In this paper, I reflect on caring and witnessing through engaged ethnography of an urban poor community during the onset of the COVID19 pandemic. The urban poor are individuals and families who live below the poverty line in metropolitan areas, many of whom have little or no political voice and are insufficiently protected by social networks and other institutions. In March 2020, the government placed Metro Manila under Enhanced Community Quarantine to control the spread of COVID19. This left many an urban poor community in Metro Manila to struggle even more against an already precarious existence. By standard, nurses render different levels of care for urban poor clients in almost all health care settings. In public health nursing, we come in close contact to the realities of our clients when we see them in health centers, in the community, or whenever we do our home visits. Now, caring for vulnerable and marginalized groups such as the urban poor has changed due to minimum public health standards of wearing masks, physical distancing, handwashing, and enforcement of lockdowns. As a nurse, an academic, and as a student of anthropology, I came up for self-review while doing an article for a popular social news network derived from a virtually engaged ethnography. While this novel method requires you to see the world through the eyes of the “other,” and generates bioethical dialogue and awareness of personal biases in addressing ethical considerations and challenges, it gives voice and fulfills our roles as client advocates. In May 2020, the article was published with the urban poor organization and its partners as my coauthors. I borrowed from anthropology to arrive at a greater understanding of the socio-cultural effects and political implications of COVID19 to one of the most vulnerable nursing clientele – the urban poor.
Public Health Nursing ; Ethics, Research ; COVID-19

OBJECTIVES: The aim of this study was to introduce the concept of health inequalities, and to discuss the underlying assumptions and ethical backgrounds associated with the issue, as well as the theoretical and practical implications of health inequalities. METHODS: Based on a review of the literature, we summarize the concepts of health inequalities and inequities and discuss the underlying assumptions and ethical backgrounds associated with these issues from the view of social justice theory. We then discuss the theoretical and practical implications of health inequalities. RESULTS: Health inequality involves ethical considerations, such as judgments on fairness, and it could provide a sensitive barometer to reflect the fairness of social arrangements. Discussion on health inequalities could deepen our understanding of the social etiology of health and provide a basis for the development of comprehensive and integrative social policies. CONCLUSIONS: Health equity is not a social goal in and of itself, but should be considered as a part of a broader effort to seek social justice.
*Health Status Disparities ; Humans ; Korea ; Public Health/*ethics ; *Social Justice

Attitude to Health ; Civil Defense ; ethics ; Communicable Disease Control ; Communication ; Ethics, Medical ; Freedom ; Health Personnel ; ethics ; Health Planning ; ethics ; Health Priorities ; ethics ; Humans ; Influenza A Virus, H1N1 Subtype ; isolation & purification ; Influenza, Human ; epidemiology ; Mandatory Programs ; ethics ; Moral Obligations ; Pandemics ; ethics ; Patient Rights ; ethics ; Primary Health Care ; ethics ; Public Health ; ethics ; Public Health Administration ; ethics ; Resource Allocation ; ethics ; Singapore ; Trust

Biomedical Research ; ethics ; Human Rights ; Humans ; Public Health

Ethical considerations are essential in planning for and responding to outbreaks of infectious diseases. During the outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) in the Republic of Korea in 2015, serious challenges emerged regarding important ethical issues, such as transparency and the protection of privacy. The development of bioethics in Korea has been influenced by individualistic perspectives applied in clinical contexts, leading to a paucity of ethical perspectives relevant to population-level phenomena such as outbreaks. Alternative theories of public health ethics include the perspectives of relational autonomy and the patient as victim and vector. Public health actions need to incorporate clear and systematic procedures founded upon ethical principles. The MERS-CoV epidemic in Korea created significant public support for more aggressive early interventions in future outbreaks. This trend makes it all the more imperative for ethical principles and procedures to be implemented in future planning and responses to outbreaks in order to promote perceptions of legitimacy and civic participation.
Coronavirus Infections/*epidemiology/prevention & control ; Disease Outbreaks ; Humans ; Pandemics/ethics ; Public Health/*ethics ; Republic of Korea/epidemiology

OBJECTIVES: The traditional roles of psychiatrists are being threatened according to the changes of requests from society. Psychiatrists need to rapidly adapt to new upcoming circumstances, improve leadership skills, and prepare for emerging ethical problems. The aim of this study is to predict and suggest what will happen in the future in the area of mental health, what role models might be required, what we should do and how we can prepare. METHODS: The authors interviewed seven mental health professionals on topics of leadership, participating roles of psychiatrists. Three models for psychiatrists were suggested : clinical model, community leader model, and mental health promoting model. Afterwards, a questionnaire on each role model was distributed to members of the Korean Neuropsychiatric Association via email and results were analyzed. RESULTS: Experts and stakeholders suggested that the following components from the interview will be fostered in the future : leadership in collaboration with other communities, introduction of leadership programs for young psychiatrists, strategies for sensitization of ethical issues, active communication with community partners, training professionals in legislation and administration. Regarding the questionnaire, 32 members responded. The most preferred role model was the Community leader model (46.9%, n=15), followed by the mental health promoting model (34.4%, n=11) and clinical model (15.6%, n=5). Most responders recognized that these issues are emerging and answered affirmatively on the developmental potential of each role model. A question about primary agents who are supposed to take charge of development of a suitable model was answered as follows : university professors for the clinical model (37.5%, n=12), psychiatrists working for public hospitals both for community leader (28.1%, n=9), and mental health promoting model (43.8%, n=14). Various opinions on leadership and strategies for fulfilling the role model were proposed. CONCLUSION: This study investigated leadership, ethics, social roles, and future directions of psychiatrists in order to provide suggestions on how to properly respond to changes of environment. It is expected that this study will be helpful in establishment of guidelines for leadership development and improving ethical orientation of psychiatrists, and will provide an opportunity for Korean NeuroPsychiatric Association members to have deep consideration and radical debate on our transforming roles.
Cooperative Behavior ; Electronic Mail ; Ethics ; Ethics, Medical ; Ethics, Professional* ; Hospitals, Public ; Leadership* ; Mental Health ; Professional Role ; Psychiatry* ; Surveys and Questionnaires

Recent epidemics and pandemics have highlighted a number of ethical concerns about the response to the increasing threat of emerging infectious diseases. Some of these ethical concerns are very fundamental. They include why a pandemic was declared, how much clinical information can be collected for public health without threatening patient confidentiality and how to ensure fairness in the distribution of resources. We discuss these issues and suggest approaches to resolve these dilemmas as we anticipate the next pandemic.
Communicable Disease Control ; Communicable Diseases ; epidemiology ; Disease Outbreaks ; ethics ; Ethics, Medical ; Global Health ; Humans ; Pandemics ; ethics ; Public Health Practice ; ethics ; Quarantine ; Sentinel Surveillance ; Singapore ; epidemiology

The contents of educational goals and objectives of 32 Korean medical schools, that were listed in the Korean Medical Education Directory for 1994-1995, were analysed to help developing new educationa l goals and objectives. Regarding the professions in which the graduates of medical schools can be engaged, all of the 32 school were aiming at the medical doctor. 34.4% at the medical scientist, 28.1% at the medical educator, and 15.6% at the health administrator. Only 37.5% of the medical schools stated that their educational objective is training the primary physician and 50% of the schools did not specify the level of their graduates as a physician. The proportion of schools which stated that the medical student should learn in three domains of educational objectives, i.e. medical knowledge,clinical skills and attitude were 18.8% and 56.3% of the schools descirbed learning just in two domains of medical knowledge and skills which may reflect underating the importance of attitude. The proportions of knowledge and skills which may reflect underating the importance of attitude. The proportions of schools that stated aquiring the ability of holistic management of patients and self-learning/life long study in their educational objectives were 28.1% and 62.5%, respectively. The proportion of schools that emphasized on the medical ethics and morality was 93.8% and on cultivating human nature was 71.9%. These reflect that a high quality of ethics and morality was 93.8% and on cultivating human nature was 71.9%. These reflect that a high quality of ethics and human nature is required to the medical doctor. The universal and ultimate goal of human society and universities, such as democratic educational ideology, Korean educational ideology, prosperity of human society, promotion of human welfare, and improvement of public health, were included in the educational goals in 43.8% of the schools. As the primary goal of medical schools is the producing primary physicians, it is suggested to include the affective domain(attitude), cultivation of the capacity of self-learning and ability of holistic management of patients in the educational objectives of medical shools.
Administrative Personnel ; Education, Medical ; Ethics ; Ethics, Medical ; Human Characteristics ; Humans ; Learning ; Morals ; Public Health ; Schools, Medical* ; Students, Medical

OBJECTIVES: The objective of this paper is to discuss the importance of obtaining informed consent for conducting epidemiological studies and public health activities, based on the Report of the UNESCO's Working Group on Informed Consent. METHODS: The Report of the UNESCO's Working Group on Informed Consent was reviewed and discussed in connection with the ethical considerations of public health activities and epidemiological research. RESULTS: It was at the Nuremberg Trial for the German war criminals of the Second World War that the principle of 'consent' was first stated as a consequence of the medical abuses carried out during the War. As a result of the Trial, the Nuremberg Code came out in 1947. Since then, various international declarations or ethical principles on 'informed consent' have been developed and published. These ethical principles on 'informed consent' have mostly to do with the clinical research that involves human subjects, and not with epidemiological studies and public health activities. However, UNESCO recently issued a comprehensive Report on Informed Consent based on the Universal Declaration on Bioethics and Human Rights adopted in 2005, and this included detailed guidelines on informed consent in epidemiological studies and public health activities. CONCLUSIONS: Universal Declaration on Bioethics and Human Rights emphasizes the principle of autonomy to protect the human rights of the human subjects involved in any public health activities and epidemiological research. As a practical guideline, obtaining informed consent is strongly recommended.
*Bioethics ; Consensus ; Epidemiologic Studies ; *Human Rights ; Humans ; Informed Consent/*ethics/legislation & jurisprudence ; Public Health/*ethics/legislation & jurisprudence ; *United Nations

With the rapid spread of AIDS, the ethical issues of its prevention is intensify more and more, it mainly reflected in the four areas such as discrimination of disease and moral panic, individual rights and public health, privacy and right to know, social responsibility and behavior guidance. To resolve these ethical conflicts and safeguard legitimate rights of AIDS patients, we must adhere to love and tolerance, favorable and fair, the principles of autonomy and coordination, thus promoting AIDS prevention, maintaining social ethics and justice, equal and harmonious reconstruction of the ethical relationship.
Acquired Immunodeficiency Syndrome ; prevention & control ; psychology ; Communicable Disease Control ; Ethics ; Fear ; Humans ; Personal Autonomy ; Privacy ; Public Health ; ethics ; Social Discrimination ; ethics ; Social Responsibility