Background During the most critical phases of COVID-19 pandemic, dramatic situations were experienced in hospitals and care centers that nurses could hardly verbalize. Especially relevant were deep challenges related to terminal illness, situations of extreme sacrifice, as well as reflections on protective measures mixed with beliefs. We intend to analyze which problems had the greatest impact on professionals. Aim The aim is to explore the ultimate basis for action when making decisions and the orientation of their behavior in the face (...) of moral conflicts. Method The methodological strategy is an interpretive synthesis. Narrative review of academic articles that analyzed ethical dilemmas during the pandemic was carried out by searching five databases (Pubmed, Scopus, Psycinfo, CINHAL, and WOS) between January 2020 and December 2022. Finally, 43 articles were selected. Ethical Considerations Ethical requirements were respected in all study phases. Results The reading and review of the 43 articles initiated the first phase of inductive coding which resulted in 14 initial sub-themes. Based on this structure, a second phase of coding was carried out, giving rise to six categories or emerging themes. To facilitate the process of identifying the central category, the authors agreed to carry out a phase of synthesis, grouping the six themes into three meta-themes: the identification and acceptance of human vulnerability; the discovery of positive paradigms in traumatic situations in society; the prevalence of the common good over the particular interest, as the core structure of any society. Conclusion The study has shown the need to consider healthcare benevolence as a new dimension of health care upon global vulnerability. Responsibility is required to ensure the well-being of a global society, prioritizing the common good over particular interests and building solutions on solid moral structures. A new ethical landscape is essential, starting with a humanistic curricular training of all healthcare professionals. (shrink)

The COVID-19 pandemic has caused a global societal, economic, and social upheaval unseen in living memory. There have been substantial cross-national differences in the kinds of policies implemented by political decision-makers to prevent the spread of the virus, to test the population, and to manage infected patients. Among other factors, these policies vary with politicians’ sex: early findings indicate that, on average, female leaders seem more focused on minimizing direct human suffering caused by the SARS-CoV-2 virus, while male leaders implement (...) riskier short-term decisions, possibly aiming to minimize economic disruptions. These sex differences are consistent with broader findings in psychology, reflecting women’s stronger empathy, higher pathogen disgust, health concern, care-taking orientation, and dislike for the suffering of other people—as well as men’s higher risk-taking, Machiavellianism, psychopathy, narcissism, and focus on financial indicators of success and status. This review article contextualizes sex differences in pandemic leadership in an evolutionary framework. Evolution by natural selection is the only known process in nature that organizes organisms into higher degrees of functional order, or counteracts the unavoidable disorder that would otherwise ensue, and is therefore essential for explaining the origins of human sex differences. Differential sexual selection and parental investment between males and females, together with the sexual differentiation of the mammalian brain, drive sex differences in cognition and behavioral dispositions, underlying men’s and women’s leadership styles and decision-making during a global pandemic. According to thesexually dimorphic leadership specialization hypothesis, general psychobehavioral sex differences have been exapted during human evolution to create sexually dimorphic leadership styles. They may be facultatively co-opted by societies and/or followers when facing different kinds of ecological and/or sociopolitical threats, such as disease outbreaks or intergroup aggression. Early evidence indicates that against the invisible viral foe that can bring nations to their knees, the strategic circumspection of empathic feminine health “worriers” may bring more effective and humanitarian outcomes than the devil-may-care incaution of masculine risk-taking “warriors”. (shrink)

Insular populations have traditionally drawn a lot of attention from epidemiologists as they provide important insights regarding transmission of infectious diseases and propagation of epidemics. There are numerous historical instances where isolated populations showed high morbidity once a new virus entered the population. Building upon that and recent findings that the activation of the behavioral immune system depends both upon one’s vulnerability and environmental context, we predicted that, during the COVID-19 pandemic, place of residence explains a significant proportion of variance (...) in preferred interpersonal distances, animosity toward strangers, and willingness to punish those who do not adhere to COVID-19 preventive measures. With 48 populated islands, Croatia provides a fruitful testing ground for this prediction. We also opted to explore relations among BIS-related variables and social cognitions in a more natural context than has previously been done. The study was conducted online, on Croatian residents, during April and May 2020. As expected, the BIS variables contributed significantly to preferred interpersonal distances, negative emotions toward strangers, and willingness to punish those who do not adhere to COVID-19 preventive measures. Furthermore, our results showed that geographical location explained a significant amount of variance in preferred social distances and negative emotions toward foreigners. As Croatian islands are extremely frequent travel destinations, these differences between mainlanders and islanders cannot be explained by the lack of exposure to foreigners. Additionally, we found that scores on preferred interpersonal distances, pathogen disgust, and germ aversion were significantly higher compared to those obtained in Croatian samples before the COVID-19 pandemic. Furthermore, men scored higher in perceived infectability than before the COVID-19 pandemic, and women did not, which reflects the objectively higher risk of SARS-CoV-2 for men than for women. Taken together, our results support the notion that BIS is a highly adaptive and context-dependent response system, likely more reactive in more susceptible individuals. (shrink)