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Boateng OA. Biological citizenship through litigation: Ebola survivors in Sierra Leone and the suit to redefine corruption. CRITICAL PUBLIC HEALTH 2022. [DOI: 10.1080/09581596.2021.1999395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Palliative Care’s Role in Austere Medicine. Wilderness Environ Med 2022; 33:102-108. [DOI: 10.1016/j.wem.2021.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 11/28/2021] [Accepted: 12/09/2021] [Indexed: 11/20/2022]
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Nouvet E, Bezanson K, Hunt M, Kouyaté S, Schwartz L, Diallo FB, de Laat S, Bah-Sow OY, Diallo AA, Diallo P. Dying in honour: experiences of end-of-life palliative care during the 2013-2016 Ebola outbreak in Guinea. JOURNAL OF INTERNATIONAL HUMANITARIAN ACTION 2021; 6:10. [PMID: 38624820 PMCID: PMC8105689 DOI: 10.1186/s41018-021-00099-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 04/15/2021] [Indexed: 04/17/2024]
Abstract
With no cure and a high mortality rate, Ebola virus disease (EVD) outbreaks require preparedness for the provision of end-of-life palliative care. This qualitative study is part of a larger project on palliative care in humanitarian contexts. Its goal was to document and deepen understanding of experiences and expectations related to end-of-life palliative care for patients infected with Ebola virus disease (EVD) in West African Ebola treatment centres (ETCs) during the 2013-2016 epidemic. It consisted of 15 in-depth semi-structured interviews with individuals impacted by EVD in a Guinean ETC: either as patients in an ETC, healthcare providers, healthcare providers who were also EVD patients at one point, family relations who visited patients who died in an ETC, or providers of spiritual support to patients and family. Analysis was team based and applied an interpretive descriptive approach. Healthcare delivery in humanitarian emergencies must remain respectful of patient preferences but also local and contextual values and norms. Of key importance in the Guinean context is the culturally valued experience of "dying in honour". This involves accompaniment to facilitate a peaceful death, the possibility of passing on final messages to family members, prayer, and particular practices to enact respect for the bodies of the deceased. Participants emphasized several challenges to such death in Ebola treatment centres (ETCs), as well as practices they deemed helpful to alleviating dying patients' suffering. An overarching message in participants' accounts was that ideally more would have been done for the dying in ETCs. Building on participants' accounts, we outline a number of considerations for optimizing end-of-life palliative care during current and future public health emergencies, including for COVID-19.
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Affiliation(s)
- Elysée Nouvet
- School of Health Studies, Western University, London, Canada
| | - Kevin Bezanson
- Thunder Bay Regional Health Sciences Centre, Thunder Bay, Canada
| | - Matthew Hunt
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - Sekou Kouyaté
- Laboratoire Socio-Anthropologique de la Guinée, Conakry, Guinea
| | - Lisa Schwartz
- Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
| | - Fatoumata Binta Diallo
- Faculté des Sciences et Techniques en Santé, Université Gamal Abdel Nasser Conakry, Conakry, Guinea
| | - Sonya de Laat
- Global Health Program, McMaster University, Hamilton, Canada
| | | | - Alpha Ahmadou Diallo
- Ministry of Health, Republic of Guinea and Université de Conakry, Conakry, Guinea
| | - Pathé Diallo
- Centre Médical & Conseil en Santé (CEMECO), Conakry, Guinea
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Hedges CE, Rosoff PM. Transplants for non-lethal conditions: a case against hand transplantation in minors. JOURNAL OF MEDICAL ETHICS 2018; 44:661-665. [PMID: 29903852 DOI: 10.1136/medethics-2018-104819] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 05/18/2018] [Accepted: 05/31/2018] [Indexed: 06/08/2023]
Abstract
Human allografts for life-threatening organ failure have been demonstrated to be lifesaving and are now considered to be standard of care for many conditions. Transplantation of non-vital anatomic body parts has also been accomplished. Hand transplantation after limb loss in adults has been shown to offer some promising benefits in both functional and psychological measures in preliminary studies. It has been suggested to expand eligibility criteria to include minors, with one such operation having already been performed. With this in mind, we examine the current state of hand transplantation research in the context of available alternatives. We examine the ethics of carrying out these operations in minors, including under the protections of clinical research. We argue that children should not be considered for this surgery due to the substantial risks of immunosuppressive medication, the likelihood that the graft will need to be replaced during the patient's lifetime and the lack of significant compensatory advantages over modern prosthetics.
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Affiliation(s)
- Charles E Hedges
- Duke Initiative for Science and Society, Duke University, Durham, North Carolina, USA
| | - Philip M Rosoff
- Duke Initiative for Science and Society, Duke University, Durham, North Carolina, USA
- Trent Center for Bioethics, Humanities and History of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
- Departments of Pediatrics and Medicine, Duke University Medical Center, Durham, North Carolina, USA
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Knaul FM, Farmer PE, Krakauer EL, De Lima L, Bhadelia A, Jiang Kwete X, Arreola-Ornelas H, Gómez-Dantés O, Rodriguez NM, Alleyne GAO, Connor SR, Hunter DJ, Lohman D, Radbruch L, Del Rocío Sáenz Madrigal M, Atun R, Foley KM, Frenk J, Jamison DT, Rajagopal MR. Alleviating the access abyss in palliative care and pain relief-an imperative of universal health coverage: the Lancet Commission report. Lancet 2018; 391:1391-1454. [PMID: 29032993 DOI: 10.1016/s0140-6736(17)32513-8] [Citation(s) in RCA: 599] [Impact Index Per Article: 99.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 07/28/2017] [Accepted: 07/28/2017] [Indexed: 02/07/2023]
Affiliation(s)
- Felicia Marie Knaul
- Department of Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Coral Gables, FL, USA; Institute for Advanced Study of the Americas, University of Miami, Coral Gables, FL, USA; Sylvester Comprehensive Cancer Center, University of Miami, Coral Gables, FL, USA; Tómatelo a Pecho, A.C., Mexico City, Mexico; Fundación Mexicana para la Salud, A.C., Mexico City, Mexico.
| | | | - Eric L Krakauer
- Harvard Medical School, Boston, MA, USA; Massachusetts General Hospital, Boston, MA, USA; World Health Organization, Geneva, Switzerland
| | - Liliana De Lima
- International Association for Hospice and Palliative Care, Houston, TX, USA
| | - Afsan Bhadelia
- Institute for Advanced Study of the Americas, University of Miami, Coral Gables, FL, USA; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Xiaoxiao Jiang Kwete
- Institute for Advanced Study of the Americas, University of Miami, Coral Gables, FL, USA; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Héctor Arreola-Ornelas
- Institute for Advanced Study of the Americas, University of Miami, Coral Gables, FL, USA; Tómatelo a Pecho, A.C., Mexico City, Mexico; Fundación Mexicana para la Salud, A.C., Mexico City, Mexico
| | | | - Natalia M Rodriguez
- Institute for Advanced Study of the Americas, University of Miami, Coral Gables, FL, USA
| | - George A O Alleyne
- Pan American Health Organization, Regional Office of WHO, Washington, DC, USA
| | | | - David J Hunter
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Diederik Lohman
- Health and Human Rights Division, Human Rights Watch, Maplewood, NJ, USA
| | - Lukas Radbruch
- International Association for Hospice and Palliative Care, Houston, TX, USA; Department of Palliative Medicine, University Hospital Bonn, Germany; The Malteser Hospital, Bonn, Germany
| | | | - Rifat Atun
- Harvard Medical School, Boston, MA, USA; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Julio Frenk
- Department of Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Coral Gables, FL, USA; School of Business Administration, University of Miami, Coral Gables, FL, USA
| | | | - M R Rajagopal
- Trivandrum Institute of Palliative Sciences, WHO Collaborating Centre for Training and Policy on Access to Pain Relief, Pallium India, Kerala, India
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Ji D, Ji YJ, Duan XZ, Li WG, Sun ZQ, Song XA, Meng YH, Tang HM, Chu F, Niu XX, Chen GF, Li J, Duan HJ. Prevalence of psychological symptoms among Ebola survivors and healthcare workers during the 2014-2015 Ebola outbreak in Sierra Leone: a cross-sectional study. Oncotarget 2017; 8:12784-12791. [PMID: 28061463 PMCID: PMC5355054 DOI: 10.18632/oncotarget.14498] [Citation(s) in RCA: 139] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 12/12/2016] [Indexed: 01/15/2023] Open
Abstract
The 2014–2015 Ebola epidemic was considered to be the largest and most complex outbreak, which caused 11,310 reported deaths. The epidemic disease can cause a mental health crisis, however, there is only a small amount of scientific literature available related to this health issue so far. We evaluated the psychological symptoms of 161 participants including Ebola survivors and healthcare workers in Sierra Leone, analyzed the impact of job classification, education level on psychological status. We found that the order of total general severity index (GSI) scores from high to low was EVD survivors, SL medical staff, SL logistic staff, SL medical students, and Chinese medical staff. There were 5 dimensions (obsession-compulsion, anxiety, hostility, phobic anxiety, and paranoid ideation) extremely high in EVD survivors. GSI were associated with university education negatively. We believed our information is necessary to develop the comprehensive emergency response plan for emerging infectious disease outbreak.
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Affiliation(s)
- Dong Ji
- Military Hospital of China, Beijing, China.,Sierra Leone-China Friendship Hospital, Freetown, Sierra Leone
| | - Ying-Jie Ji
- Military Hospital of China, Beijing, China.,Sierra Leone-China Friendship Hospital, Freetown, Sierra Leone
| | - Xue-Zhang Duan
- Military Hospital of China, Beijing, China.,Sierra Leone-China Friendship Hospital, Freetown, Sierra Leone
| | - Wen-Gang Li
- Military Hospital of China, Beijing, China.,Sierra Leone-China Friendship Hospital, Freetown, Sierra Leone
| | - Zhi-Qiang Sun
- Military Hospital of China, Beijing, China.,Sierra Leone-China Friendship Hospital, Freetown, Sierra Leone
| | - Xue-Ai Song
- Military Hospital of China, Beijing, China.,Sierra Leone-China Friendship Hospital, Freetown, Sierra Leone
| | - Yu-Hua Meng
- Military Hospital of China, Beijing, China.,Sierra Leone-China Friendship Hospital, Freetown, Sierra Leone
| | - Hong-Mei Tang
- Military Hospital of China, Beijing, China.,Sierra Leone-China Friendship Hospital, Freetown, Sierra Leone
| | - Fang Chu
- Military Hospital of China, Beijing, China.,Sierra Leone-China Friendship Hospital, Freetown, Sierra Leone
| | | | | | - Jin Li
- Military Hospital of China, Beijing, China.,Sierra Leone-China Friendship Hospital, Freetown, Sierra Leone
| | - Hui-Juan Duan
- Military Hospital of China, Beijing, China.,Sierra Leone-China Friendship Hospital, Freetown, Sierra Leone
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Abstract
Introduction An appreciation of the experience of Ebola survivors is critical for community engagement and an effective outbreak response. Few qualitative, descriptive studies have been conducted to date that concentrate on the voices of Ebola survivors. Problem This study aimed to explore the experiences of Ebola survivors following the West African epidemic of 2014. METHOD An interpretive, qualitative design was selected using semi-structured interviews as the method of data collection. Data were collected in August 2015 by Médecins Sans Frontières (MSF) Belgium, for the purposes of internal evaluation. Data collection occurred at three sites in Liberia and Sierra Leone and involved 25 participants who had recovered from Ebola. Verbal consent was obtained, audio recordings were de-identified, and ethics approval was provided by Monash University (Melbourne, Australia). Findings Two major themes emerged from the study: "causes of distress" and "sources of resilience." Two further sub-themes were identified from each major theme: the "multiplicity of death," "abandonment," "self and community protection and care," and "coping resources and activities." The two major themes were dominant across all three sample groups, though each survivor experienced infection, treatment, and recovery differently. CONCLUSIONS By identifying and mobilizing the inherent capacity of communities and acknowledging the importance of incorporating the social model of health into culturally competent outbreak responses, there is an opportunity to transcend the victimization effect of Ebola and empower communities, ultimately strengthening the response. Schwerdtle PM , De Clerck V , Plummer V . Experiences of Ebola survivors: causes of distress and sources of resilience. Prehosp Disaster Med. 2017;32(3):234-239.
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Affiliation(s)
- James Smith
- 1 Research Unit on Humanitarian Stakes and Practices (UREPH), Médecins Sans Frontières, Geneva, Switzerland
| | - Tammam Aloudat
- 2 Medical Department, Médecins Sans Frontières, Geneva, Switzerland
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Keirns CC. Everyday ethics and Ebola: planning for the unlikely. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2015; 15:68-70. [PMID: 25856610 DOI: 10.1080/15265161.2015.1010020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Danis M. Weighing the importance of palliation of symptoms for Ebola patients during the epidemic in West Africa. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2015; 15:70-72. [PMID: 25856611 DOI: 10.1080/15265161.2015.1011000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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