DMEJ

   Duke Medical Ethics Journal   

Fall 2021 Blog Highlights

The Mental Pressures of Re-entering the Real World

Dhanasheel Muralidharan  •  October 10

"It’s been well over a year and a half since the world went into lockdown and the average day for everyone completely changed. We lost the ability to see our friends and families face-to-face and the ability to do countless day-to-day activities. But as we slowly adjusted to our isolation bubbles, we adapted and quickly learned how to traverse life through the internet without human contact. However, as we now enter into the latter part of 2021, the world around us is finally returning to some sense of normalcy. Businesses and restaurants are welcoming customers, Zoom meetings are becoming in-person ones, and students are returning to their classrooms. Yet, no matter how “normal” life may seem, it is impossible to pretend that this pandemic hasn’t radically altered the world we live in..."

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COVID and Minority Mental Health

Riya Mohan  •  October 10
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"The COVID pandemic has brought many changes to the way we live our lives. One of the biggest advances has been destigmatizing mental health issues in a way that couldn’t be achieved in decades past. However, studies show that high levels of stigma towards mental health care continue to persist in minority communities. Culturally sensitive care, or the ability of systems to provide care to patients with diverse backgrounds, will create a sustainable solution to this disparity and can be achieved by including more diversity within the medical health spaces and by utilizing updated pedagogy at multiple levels of the medical community..."

Camille Krejdovsky  •  October 17

"Over the past several months, life in the US has begun to resemble some form of post-COVID normalcy. With air travel rebounding, sporting venues reopening, and concerts on the horizon, life is beginning to look a lot more like pre-January 2020 times. The current COVID-19 vaccines have facilitated this, allowing many to go about their daily lives with a greater sense of security, knowing that their risk of severe illness is lowered. In some instances, the white paper vaccine card has become a sort of ticket to freedom, with many leisure venues requiring it for entry..."

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Talia Goodman  •  October 17
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"No one wants a new normal, but the presence of COVID-19 requires a new normal. Vaccines appear to be the first step in returning the world to its former state. Globally, 6.6 billion doses have been administered, and 23.17 million are distributed each day. As of October 14, 2021, over 187 million Americans, or 56.6% of the total U.S. population, have been vaccinated against COVID-19 [1]. The United Arab Emirates leads the world in vaccine rates, with 94.83% of their population being vaccinated, and Tanzania lies at the bottom of the list with only 0.97%. Countries like the UAE and the United States give the appearance of progress towards normalcy, but the majority of the world does not have access to the same resources. Only 2.5% of people in low-income countries have received at least one dose [2]. Inequity in vaccine distribution makes the idea of vaccine passports, certifications of vaccination that reduce public health restrictions for their bearers, unfair..."

Disability, COVID-19, and the Medical System

Ishaan Brar •  October 24

"People with disabilities represent the largest minority in the United States, yet coverage on the pandemic rarely considers an analysis of how disabled people were affected by COVID - 19. Broadly, this lack of coverage is just one way by which ableism, discrimination against disabled individuals, manifests. Broadly, the COVID - 19 pandemic demonstrates the way by which ableism manifests itself as a system of power both in general society within healthcare systems. It's critical the field of medicine interrogates itself and shifts the paradigm by which it views care..."

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Annie Vila  •  October 24

"It’s 2021, and, for many of us, it is starting to feel like we are getting past the toughest part of the Covid-19 pandemic. People are getting vaccinated, and while mask mandates are still encouraged and enforced in many areas, they are starting to become less prevalent in vaccinated populations. This is what we’ve all been wishing for since the pandemic first began. Unfortunately, this is not the case for many patients and victims of Covid-19. Long Covid: what is it, what causes it and who does it affect?"...

Unethical Health Practices in US Prisons

Avijit Singh •  October 31

"The criminal justice system is littered with inequality: from predatory probation and parole, racial disparities in sentencing, and blanket impunity for police violence, many working in this space find it so morally repulsive that it’s sometimes referred to as the criminal “injustice” system (Harvard, 2021). This broken system is not free of ethical problems in a medical context, with utter neglect often assigned to the health of those held within prisons and jails. Incarcerated people are viewed as completely expendable: subhuman objects with an expiration date that has been predetermined through cruel and inhumane practices. As a consequence of this, their fundamental right to access equal and fair healthcare is undermined. Lawmakers have done little to no work to address these deep-rooted issues, and the onus is on us within the medical field to raise the alarm and stop the blatant mistreatment of our brothers and sisters within US correctional facilities..."

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Abby Cortez •  October 31

" Polio, measles, smallpox. Many people today don't give these deadly diseases a second thought. Since the development of the polio vaccine in the 1950s, immunizations have prevented many devastating viral infections.​​

Humans have been creating vaccines for years, and we get at least one every year when flu season comes around. What’s special about the COVID shot?.."

Hospital Overflow is Far From Over: Patients Are Returning to Regular Care on Top of COVID-19 Influx

Abby Cortez •  November 10

"For nearly two years, the COVID-19 pandemic has overwhelmed hospitals across the country. The mass influx of patients took its toll on things like resources and nurses. But coronavirus patients weren’t the only people sick in 2020; they were just the only ones seeking care. The CDC reported that 41% of American adults delayed or simply avoided medical care due to the pandemic. Some even avoided basic care and screenings. In Austin, Texas mammograms were down 90%, and according to TIME, about 15% of Americans skipped specialist appointments like cardiologists. These are concerning numbers considering cancer and heart conditions are deadly; what’s further concerning is that as many as 12% of those patients did not seek emergency care..."

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Impact of the Pandemic on Minorities

Marilyn Perez •  November 10
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"How has COVID-19 affected you? For many, the answer could include quarantine, working from home, virtual schooling, and more subtle changes in their daily routine. However, some populations have been more adversely affected by the changes the pandemic has brought, including several ethnic minority groups.

 

For that matter, the hospitalization and deaths for minority populations has been up to 3 times the rate of white and non-minority identifying populations1. In the Durham community alone, the Hispanic/Latinx population has accounted for 27.01% of COVID cases in the previous months while Black/African American communities accounted for almost 39.55% of COVID cases2. However, the Hispanic/Latinx community accounts for only 14% of the total Durham County population, while Black/African American communities account for 37% of Durham County. This discrepancy in numbers demonstrates how minorities are more profoundly affected by COVID in the county that we reside in..."

Do You Need the COVID-19 Booster? Is it Ethical to Get a Third Dose When Many Have Not Had a First?

Morgan Robinson  •  November 14

"Ever since the dreadful March COVID pandemic shut down, there has been one hot topic on the news and everyone's minds: the COVID-19 vaccine. When would it be made? Who would be able to get it? Would it be effective?

Thankfully, we are now months out from this time of heightened uncertainty and the vaccine has been developed, tested, and implemented relatively well, bringing the world to some sense of normalcy. However, questions have recently been raised regarding the necessity and ethicality of the COVID-19 booster shot..."

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Liquid Gold at the End of the Rainbow: What the COVID-19 Pandemic Has Done for MSM Blood Donations

Simone Nabors  •  November 21
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"At the height of the first wave, the plasma from recovered COVID-19 patients was in high demand. A treatment known as plasma-derived therapy was introduced from the antibodies present in the plasma of those who had recently recovered from COVID. This plasma could be donated and used as a treatment for someone actively battling the virus (1). Due in part to its color and value, this plasma became colloquially known as “liquid gold,” but what happens when this gold is found at the end of a rainbow?

For men who have sex with men (MSM), donating their potentially lifesaving plasma isn’t as simple as walking into a donation center. As of April 2, 2020, the Food and Drug Administration’s policy on blood donations requires a deferral period of 3 months “for a man who has had sex with another man during the past 3 months” (2). To clarify, this means that any MSM who wish to donate their blood, including those who are in long-term, monogamous relationships, must remain celibate for 3 months prior to donation. This is an update from their previous lifetime and 12-month bans..."

Victims and Vectors: The Ethical Implications of      Covid-19 Surveillance Testing

Makayla Gorski •  November 21

"Due to the fact that the field of bioethics, or the study of ethical issues as they relate to biomedical research, emerged at a time when infectious disease was not of high pertinence, there exists a lack of guidance for how to ethically conduct associated, health-related interventions.1 This issue came to fruition in the months following March of 2020, as the Covid-19 pandemic evolved and considerable opposition to public health interventions such as mask mandates and vaccinations commenced. Now, in a society in which mask usage and vaccination are more normalized, continued efforts to maintain public health have turned to the surveillance testing of asymptomatic individuals. From confidentiality, to autonomy, to informed consent, to familial risks, to a clinician’s duty-to-warn, there is an array of ethical implications associated with Covid-19 testing as the pandemic slowly progresses towards the endemic stage. For the sake of brevity, this blog post will focus on the ethics of obligatory testing as well as the potential threat of DNA privacy associated with the collection of testing samples—both as they pertain to testing in the United States and Duke University..."

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