Ethical and Legal Debates on Vaccine Infodemics

Over the course of three and a half years, the global toll of coronavirus disease 2019 (COVID-19) has claimed the lives of millions of individuals. Scientific breakthroughs, exemplified by mRNA vaccines, have emerged as crucial tools in saving numerous lives and fortifying our defenses against future pandemics. However, the battle against the virus has been complicated by the dissemination of misleading political and ethical information, resulting in avoidable fatalities. Recognizing this phenomenon, the term 'infodemics' has been coined to denote the proliferation of false or misleading information that hinders effective social responses. Given the historical prevalence of infodemics surrounding vaccinations, this discussion delves into the ongoing ethical and legal deliberations concerning vaccination mandates, an indispensable health intervention in the face of pandemics. Governments bear the responsibility of safeguarding their citizens, acknowledging the social requirements imposed by the collective well-being. The protection of both citizens and healthcare workers becomes paramount, considering the potential risks of infection and mortality associated with individuals refusing vaccination. Historically, governments have played a pivotal role in eradicating pandemics through the implementation of vaccine mandates. However, the contemporary landscape is marked by the infusion of political and misleading misinformation, presenting new challenges. Governments are now confronted with an ethical duty to ensure that citizens possess the necessary information to make informed decisions and safeguard their well-being. While grappling with the realization that extraordinary circumstances demand extraordinary responses, the lessons from past pandemics underscore the imperative of prioritizing public health, especially in the context of the high numbers of casualties worldwide. This discourse explores the ethical and legal dimensions surrounding vaccine mandates, with particular emphasis on their relevance to healthcare workers.

Undergraduate nursing students' responses to an end-of-life educational session

End-of-life care is an important component of healthcare students' education. The purpose of this study was to explore nursing students' perspectives of end-of-life decision-making and end-of-life care following an ethics session during the 2020-2021 academic year. A qualitative study was performed. Thirty-six undergraduate nursing students in their junior year at a private, Catholic university located in the northeast United States participated. Two nursing faculty and one bioethicist conducted an educational session on end-of-life care developed with a focus on decision-making, autonomy and dignity while employing debate pedagogy as a teaching modality. Following the session, the students were given a letter of solicitation with a link to a Qualtrics survey with four open ended questions related to end-of-life care. Four main themes, as being perceived by students, were discovered: decision-making, autonomy, the nurses' role, and the interprofessional team as important components of end-of-life care. Implications for future research include debate pedagogy as a method to teach end-of-life care and ethical decision-making as well as quantitative research or mixed methods with larger sample sizes and across health professions.

Legislation, activism and power play - Medical education policies in colonial and post-colonial India

Colonial medical education and public health policies emerged from an intriguing discourse of negotiation between the government and the people. These 'structured conflicts', rooted in the politics and the debates of the colonial institutions not only provided opportunities for creative thinking about public health but also for imposing constraints. The colonial and post-colonial India medical legislative debates revealing a new language of protest, assumed greater significance with the growing nationalist movement and the general (though variegated) intellectual polarisation - western and indigenous systems of medicine. Problematising the historiographic assertion of medical modernisation in colonial India to be a part of 'civilising mission', this paper argues that legislature emerged as a platform of activism and protest against the colonial and post-colonial State's appropriation of modernity. While some members appealed for extending the benefit of 'modern' western medicine to the general Indian population, some debated in favour of introducing the indigenous medical systems to the terms of modern professionalisation. The post-colonial policies reveal the true significance of the legislative debates in reviving the position of indigenous systems of medicine in the context of professional modernity.

Effectiveness of Journal Club Activities Versus Clinical Debate Activities in Pharmacy Experiential Education

Objective. Within pharmacy experiential education, practicing literature evaluation skills usually occurs via journal clubs. Clinical debates have gained traction as an engaging alternative to journal club meetings while completing advanced pharmacy practice experiences (APPEs). The purpose of this study was to compare clinical knowledge and literature evaluation application between journal clubs and clinical debates during APPEs.Methods. This mixed-methods prospective study was conducted in fourth year pharmacy students completing inpatient general medicine APPEs at four institutions. Students participated in a journal club and clinical debate during their experience. Students completed a 10-item knowledge assessment after each activity. Differences in journal club and clinical debate assessment scores were analyzed. Following completion of both activities, a perception survey was administered to gauge preferences and opinions. Differences in perception survey scores for journal clubs compared to clinical debates were evaluated quantitatively, and a thematic analysis was completed for qualitative responses.Results. Fifty students participated in both activities. There were no differences between journal club and clinical debate assessment scores (57.4%±21.0% and 62.9%±20.7%, respectively). Forty students completed the post-perceptions survey and globally agreed or strongly agreed that both journal clubs and clinical debates improved confidence in literature evaluation and clinical skills. Common themes identified included applicability to pharmacists' roles and need for clear instructions and examples.Conclusion. There was no significant difference between student performance on knowledge assessments of journal clubs and clinical debates, and students found both activities to be beneficial. Clinical debates are a reasonable alternative to journal clubs to improve pharmacy students' knowledge and literature evaluation skills.

Is Rechallenge Appropriate in Patients that Develop Immune Checkpoint Inhibitor-Associated AKI?: PRO

This is an Early Access article. Please select the PDF button, above, to view it. Be sure to also read the CON: 10.34067/KID.0003902021 and the COMMENTARY 10.34067/KID.0005592021

Is Rechallenge Appropriate in Patients that Develop Immune Checkpoint Inhibitor-Associated AKI?: CON

This is an Early Access article. Please select the PDF button, above, to view it. Be sure to also read the PRO: 10.34067/KID.0003962021 and the COMMENTARY 10.34067/KID.0005592021

Evaluation of a Modified Debate Exercise Adapted to the Pedagogy of Team-Based Learning

Objective. To assess the impact of a debate exercise on self-reported evidence of student learning in literature evaluation, evidence-based decision making, and oral presentation. Methods. Third-year pharmacy students in a required infectious disease therapeutics course participated in a modified debate exercise that included a reading assignment and readiness assessment tests consistent with team-based learning (TBL) pedagogy. Peer and faculty assessment of student learning was accomplished with a standardized rubric. A pre- and post-debate survey was used to assess self-reported perceptions of abilities to perform skills outlined by the learning objectives. Results. The average individual readiness assessment score was 93.5% and all teams scored 100% on their team readiness assessments. Overall student performance on the debates was also high with an average score of 88.2% prior to extra credit points. Of the 95 students, 88 completed both pre- and post-surveys (93% participation rate). All learning objectives were associated with a statistically significant difference between pre- and post-debate surveys with the majority of students reporting an improvement in self-perceived abilities. Approximately two-thirds of students enjoyed the debates exercise and believed it improved their ability to make and defend clinical decisions. Conclusion. A debate format adapted to the pedagogy of TBL was well-received by students, documented high achievement in assessment of skills, and improved students' self-reported perceptions of abilities to evaluate the literature, develop evidence-based clinical decisions, and deliver an effective oral presentation.

Meeting Report of the XIV International Small Bowel Transplant Symposium: Summary of Presentations, Workshops, and Debates From a Comprehensive Meeting on Intestinal Failure, Rehabilitation, and Transplantation, Buenos Aires, Argentina, June 10-13, 2015

The 2015 meeting of the Intestinal Transplant Association was held in Buenos Aires, Argentina. This was the 14th International Small Bowel Transplant Symposium, and it was the first meeting organized as a joint venture of the Transplantation Society, the Intestinal Transplant Association, and the Argentinean Transplant Society (Sociedad Argentina de Trasplantes). Innovative aspects of the classic meeting format included workshops sessions, debates, and multicenter studies. This report highlights the most prominent scientific contributions and results of the first such symposium in a Latin American country.

Mitochondrial Replacement Techniques: Who are the Potential Users and will they Benefit?

In February 2015 the UK became the first country to legalise high-profile mitochondrial replacement techniques (MRTs), which involve the creation of offspring using genetic material from three individuals. The aim of these new cell reconstruction techniques is to prevent the transmission of maternally inherited mitochondrial disorders to biological offspring. During the UK debates, MRTs were often positioned as a straightforward and unique solution for the 'eradication' of mitochondrial disorders, enabling hundreds of women to have a healthy, biologically-related child. However, many questions regarding future applications and potential users remain. Drawing on a current qualitative study on reproductive choices in the context of mitochondrial disorders, this article illustrates how the potential limitations of MRTs have been obscured in public debates by contrasting the claims made about the future beneficiaries with insights from families affected by mitochondrial disorders and medical experts. The analysis illuminates the complex choices with which families and individuals affected by mitochondrial disorders are faced, which have thus far remained invisible. An argument is presented for improved information for the public as well as an intensification of critical empirical research around the complex and specific needs of future beneficiaries of new reproductive biotechnologies.