1
|
Park YS, Kim OJ. Government Initiatives for Research Ethics During COVID-19 Pandemic in Korea. J Korean Med Sci 2024; 39:e116. [PMID: 38565174 PMCID: PMC10985498 DOI: 10.3346/jkms.2024.39.e116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 03/04/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Despite the growing necessity for government-led policy changes on clinical research ethics during pandemic, the scope of previous literature is limited to Korean government's pandemic response strategies or reflections of research ethics at the level of institutions and academic societies. This paper examines the proactive policy changes and responses by the South Korean government in addressing the challenges and issues of research ethics against the backdrop of the urgency of rapid development and emergency supply of medical products during the coronavirus disease 2019 (COVID-19) pandemic. METHODS We conducted searches of various government documents, using predetermined keywords related to research ethics and integrity during the COVID-19 pandemic. Only documents issued by governments or public institutions were included. A total of 24 documents were selected for analysis. They were divided into two phases: the first phase for urgent response (January 2020-February 2021) and the second phase (March 2021-February 2023) for long-term preparedness. RESULTS The Korean government recommended several measures of research governance to accelerate the ethical review of COVID-related research to be shortened less than one week: the joint operation of Institutional Review Boards (IRBs), exempted or expedited review by a special review committee, guidelines for urgent reviews, and designation of the Korean Academy of Medical Sciences as the supervising agency for the Clinical Trial Safety Support Institution as well as the Central IRB. It allowed temporary non-face-to-face methods for informed consent process (telephone explanations and a photo of the original signed consent) and clinical trials (telephone counselling and prescription, proxy prescription, and drug delivery and supply to clinical trial participants, and online ethics training). CONCLUSION As a result of South Korea's commitment to ethical principles in their pandemic response, the medical system did not experience collapses due to the pandemic, and pandemic research was conducted with careful ethical considerations. The pandemic ethics immunization during the Middle East respiratory syndrome epidemic in 2015 laid the foundation for prompt government initiatives that ensured both pandemic research ethics and pandemic response ethics.
Collapse
Affiliation(s)
- Young Su Park
- Department of the History of Medicine and Medical Humanities, Seoul National University College of Medicine, Seoul, Korea
| | - Ock-Joo Kim
- Department of the History of Medicine and Medical Humanities, Seoul National University College of Medicine, Seoul, Korea.
| |
Collapse
|
2
|
Rushovich T, Nethery RC, White A, Krieger N. 1965 US Voting Rights Act Impact on Black and Black Versus White Infant Death Rates in Jim Crow States, 1959-1980 and 2017-2021. Am J Public Health 2024; 114:300-308. [PMID: 38301191 PMCID: PMC10882397 DOI: 10.2105/ajph.2023.307518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Objectives. To investigate the impact of the US Voting Rights Act (VRA) of 1965 on Black and Black versus White infant deaths in Jim Crow states. Methods. Using data from 1959 to 1980 and 2017 to 2021, we applied difference-in-differences methods to quantify differential pre-post VRA changes in infant deaths in VRA-exposed versus unexposed counties, controlling for population size and social, economic, and health system characteristics. VRA-exposed counties, identified by Section 4, were subject to government interventions to remove existing racist voter suppression policies. Results. Black infant deaths in VRA-exposed counties decreased by an average of 11.4 (95% confidence interval [CI] = 1.7, 21.0) additional deaths beyond the decrease experienced by unexposed counties between the pre-VRA period (1959-1965) and the post-VRA period (1966-1970). This translates to 6703 (95% CI = 999.6, 12 348) or 17.5% (95% CI = 3.1%, 28.1%) fewer deaths than would have been experienced in the absence of the VRA. The equivalent differential changes were not significant among the White or total population. Conclusions. Passage of the VRA led to pronounced reductions in Black infant deaths in Southern counties subject to government intervention because these counties had particularly egregious voter suppression practices. (Am J Public Health. 2024;114(3):300-308. https://doi.org/10.2105/AJPH.2023.307518).
Collapse
Affiliation(s)
- Tamara Rushovich
- Tamara Rushovich and Nancy Krieger are with the Department of Social and Behavioral Sciences and Rachel C. Nethery is with the Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA. Ariel White is with the Department of Political Science, Massachusetts Institute of Technology, Cambridge, MA
| | - Rachel C Nethery
- Tamara Rushovich and Nancy Krieger are with the Department of Social and Behavioral Sciences and Rachel C. Nethery is with the Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA. Ariel White is with the Department of Political Science, Massachusetts Institute of Technology, Cambridge, MA
| | - Ariel White
- Tamara Rushovich and Nancy Krieger are with the Department of Social and Behavioral Sciences and Rachel C. Nethery is with the Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA. Ariel White is with the Department of Political Science, Massachusetts Institute of Technology, Cambridge, MA
| | - Nancy Krieger
- Tamara Rushovich and Nancy Krieger are with the Department of Social and Behavioral Sciences and Rachel C. Nethery is with the Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA. Ariel White is with the Department of Political Science, Massachusetts Institute of Technology, Cambridge, MA
| |
Collapse
|
3
|
Park HY, Lee H, Lee JY, Song KH, Kim Y, Lee SH. How Can We Deal with Psychosocial Issues in an Emerging Infectious Disease Outbreak? Lessons from a Qualitative Study for the MERS Outbreak in Korea. Infect Chemother 2023; 55:355-367. [PMID: 37503778 PMCID: PMC10551710 DOI: 10.3947/ic.2022.0161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 01/19/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND The 2015 Middle East respiratory syndrome (MERS) coronavirus outbreak in Korea led to profound emotional and social burdens, especially in patients and health care professionals. MATERIALS AND METHODS Focus group interviews were conducted with 2 patients, 1 family member and 6 health care professionals about psychological distress related to MERS in 2017 and analyzed the interview data using the consensual qualitative research method. RESULTS Four domains and 17 core ideas were identified within three interview groups, including psychological distress during the outbreak, problems regarding the response to the outbreak, positive experiences, and future directions for enhancing intervention to improve mental health and prevent psychosocial problems during the outbreak. Psychological consequences were affected by the characteristics of the emerging infectious disease and the structure and process of institutional or governmental response to the MERS outbreak. Mental health services and psychosocial support reduced the negative impact on psychological distress. CONCLUSION The MERS outbreak in 2015 gave rise to emotional and social injuries to patients and health care professionals, some of which can be long-lasting constraints in their lives. Preparedness in a society's response to a pandemic considering mental health in related parties can minimize negative psychological consequences and enhance resilience at the individual and society levels.
Collapse
Affiliation(s)
- Hye Yoon Park
- Department of Psychiatry, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Haewoo Lee
- Department of Psychiatry, Seoul Medical Center, Seoul, Korea
| | - Ji-Yeon Lee
- Counseling Psychology, Graduate School of Education, Hankuk University of Foreign Studies, Seoul, Korea
| | - Kyoung-Ho Song
- Division of Infectious Diseases, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Yeonjae Kim
- Division of Infectious Diseases, Department of Internal Medicine, National Medical Center, Seoul, Korea
| | - So Hee Lee
- Department of Psychiatry, National Medical Center, Seoul, Korea.
| |
Collapse
|
4
|
Jones MN, Beck AF. Vote like your health depends on it: Voter engagement in the healthcare setting. J Hosp Med 2022; 17:577-579. [PMID: 35662405 DOI: 10.1002/jhm.12851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 05/08/2022] [Accepted: 05/16/2022] [Indexed: 11/12/2022]
Affiliation(s)
- Margaret N Jones
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Andrew F Beck
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| |
Collapse
|
5
|
Hajibabaee F, Salisu WJ, Akhlaghi E, Farahani MA, Dehi MMN, Haghani S. The relationship between moral sensitivity and caring behavior among nurses in iran during COVID-19 pandemic. BMC Nurs 2022; 21:58. [PMID: 35277159 PMCID: PMC8913325 DOI: 10.1186/s12912-022-00834-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 02/24/2022] [Indexed: 11/13/2022] Open
Abstract
Background Caring for patients during a pandemic can be difficult for healthcare workers, the patients themselves, and healthcare systems. Nurses are expected to recognize ethical dilemmas and make sound judgments when confronted with them. Sensitizing nurses to ethical issues strengthen their ability to identify ethical dilemmas and make ethical choices. As a result, this study aimed to determine a relationship between moral sensitivity and caring behavior among nurses during the coronavirus (COVID-19) pandemic. Method The current study is a cross-sectional study of 406 nurses who worked in a single hospital during the COVID-19 epidemic. We used a demographic questionnaire and the caring behavior inventory (CBI) tool to collect data online. The data were analyzed using descriptive and correlational statistics. Findings Eighty-three point seven percent of participants in this study were female, and 71.9% were married. 47.5% reported caring for a COVID-19 patient for longer than a month; their average work experience was 13.1 years. Additionally, Moral Sensitivity correlated positively with caring behavior and its dimensions (r = 0.164, P = 0.001). However, a significant and inverse link existed between the dimension "following the rules" and the nurse's caring conduct (r = -0.117, P = 0.019). Conclusion During the pandemic, nurses' moral sensitivity was moderate and significantly connected with their caring behavior. Because nurses encounter numerous obstacles while caring for patients in critical conditions, they require ethical empowerment to perform correctly, as caring behavior improves with increased moral sensitivity.
Collapse
|
6
|
Yang TU, Noh JY, Song JY, Cheong HJ, Kim WJ. How lessons learned from the 2015 Middle East respiratory syndrome outbreak affected the response to coronavirus disease 2019 in the Republic of Korea. Korean J Intern Med 2021; 36:271-285. [PMID: 32872738 PMCID: PMC7969075 DOI: 10.3904/kjim.2020.371] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 08/13/2020] [Indexed: 12/13/2022] Open
Abstract
The Republic of Korea (ROK) experienced a public health crisis due to Middle East respiratory syndrome (MERS) in 2015 and is currently going through the coronavirus disease 2019 (COVID-19) pandemic. Lessons learned from the disastrous MERS outbreak were ref lected in the preparedness system, and the readiness capabilities that were subsequently developed enabled the country to successfully flatten the epidemic curve of COVID-19 in late February and March 2020. In this review, we summarize and compare the epidemiology and response of the ROK to the 2015 MERS outbreak and the COVID-19 epidemic in early 2020. We emphasize that, because further COVID-19 waves seem inevitable, it is urgent to develop comprehensive preparedness and response plans for the worst-case scenarios of the COVID-19 pandemic. Simultaneously strengthening healthcare capacity to endure the peak demand and implementing smart strategies to sustain social distancing and public hygiene are necessary until safe and effective therapeutics and vaccines against COVID-19 are available.
Collapse
Affiliation(s)
- Tae Un Yang
- Department of Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Ji Yun Noh
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Joon-Young Song
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Hee Jin Cheong
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Woo Joo Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| |
Collapse
|
7
|
Holm S. A general approach to compensation for losses incurred due to public health interventions in the infectious disease context. Monash Bioeth Rev 2020; 38:32-46. [PMID: 32130682 PMCID: PMC7095444 DOI: 10.1007/s40592-020-00104-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
This paper develops a general approach to how society should compensate for losses that individuals incur due to public health interventions aimed at controlling the spread of infectious diseases. The paper falls in three parts. The first part provides an initial introduction to the issues and briefly outlines five different kinds of public health interventions that will be used as test cases. They are all directed at individuals and aimed at controlling the spread of infectious diseases (1) isolation, (2) quarantine, (3) recommended voluntary social distancing, (4) changes in health care provision for asymptomatic carriers of multi-resistant microorganisms, and (5) vaccination. The interventions will be briefly described including the various risks, burdens and harms individuals who are subject to these interventions may incur. The second part briefly surveys current compensation mechanisms as far as any exist and argue that even where they exist they are clearly insufficient and do not provide adequate compensation. The third part will then develop a general framework for compensation for losses incurred due to public health interventions in the infectious disease context. This is the major analytical and constructive part of the paper. It first analyses pragmatic and ethical arguments supporting the existence of an obligation on the part of the state to compensate for such losses, and then considers whether this obligation can be defeated by (1) resource considerations, or (2) issues relating to personal responsibility.
Collapse
Affiliation(s)
- Søren Holm
- Centre for Social Ethics and Policy, School of Law, University of Manchester, Manchester, M13 9PL, UK.
- Center for Medical Ethics, Faculty of Medicine, HELSAM, University of Oslo, Oslo, Norway.
| |
Collapse
|
8
|
Ehlinger EP, Nevarez CR. Safe and Accessible Voting: The Role of Public Health. Am J Public Health 2020; 111:45-46. [PMID: 33119410 DOI: 10.2105/ajph.2020.306011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Edward P Ehlinger
- Edward P. Ehlinger formerly was with the Association of State and Territorial Health Officials, Arlington, VA, and the Minnesota Department of Health, St. Paul. Carmen R. Nevarez is with the Center for Health Leadership and Practice, Public Health Institute, Washington, DC. Both authors serve on the Jacob & Valeria Langeloth Foundation board, New York, NY
| | - Carmen Rita Nevarez
- Edward P. Ehlinger formerly was with the Association of State and Territorial Health Officials, Arlington, VA, and the Minnesota Department of Health, St. Paul. Carmen R. Nevarez is with the Center for Health Leadership and Practice, Public Health Institute, Washington, DC. Both authors serve on the Jacob & Valeria Langeloth Foundation board, New York, NY
| |
Collapse
|
9
|
Park HY, Park WB, Lee SH, Kim JL, Lee JJ, Lee H, Shin HS. Posttraumatic stress disorder and depression of survivors 12 months after the outbreak of Middle East respiratory syndrome in South Korea. BMC Public Health 2020; 20:605. [PMID: 32410603 PMCID: PMC7224724 DOI: 10.1186/s12889-020-08726-1] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 04/17/2020] [Indexed: 12/21/2022] Open
Abstract
Background The 2015 outbreak of Middle East Respiratory Syndrome (MERS) in the Republic of Korea is a recent and representative occurrence of nationwide outbreaks of Emerging Infectious Diseases (EIDs). In addition to physical symptoms, posttraumatic stress disorder (PTSD) and depression are common following outbreaks of EID. Methods The present study investigated the long-term mental health outcomes and related risk factors in survivors of MERS. A prospective nationwide cohort study was conducted 12 months after the MERS outbreak at multi-centers throughout Korea. PTSD and depression as the main mental health outcomes were assessed with the Impact of Event Scale-Revised Korean version (IES-R-K) and the Patient Health Questionnaire-9 (PHQ-9) respectively. Results 42.9% of survivors reported PTSD (IES-R-K ≥ 25) and 27.0% reported depression (PHQ-9 ≥ 10) at 12 months post-MERS. A multivariate analysis revealed that anxiety (adjusted odds ratio [aOR], 5.76; 95%CI, 1.29–25.58; P = 0.021), and a greater recognition of stigma (aOR, 11.09, 95%CI, 2.28–53.90; P = 0.003) during the MERS-affected period were independent predictors of PTSD at 12 months after the MERS outbreak. Having a family member who died from MERS predicted the development of depression (aOR, 12.08, 95%CI, 1.47–99.19; P = 0.020). Conclusion This finding implies that psychosocial factors, particularly during the outbreak phase, influenced the mental health of patients over a long-term period. Mental health support among the infected subjects and efforts to reduce stigma may improve recovery from psychological distress in an EID outbreak.
Collapse
Affiliation(s)
- Hye Yoon Park
- Seoul National University Hospital, Seoul, Republic of Korea
| | - Wan Beom Park
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - So Hee Lee
- National Medical Center, 245, Eulji-ro, Jung-gu, Seoul, 04564, Republic of Korea.
| | - Jeong Lan Kim
- Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Jung Jae Lee
- Dankook University School of Medicine, Cheonan, Chungnam, Republic of Korea
| | - Haewoo Lee
- Seoul Medical Center, Seoul, Republic of Korea
| | - Hyoung-Shik Shin
- National Medical Center, 245, Eulji-ro, Jung-gu, Seoul, 04564, Republic of Korea.
| |
Collapse
|
10
|
Vector control in Zika-affected communities: Local views on community engagement and public health ethics during outbreaks. Prev Med Rep 2020; 18:101059. [PMID: 32154093 PMCID: PMC7052511 DOI: 10.1016/j.pmedr.2020.101059] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 12/18/2019] [Accepted: 01/23/2020] [Indexed: 11/21/2022] Open
Abstract
Public health authorities can mitigate community resistance to aerial spraying. Zika-affected persons favor autonomy, transparency, reasonableness, and solidarity. Proliferating social media and skepticism toward government present challenges.
Aerial spraying of products to kill larvae or adult mosquitoes is a public health measure used to control vector-borne diseases. In some outbreaks, the intervention has evoked controversy and community resistance. This study evaluated how local opinion leaders in US localities affected by Zika think about community engagement in public health policies for outbreak response. In December 2017 through March 2018, 4 focus groups were convened in Houston, TX, New Orleans, LA, Miami, FL, and Brooklyn, NY. They discussed a hypothetical scenario that featured vector control by aerial spraying. Participants (N = 20) more readily accepted this vector control method under 4 conditions: They were informed of alternatives, benefits, and risks for human health and the environment. Public health claims were backed by objective evidence and an authority figure genuinely working in the community’s interests. They received timely notice about how to mitigate toxin exposure. And, aerial spraying helped to protect vulnerable individuals. The community engagement requirements of the local opinion leaders resonate with core principles of recent public health ethics frameworks: namely, personal autonomy, transparency, reasonableness, and solidarity. Participants foresaw problems with community consent in an era of growing social media use and mistrust in governmental and scientific authority. They also debated whether health authorities should use moral-based arguments, in addition to science-based ones, to communicate aerial spraying’s risks and benefits.
Collapse
|
11
|
Park C. MERS-CoV infection in South Korea and strategies for possible future outbreak: narrative review. JOURNAL OF GLOBAL HEALTH REPORTS 2019. [DOI: 10.29392/joghr.3.e2019088] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
|