Suchergebnisse

Die SARS-CoV-2-Impfung kann mit sehr hoher Wahrscheinlichkeit schwere COVID-19-Krankheitsverläufe und -Todesfälle verhindern und mit hoher Wahrscheinlichkeit die Übertragung der SARS-CoV-2-Infektion auf andere Personen verringern, sodass die Impfung eine sehr effektive oder vielleicht sogar die effektivste Strategie zur Bekämpfung der COVID-19-Pandemie darstellt. Dabei handelt es sich um eine Strategie, die mit vergleichsweise wenigen populationsbezogenen Nebenwirkungen und Schadenspotenzialen verbunden ist. Gerechtigkeitsethische Fragen ergeben sich allerdings im ganzen Verlauf der Anwendung dieser Strategie. Die Logistik der Impfung und die begrenzt verfügbaren Impfstoffe erfordern eine Priorisierung. Die zweite Frage, die Georg Marckmann in seinem Beitrag diskutiert, ist folgende: Wäre es angesichts der steigenden Impfraten nicht ethisch gerechtfertigt, selektiv Freiheitseinschränkungen zurückzunehmen für die Menschen, die bereits geimpft wurden und damit einen weitgehenden Schutz vor der COVID-19-Erkrankung erlangt haben? ; SARS-CoV-2 vaccination has a very high probability of preventing severe COVID-19 disease progression and death and a high probability of reducing transmission of SARS-CoV-2 infection to others, making vaccination a very effective, or perhaps the most effective, strategy for combating the COVID-19 pandemic. It is a strategy associated with comparatively few population-related side effects and potential for harm. Justice ethics issues arise, however, throughout the application of this strategy. The logistics of vaccination and the limited vaccines available require prioritization. The second question Georg Marckmann discusses in his paper is this: Given the increasing vaccination rates, would it not be ethically justified to selectively roll back restrictions on liberty for those people who have already been vaccinated and have thus gained extensive protection against COVID-19 disease?

Abstract
The selection and balancing of values for the Eurotransplant kidney allocation algorithm poses both practical and ethical challenges. The paper argues that any allocation algorithm can only be justified by reference to some substantive conception of a good life that reflects our value preferences regarding the allocation of scarce donor kidneys. It is concluded that the criterion of HLA compatibility maximizes overall rather than individual utility. The paper emphasizes that good pragmatic arguments for maintaining the primacy of HLA matching can never replace a more systematic, independent ethical justification. As neither the selection nor the balancing of the different allocation criteria are based on an explicit ethical justification, the paper concludes that the choice of the Wujciak-algorithm was rather a product of pragmatic compromise than moral consensus.

INTRODUCTION: Unlike issues in biomedical research ethics, ethical challenges arising in daily clinical care in Sub-Saharan African countries have not yet been studied in a systematic manner. However this has to be seen as a distinct entity as we argue in this paper. Our aim was to give an overview of the spectrum of clinical ethical issues and to understand what influences clinical ethics in the Sub-Saharan country of Gabon. MATERIALS AND METHODS: In-depth interviews with 18 health care professionals were conducted at three hospital sites in Gabon. Interview transcripts were analyzed using a grounded theory approach (open and axial coding), giving a qualitative spectrum of categories for clinical ethical issues. Validity was checked at a meeting with study participants and other health care experts in Gabon after analysis of the data. RESULTS: Twelve main categories (with 28 further-specified subcategories) for clinical ethical issues were identified and grouped under three core categories: A) micro level: "confidentiality and information", "interpersonal, relational and behavioral issues", "psychological strain of individuals", and "scarce resources"; B) meso level: "structural issues of medical institutions", "issues with private clinics", "challenges connected to the family", and "issues of education, training and competence"; and C) macro level: "influence of society, culture, religion and superstition", "applicability of western medicine", "structural issues on the political level", and "legal issues". DISCUSSION: Interviewees reported a broad spectrum of clinical ethical issues that go beyond challenges related to scarce financial and human resources. Specific socio-cultural, historical and educational backgrounds also played an important role. In fact these influences are central to an understanding of clinical ethics in the studied local context. Further research in the region is necessary to put our study into perspective. As many participants reported a lack of awareness of ethical issues amongst other health care professionals in daily clinical practice, we suggest that international organizations and national medical schools should consider infrastructure and tools to improve context-sensitive capacity building in clinical ethics for Sub-Saharan African countries like Gabon. ; peerReviewed