Dignity, Health, and Membership: Who Counts as One of Us?

Pilkington, Bryan

doi:10.1093/jmp/jhw001

Cited by 10 publications

(6 citation statements)

References 26 publications

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“…Though there are a variety of ways to think about members of communities and a variety of ethical concepts in which a prioritization (or heavy weighting) of members of communities could be supportede.g., rights, liberties, respect for autonomy, justice, et ceterafor the purposes of IHEs, we find the concept of dignity to be the most useful. Though the concept and the normative implications for taking it seriously have both been described in different ways, we focus on two features of one account of dignity (Pilkington 2016), which highlight that respecting the dignity of a community memberand for our purposes, the member of a community which the IHE servesrequires avoiding the humiliation of those members and also affording those members the necessary opportunities in virtue of the kinds of beings that they are. That is to say that when members of learning communities are humiliated or denied certain opportunities, their dignity is violated.…”

Section: Dignitymentioning

confidence: 99%

Educating ethically during COVID-19

Pilkington

Wilkins

Nichols

2021

International Journal of Ethics Education

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One of the perplexing features of an infectious disease is the damage it causes, not only to physical health, but to mental health and to social relationships. This tension between the separation that is required for safety and the human need for contact is especially felt by institutions of higher education. Many such institutions not only educate students but seek to foster the kinds of communities which have thrived on personal interaction and shared physical space. Different institutions have responded to COVID-19 and its impacts on their members differently. Given that the spring semester will begin months before COVID-19 vaccines are widely available, we offer seven recommendations and argue that for a university, college, or other similarly situated educational institution to ethically respond to the pandemic, it must follow these recommendations. These recommendations are grounded in both scientific research and ethical analysis. Proper ethical analysis, which is necessary for the implementation of good policies, cannot be accomplished without an evidence-based grounding. After describing features of the virus and the situation that faces higher education institutions, in general, we turn to a detailed discussion of transmission. We discuss interventions available to institutions, including masking, hygiene, barriers, and testing and surveillance. Our recommendations are supported by an ethical analysis reliant on four themes: expertise, planning, stewardship, and dignity.

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Section: Dignitymentioning

confidence: 99%

Educating ethically during COVID-19

Pilkington

Wilkins

Nichols

2021

International Journal of Ethics Education

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“…Perhaps the barrier to policy change emanates from a manifestation of an us-versus-them attitude. Related, Pilkington ( Pilkington, 2016 ) employs an us/we-versus the/them approach with regard to medicine. We intimately care for our own health and for those we care about the most.…”

Section: Barriers and Opposition To Policy Changementioning

confidence: 99%

Values-Based Foundation for a U.S. Single Payer Health System Model

Markowitz

McLeod-Sordjan

2021

Front. Sociol.

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A universal, single payer model for the American health system aligns with and should emanate from commonly held values contained within the country’s foundational religious teachings, morals, ethics and democratic heritage. The Affordable Care Act in its attempt to create expanded health access has met with significant challenges. The conservative Supreme Court decreases the likelihood of a federal mandated single payer model. As uncertainty of the structure of the healthcare system increases, this paper supports its transformation to a single payer model. Healthcare should be considered a duty within the framework of a Kantian approach to ethics and a social good. Evidently ignoring this duty, the American health system perpetuates a healthcare underclass, with underserved portions of the population, with unequal access to quality care and persistent health status and outcome disparities. The COVID-19 pandemic demonstrated the effect of social determinants on optimal health outcome. A health insurance system based on the nation’s commonly held values has the potential to eliminate these disparities.

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“…The fact that delayed time to administration resulted in increased mortality even with inclusion of this large subset of infants with CONS sepsis is notable, because multiple prior large studies in neonates have shown no association between CONS bacteremia/sepsis and mortality, [4][5][6][7][8] and no survival benefit to early empiric antibiotic treatment in infants identified to have CONS bacteremia. 9,10 The authors declare no conflicts of interest.…”

Section: Every Minute Counts: the Urgency Of Identifyingmentioning

confidence: 99%

From Iowa: Cautious Optimism?

Carter

2020

The Journal of Pediatrics

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I n their report from the University of Iowa Hospitals and Clinics, Watkins et al 1 give what may be viewed as hopeful information on the outcomes of infants born between 22 and 25 weeks of completed gestation. Although limited to a single site, and retrospective in nature, their cohort represents perhaps the largest of infants born in this periviable period (n = 255). Indeed, the cohort of infants born at 22-23 weeks of gestation is the largest such cohort from North America, Australia, or Europe (n = 70), with a remarkable survival to hospital discharge of 78%. Their further demonstration of improved outcomes at 18-22 months of adjusted age, with better than 60% of survivors having no or mild neurodevelopmental impairment, certainly exceeds published norms. 2,3 These figures alone may cause many to beg for what the secret to their success might be. They provide some clues: the consistent provision of antenatal steroids (ANS) by obstetricians and the unwavering active resuscitation of babies by neonatologists, or neonatology fellows, when requested by parents. We are told that all these babies were inborn, assisted by high-frequency ventilation, and cared for in a specialized environment within, but separate from, the remainder of the neonatal intensive care unit (NICU) and by a special dedicated staff. However, other factors also must have contributed over the 10 years of the study's reflection, and these should be published in greater detail. Since the report by Rysavy et al 4 in 2015, the variability in resuscitation and survival of babies from 22-25 weeks of gestation has been well documented. This variability exists elsewhere in the world and is contributed to by many factors. At times resource limitations are cited, 5 as may be guidelines from professional societies 2-although what such guidelines should state remains debatable 6-and attention to perceived infant pain, suffering, and a poor quality of life both in the NICU and, for the many who survive with impairments, throughout their lives. 2,3 The study by Watkins et al would suggest that at least the latter 3 concerns are not insurmountable. And, in America, the resource use matter may be moot, especially given the very small proportion of births occurring between 22-25 weeks of gestation (here note there were only 20 infants born at 22 weeks and 50 at 23 weeks over the 10 years of the Iowa cohort). Yet these results urge caution. If there was an increasing survival and decreasing morbidity over the 10 years reported,

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Dignity, Health, and Membership: Who Counts as One of Us?

Cited by 10 publications

References 26 publications

Educating ethically during COVID-19

Educating ethically during COVID-19

Values-Based Foundation for a U.S. Single Payer Health System Model

From Iowa: Cautious Optimism?

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