Bioethics: “The Science of Survival”?

Stoeklé, Henri‐Corto; Ivasilevitch, Achille; Hervé, Christian

doi:10.7202/1087220ar

Cited by 4 publications

(6 citation statements)

References 9 publications

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“…We identified and tried to resolve one main bio-ethical issue: vaccination policy. More precisely, according to our bioethical theory [ 13 ], and method (Table 1 ), we characterized a major tension between “the recommendation of anti-COVID-19 vaccination” (a new clinical practice) and “free will” (a moral value), but also the duty to “protect each other” (a moral standard). Mandatory vaccination could resolve this tension, at least in France, with positive effects on the quality of life (i.e.…”

Section: Discussionmentioning

confidence: 99%

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From a voluntary vaccination policy to mandatory vaccination against COVID-19 in cancer patients: an empirical and interdisciplinary study in bioethics

et al. 2022

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Background At the start of 2021, oncologists lacked the necessary scientific knowledge to adapt their clinical practices optimally when faced with cancer patients refusing or reluctant to be vaccinated against COVID-19, despite the marked vulnerability of these patients to severe, and even fatal forms of this new viral infectious disease. Oncologists at Foch Hospital were confronted with this phenomenon, which was observed worldwide, in both the general population and the population of cancer patients. Methods Between April and November 2021, the Ethics and Oncology Departments of Foch Hospital decided to investigate this subject, through an empirical and interdisciplinary study in bioethics. Our scientific objective was to try to identify and resolve the principal bio-ethical issues, with a view to improving clinical practices in oncology during future major pandemics of this kind, from a highly specific bio-ethical standpoint (= quality of life/survival). We used a mainly qualitative methodological approach based on questionnaires and interviews. Results In April 2021, 29 cancer patients refused or were reluctant to be vaccinated (5.6%; 29/522). Seventeen of these patients said that making vaccination mandatory would have helped them to accept vaccination. In October 2021, only 10 cancer patients continued to maintain their refusal (1.9%; 10/522). One of the main reasons for the decrease in refusals was probably the introduction of the “pass sanitaire” (health pass) in July 2021, which rendered vaccination indispensable for many activities. However, even this was not sufficient to convince these 10 cancer patients. Conclusion We identified a key bio-ethical issue, which we then tried to resolve: vaccination policy. We characterized a major tension between “the recommendation of anti-COVID-19 vaccination” (a new clinical practice) and “free will” (a moral value), and the duty to “protect each other” (a moral standard). Mandatory vaccination, at least in France, could resolve this tension, with positive effects on quality of life (i.e. happiness), or survival, in cancer patients initially refusing or reluctant to be vaccinated, but only if collective and individual scales are clearly distinguished.

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Section: Discussionmentioning

confidence: 99%

“…happiness] and/or the survival of the individuals and/or societies directly or indirectly concerned by these practices, and the social and complex phenomena that they constitute. ”[ 13 ]. We focused here on the quality of life (i.e.…”

Section: Methodsmentioning

confidence: 99%

From a voluntary vaccination policy to mandatory vaccination against COVID-19 in cancer patients: an empirical and interdisciplinary study in bioethics

et al. 2022

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“… 21 We consider bio‐ethical issues to be, first and foremost, tensions between moral values or standards and medical or scientific practices. 22 The identification and evaluation of these issues and possible solutions are based on the experience of practitioners, scientific knowledge, and actual and potential effects on the quality of life—or happiness—and survival of people and societies affected by the presence, absence, or quality of these practices, taking environmental concerns and cultural differences into account. 22 Here, we focus principally on the quality of life (i.e., happiness) and survival of cancer patients, their families and oncologists, mostly at hospital level.…”

Section: Methodsmentioning

confidence: 99%

Bio‐ethical issues in oncology during the first wave of the COVID‐19 epidemic: A qualitative study in a French hospital

Stoeklé

Ladrat

Landrin³

et al. 2022

Evaluation Clinical Practice

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Background Using a specific bioethical theory (=global bioethics) and method (=a posteriori), we try here to identify and evaluate the bio‐ethical issues raised by the COVID‐19 pandemic, and possible solutions, to improve the management of cancer patients at the hospital in future pandemics, before the emergence of vaccines or scientifically validated treatments. Materials & Methods Our work is based primarily on the clinical experience of three oncologists from the oncology department of Foch Hospital in France, who were on the frontline during the first wave of the epidemic. We compared their perceptions with published findings, to complete or nuance their views. Results Three bio‐ethical issues were identified, and possible solutions to these problems were evaluated: (1) scientific evidence versus lack of time → the creation of emergency multidisciplinary team meetings (MTM); (2) healthcare equality versus lack of resources → the development of telemedicine; (3) individual liberties versus risk of contamination → role of cancer patients' associations, psychologists and bioethicists. Conclusion We consider the creation of an emergency MTM, in particular, in addition to a true ethics committee with real competence in bioethics, to be a first solution that would be easy to implement in hospitals in many countries.

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“…This request led to the scheduling of the so-called "emergency" multidisciplinary team meeting (MTM), the principle of which was subsequently described in various scientific journals. 4,[5][6][7][8][9][10][11][12][13][14][15][16][17][18] The general idea was to expand the fields of competence and knowledge of "classic" MTMs, 19 which are limited to only a few medical specialties (e.g. oncology, radiology, etc.…”

Section: First Wave Of the Covid-19 Pandemicmentioning

confidence: 99%

“…3 This is, indeed, what we have tried to do at Foch Hospital, 4,5 through an ethical theory, and precise research methodologies, focusing more on the future than the present. 6…”

Section: Introductionmentioning

confidence: 99%

Bioethics after the COVID-19 pandemic: More research, fewer committees?

Stoeklé

Hervé

2022

Clinical Ethics

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In the face of the pandemic, bioethics, once again, proved its scientific utility. In France, in particular, the academic approach (= peer-reviewed, scientific publications, etc.) should be given priority over the institutional approach (= public surveys, public meetings, etc.), in hospitals, research institutes, universities, and companies, with the professionalization that this would imply (i.e. bioethicists).

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Bioethics: “The Science of Survival”?

Cited by 4 publications

References 9 publications

From a voluntary vaccination policy to mandatory vaccination against COVID-19 in cancer patients: an empirical and interdisciplinary study in bioethics

From a voluntary vaccination policy to mandatory vaccination against COVID-19 in cancer patients: an empirical and interdisciplinary study in bioethics

Bio‐ethical issues in oncology during the first wave of the COVID‐19 epidemic: A qualitative study in a French hospital

Bioethics after the COVID-19 pandemic: More research, fewer committees?

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