments against force-feeding by medical professionals. We conclude that healthcare providers should not participate in the force-feeding of prisoners. (shrink)

In this article, we describe in detail the health and general living conditions resulting from the ongoing armed conflict in Yemen, including the historical and geopolitical underpinnings. In addition to mere reporting, we use Yemen as a case study to examine the responsibility of bioethicists in general. We find it unacceptable that bioethics neglects the largest humanitarian crisis taking place in the world at the moment as well as the largest Cholera outbreak in history. We argue that bioethicists should do (...) more to address armed conflicts and their resulting basic human rights violations. We end with a few recommendations to prevent such neglect. (shrink)

Using Madison Powers and Ruth Faden's definition of ‘well‐being,’ the authors argue that Israel, the international community and public health practitioners have a justice‐based obligation to assist the Palestinian people in the Occupied Palestinian Territories. Focusing on Palestinians in Gaza, the authors first outline a normative framework of justice, as articulated by Powers and Faden. Following Powers and Faden's assumption that empirical assessments of justice can be made using the six dimensions of well‐being, the authors next present current data on (...) the living conditions in Gaza and describe how these conditions prevent residents from achieving sufficient levels of well‐being. Using these indicators to demonstrate that Palestinians living in Gaza suffer deficiencies in these dimensions of well‐being, the authors present a strong argument from justice to assist the residents of Gaza. The medical, public health, and bioethics community cannot sit idle while injustice continues. (shrink)

This paper argues that a lonely death is, by definition, a bad death and that society as a whole, as well as individuals in society are obligated to assure a certain degree of well‐being, flourishing, or care among and for fellow individuals. Individuals can then be said to have a right against dying a lonely death. Such a right has corresponding duties. The paper further specifies what such duties may entail based on what individuals may need on their deathbed, specifically (...) focusing on the need for human touch. Assuming that human touch might indeed be needed by some individuals in order to avoid a lonely death, the paper explores potential implications from a public health perspective, particularly during infectious disease outbreaks such as COVID. (shrink)

One Health is a novel paradigm that recognizes that human and non-human animal health is interlinked through our shared environment. Increasingly prominent in public health responses to zoonoses, OH differs from traditional approaches to animal-borne infectious risks, because it also aims to promote the health of animals and ecological systems. Despite the widespread adoption of OH, culling remains a key component of institutional responses to the risks of zoonoses. Using the threats posed by highly pathogenic avian influenza viruses to human (...) and animal health, economic activity and food security as a case exemplar, we explore whether culling and other standard control measures for animal-borne infectious disease might be justified as part of OH approaches. Our central premise is that OH requires us to reformulate ‘health’ as universal good that is best shared across species boundaries such that human health and well-being are contingent upon identifying and meeting the relevant sets of human and non-human interests and shared dependencies. Our purpose is to further nascent discussions about the ethical dimensions of OH and begin to describe the principles around which a public health agenda that truly seeks to co-promote human and non-human health could potentially begin to be implemented. (shrink)

The 2013 Ebola virus outbreak in West Africa, as of writing, is declining in reported human cases and mortalities. The resulting devastation caused highlights how health systems, in particular in West Africa, and in terms of global pandemic planning, are ill prepared to react to zoonotic pathogens. In this paper we propose One Health as a strategy to prevent zoonotic outbreaks as a shared goal: that human and Great Ape vaccine trials could benefit both species. Only recently have two phase (...) 2/3 Ebola human vaccine trials been started in West Africa. This paper argues for a conceptual change in pandemic preparedness. We first discuss the ethics of One Health. Next, we focus on the current Ebola outbreak and defines its victims. Third, we present the notion of a ‘shared benefit’ approach, grounded in One Health, and argue for the vaccination of wild apes in order to protect both apes and humans. We believe that a creation of such inter-species immunity is an exemplar of One Health, and that it is worth pursuing as a coextensive public health approach. (shrink)

Loneliness is a major public health concern, particularly during pandemics such as Covid. It is extremely common, and it poses a major risk to human health. Technological solutions including social media, robots, and virtual reality have been advocated and implemented to relieve loneliness, and their use will undoubtedly increase in the near future. This paper explores the use of technological solutions from a normative perspective, asking whether and to what extent such measures should indeed be relied upon. The conclusion is (...) that technological solutions are unquestionably part of the solution to loneliness, but that they cannot and should not constitute the whole solution. It is important to note that this is not a straw‐man argument, as several organizations and scholars have strictly focused on such technological solutions for loneliness. (shrink)

This article poses an invitation for bioethicists to engage with loneliness as a bioethics and public health concern. I argue that loneliness is a relevant issue for bioethicists for three main reasons: it causes ill‐health; particularly in the age of Covid‐19, it is becoming prominent on the clinical and public health agenda, affecting millions worldwide; and it engenders several ethical and philosophical questions as a social determinant of health with a rich conceptual background. In what follows I first review the (...) link between loneliness and ill‐health and argue that it should concern bioethicists because of this link. I also demonstrate how pertinent the issue of loneliness is being considered nowadays, and mark this as another reason for bioethicists to become engaged. I then move on to define loneliness and its various forms, drawing from modern and contemporary philosophers. The way we choose to cope with the pandemic of loneliness depends in part on its theoretical underpinnings, as well as its empirical scope. Theory thus combines with empirical data in order to devise and implement a rational public health policy, necessitating the kind of interdisciplinary approach that is the bedrock of bioethics. I conclude by suggesting future areas of research and recommendations. (shrink)

In this paper, the authors consider the idea of the public biobank governance framework with respect to the innovative paradigm of One Health. The One Health initiative has been defined as an integrative and interdisciplinary effort to improve the lives and well-being of human beings and non-human animals, as well as to preserve the environment. Here, we use this approach as a starting presumption with respect to institutional design. We examine the theoretical and legal framework underlying the concept of biobanking (...) that, being public orientated, is _for the public good_. We suggest that this account of research practice does not ethically correlate with One Health principles. Instead, we argue that One Health requires a model of biobanking that is based on universal goods, that is, goods that serve human beings as well as non-human animals and the environment, and which we define in detail. Our purpose is to begin a discussion on how One Health principles might be implemented in health initiatives. (shrink)

One of most pertinent and acute risks that the world is now facing is emerging or re-emerging zoonotic diseases. This article focuses on culling as a measure for zoonotic disease control, specifically the culling of 11,000 badgers as part of the Randomized Badger Culling Trial in the UK and the culling exercises in Singapore. The independent expert panel that devised the UK study concluded that reactive culling was ineffective in reducing the cases of bovine tuberculosis in cattle. The panel also (...) concluded that proactive culling was not cost-effective. Behind the scarcity of empirical evidence to support culling, the resultant reduction in biodiversity can actually harm both animals and humans. Public health policies should be evidence-based, culturally adaptable and ethically justified; a novel biomedical and public health approach, named One Health, plausibly provides a reasonable ethical framework as well as research and interventional methods that square with that framework. OH recognizes that nonhuman animals and humans are interlinked in both sickness and health, since we all share the same ecosystem. OH could potentially replace standard public health strategies, as it provides alternative evidence-based methods for biomedical research and adds a non-anthropocentric component to an ethical decision-making process. (shrink)

This paper argues in support of the WHO’s proposal to forego COVID-19 booster shots until 10% of people in every country are fully vaccinated. The Ethical Argument section shows that we save the most lives and ensure the least amount of suffering by allocating doses first to unvaccinated people. It also argues that there is a duty to support decent lives and to promote health equity, which establish that refraining from boosters is a requirement of justice, not charity. The Replies (...) to Objections section answers objections that appeal to pragmatism, nationalism, ownership, scientific advancement, self-interest, semantics and futility. The Conclusion section emphasizes that for now, wealthy nations should not boost vaccinated people’s immunity and should instead send doses to poorer nations where they are most urgently needed. No data was used in this study. (shrink)

ABSTRACT: Social robots are increasingly being deployed to address social isolation and loneliness, particularly among older adults. Clips on social media attest that individuals availing themselves of this option are pleased with their robot companions. Yet, some people find the use of social robots to meet fundamental human emotional needs disturbing. This article clarifies and critically evaluates this response. It sets forth a framework for loneliness, which characterizes one kind of loneliness as involving an affective experience of lacking human relations (...) that provide certain social goods. Next, the article discusses social robots and critically reviews the literature on the ethics of using them in light of this loneliness characterization. Third, we present a normative argument connecting the philosophical critique of loneliness-as-absence with the design and deployment of social robots. Finally, we draw out the implications of our analysis for public health and for interrogating the aims of commercial companies who make social robots. (shrink)

Many families of patients hold the view that it is their right to be present during a loved one's resuscitation, while the majority of patients also express the comfort and support they would feel by having them there. Currently, family presence is more commonly accepted in paediatric cardiopulmonary resuscitation than adult CPR. Even though many guidelines are in favour of this practice and recognise potential benefits, healthcare professionals are hesitant to support adult family presence to the extent that paediatric family (...) presence is supported. However, in this paper, we suggest that the ethical case to justify family presence during paediatric resuscitation is weaker than the justification of family presence during adult resuscitation. We go on to support this claim using three main arguments that people use in clinical ethics to justify FPDR. These include scarcity of evidence documenting disruption, psychological benefits to family members following the incident and respect for patient autonomy. We demonstrate that these arguments actually apply more strongly to A-FPDR compared with P-FPDR, thereby questioning the common attitude of healthcare professionals of allowing the latter while mostly opposing A-FPDR. Importantly, we do not wish to suggest that P-FPDR should not be allowed. Rather, we suggest that since P-FPDR is commonly allowed, so should A-FPDR. This is because the aforementioned arguments that are used to justify FPDR in general actually make a stronger case for A-FPDR. (shrink)

Culling is used in traditional public health policies to control animal populations. These policies aim primarily to protect human interests but often fail to provide scientific evidence of effectiveness. In this article, we defend the need to move from a strictly anthropocentric approach to disease control towards a One Health ethics, using culling practices as an example. We focus on the recent badger culls in the UK, claiming that, based on data provided by the English Government, these culls may be (...) unjustified, all thing considered. We highlight the relevance of ethical reasoning rooted in One Health for this discussion, and make several suggestions including a moratorium on culling until data are provided to support the effectiveness of culling; to conduct a randomized trial to compare proactive culling with alternative methods; to apply deliberative democratic methods to assess public opinion towards the culls, and to find in Brexit an opportunity for aiming for more effective control measures. (shrink)

Loneliness has been a major concern for philosophers, poets and psychologists for centuries. In the past several decades, it has concerned clinicians and public health practitioners as well. The research on loneliness is urgent for several reasons. First, loneliness has been and still is extremely ubiquitous, potentially affecting people across multiple demographics and geographical areas. Second, it is philosophically intriguing, and its analysis delves into different branches of philosophy including phenomenology, existentialism, philosophy of mind, etc. Third, empirical research has shown (...) that loneliness is a significant health risk factor. Loneliness may thus be defined as a (negative) social determinant of health.Having that said, COVID-19 has demonstrated how little we as members of humanity have been prepared to face the loneliness resulting from the global response to the virus. As people worldwide are literally dying from loneliness, we still do not know what makes one feel lonely while making another feel being in solitude, or how is it that one feels lonely in the heart of London.In this essay, I first review loneliness in general and specifically in the context of COVID-19. I then argue that loneliness should be understood as a social determinant of health. Lastly, I argue that individuals have a right not to be lonely. Such right stems in turn from the right to healthcare or even a right to health. (shrink)

Capps and Lederman, in a paper published in this journal in 2015, argued that, at the time, the dismal circumstances of the Ebola outbreak in West Africa was an opportunity to revisit public health responses to emergent infectious diseases. Using a One Health lens, they argued for an ecological perspective—one that looked to respond to zoonoses as an environmental as well as public health concern. Using Ebola virus disease as an example, they suggested shared immunity as a strategy to (...) vaccinate both humans and great apes. Since then, vaccination as a conservation strategy in this case has been debated and at least one great ape vaccination trial has been proposed: some, however, are less convinced of the ethical arguments to pursue vaccinating wild animals. Using this opportunity, we review Capps and Lederman’s arguments and directly respond to the plausible objections to them. (shrink)

This essay discusses and weaves together three interrelated topics: loneliness as a neglected bioethics problem, solidarity as one potential solution to loneliness, and the Israeli‐Palestinian Conflict as a neglected bioethics problem in which loneliness is stark. I first present and define various kinds of loneliness, focusing on ethical loneliness, defined as suffering injustice without a proper repair process. I next discuss current health conditions in Gaza, focusing on healthcare providers who, according to the UN, are being intentionally targeted by Israel. (...) I explain how the various kinds of loneliness are reflected among people in Gaza. I lastly relate together the notions of solidarity, responsibility and personal autonomy, arguing that bioethicists and healthcare providers have a duty to support the people in Gaza, stemming from solidarity and an extended responsibility perspective. (shrink)

In this essay we discuss an ethical dilemma that recently arose in our institution, involving healthcare workers who lamented the requirement to shave their facial hair as a condition to care for COVID-19 patients. The essay represents a genuine attempt to grapple with the dilemma sensibly and vigorously. We first provide a brief introduction, focusing on the tension between religious tolerance and the institutional obligation to optimize patient care and public health in the age of COVID-19. We then discuss the (...) complex relationship between facial hair and cultural as well as religious factors throughout history. Next, we make a case, based on several principles in Islam jurisprudence, that Muslim healthcare professionals in our institution should be expected to shave their facial hair so they could care for COVID patients. We end with considering two alternative solutions that were offered in the literature. (shrink)

Johnson and Degeling have recently enquired whether one health requires a comprehensive normative framework, concluding that such a framework, while not necessary, may be helpful. In this commentary, we provide a context for this debate, and describe how pragmatism has been predominant in the OH literature. We nevertheless argue that articulating a comprehensive normative theory to ground OH practice might clear existing vagueness and provide stronger guidance in relevant health dilemmas. A comprehensive theory will also be needed eventually to ground (...) notions such as universal good. We, thus, call for the systematic articulation of a comprehensive, metaethical theory, concomitantly with already ongoing normative work. (shrink)

Whether to allow the presence of family members during cardiopulmonary resuscitation has been a highly contentious topic in recent years. Even though a great deal of evidence and professional guidelines support the option of family presence during resuscitation , many healthcare professionals still oppose it. One of the main arguments espoused by the latter is that family members should not be allowed for the sake of the patient's best interests, whether it is to increase his chances of survival, respect his (...) privacy or leave his family with a last positive impression of him. In this paper, we examine the issue of FPDR from the patient's point of view. Since the patient requires CPR, he is invariably unconscious and therefore incompetent. We discuss the Autonomy Principle and the Three-Tiered process for surrogate decision making, as well as the Beneficence Principle and show that these are limited in providing us with an adequate tool for decision making in this particular case. Rather, we rely on a novel principle and a novel integrated model for surrogate decision making. We show that this model is more satisfactory in taking the patient's true wishes under consideration and encourages a joint decision making process by all parties involved. (shrink)

Several bioethicists have recently advocated the force-feeding of prisoners, based on the assumption that prisoners have reduced or no autonomy. This assumed lack of autonomy follows from a decrease in cognitive competence, which, in turn, supposedly derives from imprisonment and/or being on hunger strike. In brief, causal links are made between imprisonment or voluntary total fasting and mental disorders and between mental disorders and lack of cognitive competence. I engage the bioethicists that support force-feeding by severing both of these causal (...) links. Specifically, I refute the claims that VTF automatically and necessarily causes mental disorders such as depression, and that these mental disorders necessarily or commonly entail cognitive impairment. Instead, I critically review more nuanced approaches to assessing mental competence in hunger strikes, urging that a diagnosis of incompetence be made on a case-by-case basis—a position that is widely shared by the medical community. (shrink)

This article poses a response to one argument supporting the force feeding of political prisoners. This argument assumes that prisoners have moral autonomy and thus cannot be force fed in the early stages of their hunger strike. However, as their fasting progresses, their cognitive competence declines, and they are no longer autonomous. Since they are no longer autonomous, force feeding becomes justified. This article questions the recurrent citation of a paper in empirical support of the claim that hunger strike causes (...) mental disorders or cognitive impairments. The paper, written by Daniel Fessler, partially relies on the Minnesota Starvation Experiment conducted in 1944 to 1945 for scientific support. Using widely accepted criteria for assessing the ethical acceptability of clinical research, we argue that the Minnesota Starvation Experiment had significant scientific shortcomings and is a case of unethical research. From this, we question the appropriateness of citing the Minnesota Starvation Experiment and consequently Fessler’s paper. If Citing Fessler’s paper becomes problematic, this particular argument for the force feeding of prisoners loses much of its strength. (shrink)

Several months ago, an Israeli resident in emergency medicine engaged in a hunger strike to protest 26-hour shifts. His protest was part of a country-wide struggle of medical residents from all disciplines against such long shifts, arguing that they are a thing of the past, and that they harm patient care. While there is actually no evidence that long shifts harm patient outcomes, they very likely reduce civility among staff members and towards patients.1 Two kinds of strategies are possible to (...) address this likely source of incivility: expect and train residents to be kinder and more patient towards their peers and patients, or do away with long shifts. Therein lies the tension in implementing the case for civility made by McCollough et al 2 should we invest in agent-based or system-based interventions? Virtue ethics is prominent in discussions of the professional duties of healthcare providers (HCPs). A common theme that threads throughout these discussions is that HCPs ought to, or are expected to behave in a kind, patient and sensitive manner towards their peers and patients, …. (shrink)

The practice of solitary confinement (SC) is established within the literature as a common occurrence of torture within the prison system, and many international and national human rights organizations have called for its abolition. A somewhat more contentious topic in the literature is the practice of force feeding (FF) of hunger-striking prisoners. The paper aims to make a case against FF by establishing a parity argument that states the following: If SC is considered an immoral practice (and indeed it should (...) be), it should follow that FF is morally impermissible as well. In conclusion, this paper will argue that FF of hunger-striking prisoners is a violation of their fundamental moral rights and constitutes cruel and inhumane treatment and, therefore, should be abolished. (shrink)

This article argues that outbreak preparedness and response should implement a ‘family presence’ policy for infected patients in isolation that includes the option of physical visits and care within the isolation facility under some conditions. While such a ‘physical family presence’ policy could increase infections during an outbreak and may raise moral dilemmas, we argue that it is ethically justified based on the least infringement principle and the need to minimize the harms and burdens of isolation as a restrictive measure. (...) Categorical prohibition of PFP during the course of an outbreak or epidemic is likely to result in unnecessary harms to patients and families, and violate values such as the moral commitments of families to care for each other. Supporting the option of PFP under particular circumstances, on the other hand, will least infringe these moral considerations. An additional reason for a family presence policy is that it may facilitate voluntary cooperation with isolation and other restrictive measures. We provide an analysis of these considerations for supporting modes of family presence during an outbreak emergency, before defending the riskier option of PFP in the isolation facility from plausible objections and concerns. (shrink)

Active surveillance cultures and contact precautions is a strategy to control the transmission of methicillin-resistant Staphylococcus aureus (MRSA) within healthcare facilities. Whether to implement this strategy to routinely screen and isolate inpatients with MRSA in non-outbreak (endemic) settings, or to remove it and use standard infection control precautions only is scientifically and ethically controversial, in view of the potential adverse effects of contact precautions on patients. To support the use of standard precautions only, it has been argued that active surveillance (...) to identify patients who are asymptomatically colonised with MRSA to place them in contact precautions is unjust or unfair to these patients in various ways. This paper will unpack and examine four distinct arguments, which are advanced from a medical ethics or quality improvement ethical framework, for why this is so. Our analysis shows that while these arguments highlight the injustice of current practices, they do not provide strong ethical reasons for justifying the removal of active surveillance and contact precautions to control MRSA transmission and infection. An implication of our arguments is that the ethical frame for evaluating prevention and control strategies for MRSA, a multi-drug resistant bacteria, should shift from healthcare to primarily public health. From a public health ethics perspective, whether a strategy is unjust, or how ethically significant its lack of fairness is, depends on assessing the evidence for its public health effectiveness and necessity in a given setting, and the extent of the harms and burdens patients with MRSA bear when they are on contact precautions, which remain matters of scientific debate or uncertainty. As an ethical consideration in the debate, the chief normative implication of justice is to provide us further reasons to revise current active surveillance-contact precautions practices, and for the need for research and interventions to minimise their potential adverse effects on patients. (shrink)

Most professional guidelines advocate family presence during resuscitation (FPDR). Many clinicians, however, are still reluctant to implement this recommendation. In this article I present the most comprehensive case for FPDR to date. I review the little that has been written about the ethics of FPDR, as well as the available empirical evidence. More importantly, I present and defend three arguments for FPDR: adherence to professional guidelines, benefit to patients and relatives, and patients’ autonomy. I conclude with suggestions for future research.

Three thousand belligerents, mostly belonging to the military arm of Hamas, stormed Southern Israel on October 7th, 2023. Along with 3,000 rockets fired at Israel from Gaza, these belligerents inva...

Loneliness is ubiquitous and is bad for our health, making it a bioethical concern. It is perhaps true now more than ever before. Recent publications in bioethics have discussed loneliness in the context of responsibility, solidarity, and autonomy, especially relational autonomy. In this paper, I elaborate on the relation between solidarity and loneliness, proposing an account of loneliness as lack of solidarity. Some cases of loneliness, I argue, may be defined and explained by not having someone to identify with you (...) in some relevant aspect or without someone to assist you. I specifically use the work of George Orwell to make my case. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Full Collection of Personal NarrativesZohar Lederman, Ola Ziara, Rachel Coghlan, Oksana Sulaieva, Anna Shcherbakova, Oleksandr Dudin, Vladyslava Kachkovska, Iryna Dudchenko, Anna Kovchun, Lyudmyla Prystupa, Yuliya Nogovitsyna, Ghaiath Hussein, Kathryn Fausch, P. P. Kyaw, Ayesha Ahmad, Richard W Sams II, Handreen Mohammed Saeed, Artem Riga, Ryan C. Maves, Elizabeth Dotsenko, Irina Deyneka, Eva V. Regel, and Vita Voloshchuk• An Unsettling Affair• How We Keep Caring While Walking Through Our (...) Pain• Adjusting Laboratory Practices to the Challenges of Wartime• Why We Stay• A Semi-Personal Story from a Ukrainian NGO Professional (or a Semi-Professional Story from a Ukrainian Person) Living through the War• When Ethics Survives Where People Do Not: A Story From Darfur• Burma’s Healthcare Under Fire: My Experience as an Exiled Medical Professional• When a Conflict Collapses on a Child: An (Aborted) Medical Evacuation of a Hazara Toddler During the Kabul Airport Blast and the Taliban Takeover• The Vagaries and Vicissitudes of War• Providing Care to a Potential Aggressor: An Ethical Dilemma• One Surgeon’s Experience During Armed Conflict in Ukraine• The Limits of Our Obligations• A Liberating Breath• Soldiers of the Invisible Front: How Ukrainian Therapists Are Fighting for the Mental Health of the Nation Under Fire• Stories of Families with Chronically Ill Pediatric Patients during the War in UkraineCopyright © 2023 Johns Hopkins University Press... (shrink)

This paper argue that loneliness is a public health ethics issue and maps a research agenda for bioethicists.

Vaccine hesitancy or refusal has been one of the major obstacles to herd immunity against Covid-19 in high-income countries and one of the causes for the emergence of variants. The refusal of people who are eligible for vaccination to receive vaccination creates an ethical dilemma between the duty of healthcare professionals (HCPs) to care for patients and their right to be taken care of. This paper argues for an extended social contract between patients and society wherein vaccination against Covid-19 is (...) conceived as essential for the protection of the right of healthcare providers to be taken care of. Thus, a duty of care is only valid when those who can receive vaccination actually receive it. Whenever that is not the case, the continuing functioning of HCPs can only be perceived as supererogatory and not obligatory. (shrink)

In this paper, the author reports on a One Health trip to India that he recently led as part of Yale-NUS Learning Across Boundaries Program. It is an attempt not only to integrate OH education into non-medical programs but also to integrate environmental ethics education into OH curricula.

In lieu of an abstract, here is a brief excerpt of the content:An Unsettling AffairZohar LedermanAdults should not bury babies. Whenever that happens, you know something in the world has gone awry.Similarly to most Israeli Jews, I had to enlist in the military when I was 18. As part of my basic military training, I had to guard a certain settlement in the West Bank for two weeks. The drill was what we call “4–8”: four hours of guarding, eight hours (...) of rest. I was supposed to stand on my feet throughout my shift without eating, reading, or doing anything that might distract my attention. The terrorists are coming, we were told, and they are bloodthirsty. You can save lives! Well, not that of the terrorist, obviously.I did very little guarding during those two weeks. I was too busy coping with depression and loneliness, although I am only now aware of the latter. Desperately struggling to keep my head above water, I did what I could to survive. I read books, lots of books. I remember reading Nietzsche’s Zarathustra’s parable of one’s development in the desert. You start off as a lion, then a camel, and finally a child. If I could bestow only one piece of advice to my younger self, it would be to pack lightly, as even the camel’s back can only take so much. My laziness paid off. Nothing happened during that time. My older brother was kind enough to drive for an hour and bring me and my comrades the best candy Israel has to offer, and Coke. So I snacked, drank, and read.Two years later, I was called to the very same settlement as an emergency medical technician, just about to commence medical school. I was accompanied by my brother, who was then in paramedic school. We were in the midst of a family dinner in one of the too-many Jewish holidays. A terrorist attack occurred—a terrorist penetrated a house while everyone was asleep and shot everything that moved, including a male baby. Being only a couple of months old, his body occupied less than a quarter of the ambulance gurney. The upper part was bare; the lower part was wrapped in a diaper. There was no blood, no obvious visible signs of trauma on his body, except for a small hole in his right arm, just under the bicipital muscle, right where the brachial artery is.Talking about the ethics of futile care seems out of sync in such moments, even if I were aware then of the debate. When a baby is dying, you do everything to save him. Two fingers on the chest, 15 chest compressions, 2 breaths. That is what we had to do then, and that is what we did. Needless to say, the pale body did not respond. My brother and I drove the small body to the morgue. I could do nothing but stare at it throughout the 50-minute drive. There is something wrong in a world where this kind of thing happens. I promised the baby that I would fix it.I have not fixed it. But I have been trying.I am now an emergency medicine physician and a bioethicist. I have not been involved in other terrorist attacks since then, but I have seen my share. Some deaths feel natural and even due; others feel cruel, untimely, and unjust. The latter takes away a tiny bit of your soul and makes you question your role in the world. By being the best physician I can be, I hope to prevent future cruel, unjust, and untimely deaths, one person at a time. But there is only so much a physician can do.Similarly to others working in bioethics, my research spans several topics, from clinical to public health ethics. A few topics, however, are particularly close to my heart, and the Israeli occupation is one of them. The untimely death of the baby drives this passion.I could not save that baby. No one could. But as a physician and a privileged academic I can choose to channel my efforts to make them count towards preventing other cruel, untimely, and unjust deaths. Through... (shrink)

The argument advanced by Giubilini and Minerva is an important one, but it suffers from some shortcomings. I briefly criticise their reasoning and method and argue that after birth abortion should be limited largely to infants with disabilities. My argument is based not on solid scientific evidence or cold rational reasoning but on intuition, something that has long been discounted as irrelevant in biomedical discourse. I end with a recommendation to all of us: in order to make a change, one (...) should not only choose one’s battles, but also one’s weapon and mode of attack. (shrink)

BackgroundFamily presence during adult cardiopulmonary resuscitation is still not widely implemented. Based on empirical evidence, various national and international professional organizations recommend allowing relatives to be present during resuscitation. However, healthcare providers worldwide are still reluctant to make it standard care.PurposeThis paper is a part of an ongoing cross-cultural study that aims to solicit attitudes of healthcare providers working in emergency departments towards family presence during cardiopulmonary resuscitation. This paper reports the qualitative data from surveying healthcare providers working in an (...) emergency department at a university-affiliated hospital in Singapore.MethodHealthcare workers were asked to fill out an online survey, including both quantitative and qualitative questions. Their attitudes were critically analyzed and compared with existing empirical data.ResultsMajority of healthcare workers believed that relatives should not be present during c... (shrink)

In a recent article, Joel Marks presents the amoralist argument against vivisection, or animal laboratory experimentation. He argues that ethical theories that seek to uncover some universal morality are in fact useless and unnecessary for ethical deliberations meant to determine what constitutes an appropriate action in a specific circumstance. I agree with Marks’ conclusion. I too believe that vivisection is indefensible, both from a scientific and philosophical perspective. I also believe that we should become vegan (unfortunately, like the two philosophers (...) mentioned by Marks, I too am still struggling to reduce my meat and dairy consumption). However, I am in the dark as to Marks’ vision of normative deliberations in the spirit of amoralism and desirism. (shrink)

The dilemma of whether to allow relatives to see or even touch their loved one while she undergoes cardiopulmonary resuscitation has been discussed for roughly four decades. However, Family Presence During Adult Resuscitation is still not widely implemented. In this paper, I espouse relational autonomy to make a case for a clinical approach of family-centered care and FPDR. In recent years, family-centered care has gained increasing support. I argue that relational autonomy provides a conceptual framework for both FCC and FPDR. (...) In turn, FCC provides a plausible clinical approach to justify FPDR, while the empirical evidence that supports FPDR provides a useful example to justify FCC. (shrink)

This article examines the Israeli government’s role in supporting living conditions conducive to health in the occupied Palestinian territories. Limiting the discussion to public health, the authors argue that—whether justified in its overall political policy—the Israeli government and people are legally and ethically obligated to care for the well-being of the Palestinian people. The authors first review the current situation in the OPT and compare health statistics with Israel. Next, the authors make three arguments as to why the Israeli government (...) and citizens should assist the Palestinian people: moral responsibility, legal responsibility and solidarity. Based on these, the authors make the case for Israel’s moral duty to ensure that Palestinian people living in the OPT achieve equitable levels of health as compared to Israeli citizens, while minimizing restrictions on Palestinian self-determination. The authors urge the Israeli government and citizens to improve Palestinian’s daily living conditions, tackle inequitable distribution of power and allow international support in these efforts. Hospital Admission must therefore be open to every patient that needs it, irrespective of whether he has money or not, whether he be Jew or heathen. (shrink)

In this article we articulate a case from moral responsibility to assist Palestinians living in the Occupied Palestinian Territory (OPT). We contextualize this responsibility by focusing on access to healthcare and the provision of vaccines against COVID-19. We specifically present two arguments from responsibility, one that is global or cosmopolitan, and one that is country-specific. For the latter, we focus on Israel.

In this article we articulate a case from moral responsibility to assist Palestinians living in the Occupied Palestinian Territory (OPT). We contextualize this responsibility by focusing on access to healthcare and the provision of vaccines against COVID-19. We specifically present two arguments from responsibility, one that is global or cosmopolitan, and one that is country-specific. For the latter, we focus on Israel.

In this article we articulate a case from moral responsibility to assist Palestinians living in the Occupied Palestinian Territory (OPT). We contextualize this responsibility by focusing on access to healthcare and the provision of vaccines against COVID-19. We specifically present two arguments from responsibility, one that is global or cosmopolitan, and one that is country-specific. For the latter, we focus on Israel.

Hastings Center Report, Volume 52, Issue 5, Page 6-7, September–October 2022.