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by Henri-Corto Stoeklé Ph.D., Asmahane Benmaziane M.D., Philippe Beuzeboc M.D., Christian Hervé, M.D., Ph.D.

In a letter published in The American Journal of Bioethics, we wrote now really isn’t the time for ethical reflections in the face of COVID-19. This did not mean that nothing should be done to help clinicians in this time.

We believe that the development of specific multidisciplinary team meetings (MTMs), well known in oncology, could be vital. Actually, at the request of the clinicians themselves, we have created a new entity of this type at Foch Hospital in France.

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by Joyeeta G Dastidar, MD

In New York City, the epicenter of the COVID-19 pandemic in the country with a quarter of the nation’s cases, hospitals prepared for ventilator shortages. This included the development of ventilator allocation guidelines and, in some institutions, appointments of triage allocation committees to help determine who would get a ventilator if there was an inadequate supply of ventilators. While there was much debate and discussion over triage guidelines, ultimately in New York City, due to a lack of supportive legislation at the state or federal levels, resource allocation guidelines and committees were not utilized.

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by Fernando Hellmann, Ph.D.,  Silvia Cardoso Bittencourt, Ph.D., Fabíola Stolf Brzozowski, Ph.D., Mirelle Finkler, Ph.D.,  Marta Verdi, Sandra Caponi, Ph.D.

 In times of crisis, like the current pandemic of COVID-19, the perception that ethical standards can be relaxed due to the urgent need for solutions is growing, according to Stoeklé and Hervé. For them, “Ethics is only useful if you have the time, and right now, time is exactly what we do not have.” It is a misperception without any doubts. Ethics has always preserved its identity as a rationalization of human action. Therefore, ethical reflections to take decisions are useful all the time and must be reinforced in times of pandemic.

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by Jing Wan,Yuqiong Huang, Amaneh Abdel Hafez Aljaafreh, Dandan Dong, Yali Cong , Jun Lin, Hongxiang Chen

COVID-19 is an emerging infectious disease that is extremely contagious and can cause serious consequences and even death. Convalescent plasma, an unregistered therapy, from which the antibodies might suppress the virus, has been proven effective in the treatment of SARS, Ebola and H1N1, without severe adverse events (Chen et al. 2020). It is unclear whether it can play a role or not in the emerging infectious disease COVID-19, but it may be a potential therapy (Chen et al.

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by Craig Klugman,PhD, Angira Patel MD, MPH, Nanette Elster, JD, MPH, and Dalia Feltman, MD, MA

The debate continues on when and how to open the country back up and allow communities to return to “normal”.  Consensus is lacking and there is significant variability across the country. The federal government rejected a CDC guideline for opening. Some states have come out with their own plans, and some states are just opening all the way through both governor orders and court decisions.

In many places, we have flattened the curve. However, flattening the curve now means moving more cases of COVID to later.…

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by Katharine Wright & Julian Sheather

Pratt et al. highlight important ways in which solidarity between researchers and communities provides both an ethical underpinning, and an ethical goal, for community engagement in global health research. We suggest that for the same reasons, the aspects of solidarity identified in the target article are essential to an understanding of what constitutes ethical research during a global health emergency, such as the current COVID-19 outbreak.

SOLIDARITY AS A BASIS FOR INTERVENTION IN GLOBAL HEALTH EMERGENCIES

In its recent report on research in such emergencies, the Nuffield Council on Bioethics categorizes health emergencies as “global” where they are unlikely to be successfully prevented, contained or managed by a single affected country, and external support is required.…

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by Jerry Menikoff, MD, JD

In a world with far too much dissonance, sometimes things nonetheless manage to come together. Such is the case regarding the article by Dickert and colleagues in this issue, “Partnering with Patients to Bridge Gaps in Consent for Acute Care Research”, and the recent changes in the Common Rule relating to improving research consent.

Dickert and colleagues’ work is a refreshing and very timely attempt at determining how we can improve informed consent for acute care clinical research trials. Their patient-centered approach was especially attuned to the challenges in these types of trials that are created by there being “time limitations, stress, and severe illness.” What I particularly want to highlight is how much overlap exists between the improvements suggested by the group put together by the authors, and the overall direction provided by the new Common Rule provisions regarding informed consent in general.…

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by Nneka O. Sederstrom, PhD, MPH, MA, FCCP

The data are clear: African Americans are becoming infected with the novel coronavirus and dying at a higher rate than White Americans. The rationale is clear: African Americans have higher rates of comorbid conditions than White Americans. The reason is clear: over 400 years of systematic racism, institutional oppression, and continued colorblindness have lead to this outcome. I know that seems like a simplistic explanation for something that is so very complex but it highlights the fundamental flaws we are facing in our guidelines. Clinical experts, from ethicists to bedside physicians, are baffled with what to do to manage this problem.…

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by Jonathan Moreno, Ph.D. and Arthur Caplan, Ph.D. 

For a moment, let’s suppose that the novel coronavirus was produced by a lab in Wuhan as a biological weapon, as some in the Trump Administration have alleged. In that fictional scenario, we have nothing to fear from utterly inept Chinese military planners:  They’d have developed a malign microbe that strikes mainly at old and sick people, not the healthy, young people who fight wars and power economies.

Smart medical warriors all know that there are already bugs in nature that don’t require any engineering that target the strong and youthful.  And nature provides plenty of bioweapons on its own. …

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by Alex Dubov, Ph.D. and Steven Shoptaw, Ph.D.

Introduction
As the world grapples with COVID-19, experts are calling for better identification and isolation of new cases. In this paper, we argue that these tasks can be scaled up with the use of technology. Digital contact tracing can accelerate identifying newly diagnosed patients, instantly informing past contacts about their risk of infection, and supporting social distancing efforts. Geolocation data can be used to enforce quarantine measures. Social media data can be used to predict outbreak clusters and trace the spread of misinformation online. These technology tools have played a role in turning the tide of the epidemic and easing lockdown measures in China, South Korea, and Singapore.…

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