Description:
Internationally, marginalized populations, including indigenous people, refugees fleeing both war and the effects of climate change and people-of-color, have borne a disproportionate share of serious COVID 19 illnesses and deaths. Each contributor has a background in public health, applied psychology, and international issues, bringing a unique perspective and a valuable lens through which to view these issues. Additionally, the authors are members of the COVID-19 Ethics and Legal Issues Task Force within Division 52 (International Psychology) of the American Psychological Association. The task force has spent the last two years describing how COVID-19 has highlighted pre-existing health disparities within the U.S. and internationally. The topics investigated include strategies to manage the pandemic employed by governments in various countries as well as models of medical ethics guiding healthcare decision-making.
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Preface
In May 2020, a group of psychologists of the American Psychological Association’s Division 52 for International Psychology were initially convened by our chair, Dr. Falu Rami. We were charged with addressing legal and ethical issues related to COVID-19. In particular, we were interested in the international community’s response to the pandemic. Our group’s members have varying interests which, we soon found, made for a breadth of perspectives. Dr. Rami had a particular interest in how COVID-19 was being addressed in marginalized cosmmunities such as migrant workers and those who were incarcerated. She and her colleagues, Dr. LaShawn Thompson and Dr. Lizette Solis-Cortes, addressed the challenges faced by these populations in addressing COVID-19. Dr. Rami, with a background in both international psychology and family therapy, examined international health-care systems and selected several countries as examples for their response to COVID-19.
Ms. Megan Hall contributed her gift of excellent skills in scientific writing and her thoughtful approach to literature reviews to describe international responses and ethical isssues arising from COVID-19 testing, social distancing and policies regarding face masks. Dr. Karen Brown, with a strong background in international psychology and an interest in advocacy, contributed a chapter addressing those issues. Dr. Laura Dryjanska has published widely in applied social psychology and has a particular interest in addressing the problem of international trafficking. In this volume, Dr. Dryjanska examined the international impact of COVID-19 on mental health, health disparities and role of psychology in educating professinals for advocacy roles. Dr. Peter Battista, with a background in clinical psychology, developed an interest in the international impact of COVID-19 on mental health and how this important issue was being addressed internationally.
The editor and author of several chapters, Dr. Russell Searight, has a background in both clinical psychology and public health. While teaching medical students and family practice residents, he developed an interest in medical ethics which continues and is represented in this volume.
While there is currently a debate about whether the pandemic is over, we believe that COVID-19 highlighted issues that predate its onset, and these include the functioning of health-care systems around the world, the psychological and physical well-being of minorities and marginalized groups, the interface between politics and health, ethical dilemmas, and implementation of preventive health interventions such as vaccination.
Sault Sainte Marie, MI, USA H. Russell Searig
Table of contents :
Preface
Contents
Chapter 1: COVID-19’s Worldwide Impact and a History of Epidemics
The Death of a Whistleblower
Coronaviruses: A Brief Overview
COVID-19: Background
COVID-19 and International Declines in Life Expectancy
Origins of COVID 19: A Current Controversy
COVID-19 as a Disruptor and Focusing Event
A Brief, Selective History of Pandemics
Conclusion
References
Chapter 2: The Pre-existing Conditions Influencing COVID-19’s Impact
Introduction
The Social Determinants of Health
Social Epidemiology
Income Inequality
Deaths of Despair and the Opiate Epidemic
Health’s Social Determinants: Ethical Implications
The Rise of Populism and National Divisions
The Populist Message
The United States: COVID-19 and the 2020 Presidential Election
Populism Internationally: The Philippines, Brazil, and Hungary
Populist Attacks on Science
The Climate of Conspiracy
The Deep State, Bill Gates, and 5G
Pizzagate
The Great Replacement
Mass Formation Psychosis
Ethics and the Cognitive Terrain of Conspiracies
The Health Care System
The United States
Britain’s National Health Service
Racism as a Public Health Issue
Overview of Medical Racism
Black Lives Matter
Conclusion
References
Chapter 3: COVID-19’s Impact on the World’s Population
Introduction
Mental Health
China and the Philippines
The United States
Italy
Sweden
Brazil
Egypt
Iraq
South Africa
Education and Educational Outcomes
Income and Income Support
Impact on Employment
Impact on Productivity
Quality of Life
China
Brazil
Portugal
Saudi Arabia
Germany
Quality of Life in Cities
Government and Political Dynamics
Conclusions
Recommendations
References
Chapter 4: Health Care During COVID 19: Systems and New Developments
Health Care Systems Around the World: An Overview of Their Structure, Operations, and Funding
The United States Versus Canada
Switzerland Versus Germany
Great Britain
Brazil
India
Comparison of Different Health Care Plans
Singapore
Australia
France
Social Care Versus Health Care
International Responses to the Virus: Case Examples
COVID-19 Response in the MENA
COVID-19 Response in Peru
COVID-19 Response in Brazil
COVID-19 Responses in Low- and Middle-Income Countries
Telemedicine and Telehealth: Integrating into Primary Care
Telehealth Approaches and Efficacy with Vulnerable Populations
Conclusion
References
Chapter 5: Disparities, Discrimination, and Advocacy
Factors that Contribute to Health Disparities
Colonization
Race and Discrimination
Religion and Discrimination
Socioeconomic Status and Discrimination
Additional Factors Contributing to Health Disparities
Cultural Trauma and Health Disparities
Effects of Health Disparities
Children
Ageism as a Reflection of Disparities
Racial and Ethnic Minorities
Persons Who Are Incarcerated
Economically Challenged Communities
Mental Health Professionals and Advocacy
Conclusion
References
Chapter 6: Healthcare Disparities: Vulnerable and Marginalized Populations
A Historical Overview of Health Disparities
Health Inequalities, Health Inequities, and Health Disparities
Historical Overview of Health Disparities in Europe
Healthcare Disparities: United States, Canada, Latin America, Mexico, and the Caribbean
Healthcare Disparities in Africa, the MENA, and Asia
Who Is Disenfranchised? An International View
Social Determinants of Health
Social Determinants of Health: Ethnicity, Gender, Immigration, and Socioeconomic Status
Urban-Rural Divide and Social Determinants of Health
Structural Violence
Mass Incarceration and Detainment of Immigrant, Migrant Workers, and Asylum Seekers
International Responses to the Pandemic: COVID-19 Rates
International Migrant Workers
Global Trends for Agribusiness and Migrant Workers
Vulnerabilities Experienced by Agricultural Migrant Workers in the United States
Human and Labor Trafficking
Hazardous Work Conditions
Lack of Protection from the National Labor Relations Laws or Employee Rights
Increased Health Risks Due to Lack of Access to Healthcare and Testing
Living in Substandard Housing and Dilapidated Conditions
The Perpetual State of Poverty
Water and Sanitation
Immigrant Communities
Indigenous Peoples
Recommendations for Working with Indigenous Communities
Persons with Chronic and Severe Mental Illness and Homelessness
Homeless Individuals with Mental Illness in India
Homeless Individuals with Mental Illness and Substance Abuse in Spain
Access to Healthcare Among Marginalized Groups and Communities of Color
Conclusion
References
Chapter 7: COVID-19: Ethical Dilemmas
The God Committee
Overview of Ethical Models in Health Care
Deontology
Utilitarianism
Principlism
Virtue Ethics
Justice as Fairness
Ethical Theory Applied to COVID-19’s Moral Dilemmas
COVID-19 and Hybrid Ethics
Rationing Care During COVID-19: Guidelines
The Rationing Algorithm
Ethical Problems with Medical Care Rationing Protocols
Age
Health and Functional Status
Frailty Indices
Disability Status and “Ableist” Bias
Comorbid Medical Conditions
Groups Granted Preferential Status
A Revised Algorithm for Allocating Scarce Treatment Resources
Who Should Make the Final Decision About Rationing Care?
Code Status, Cardiopulmonary Resuscitation in the Context of COVID-19
Conclusion
References
Chapter 8: Vaccines and Vaccinations
Introduction
Vaccines: A Brief Overview
Vaccines: A Brief Social History
Mandated Vaccinations
Episodes of Vaccine-Related Harm
Herd Immunity
Herd Immunity as a COVID-19 Intervention Strategy
Britain’s Consideration of Herd Immunity
Sweden’s Herd Immunity Strategy
Brazil’s Ambivalent Herd Immunity Strategy
A Brief History of Anti-vaccination Movements
Changes in the Social Context of Health Care
Biomedicine and Scientific Research: A Loss of Public Trust
The Influence of Dubious Experts
COVID-19: Who Is and Is Not Vaccinated?
Reasons for Refusing COVID-19 Vaccination
Vaccine Quality
The Importance of Group Affiliation
Reasons for Vaccine Reluctance
Vaccines Cause Direct Harm
COVID-19 Is a Business Strategy for the Pharmaceutical Industry
Violations of Individual Liberty
Religious Objections to Vaccination
Racism, Colonization, and Vaccination
Anti-vaccination Communication as a Tool for Sowing National Discord
Ethical Issues
Mandatory COVID-19 Vaccinations and Seat Belts
Health Care for the Unvaccinated
Caring for COVID Patients Who Refused Vaccination
International Vaccine Access: An Issue of Fairness
Conclusion
References
Chapter 9: COVID-19 Testing, Preventive Measures, and Ethical Issues
Introduction
Who Used Test Results, and for What Purpose?
Ethical Implications and Diagnostic Justice
International Perspectives and Inequalities
Social Distancing and Implications for Marginalized Communities
Isolation and Family Violence
The Impact of Quarantine on Education
Masks as Prevention
Science Communication in Public Health
Political Issues Surrounding COVID-19
Facemasks as a Political Statement
What Have We Learned?
References
Chapter 10: COVID-19: Where Are We Now? What Have We Learned?
Introduction
Future Outbreaks: The Rise of Zoonotic Disease
Income Support
International Governmental and Social Care Response
Child and Adolescent Mental Health
Vaccine Hesitancy
Changes in Health Care: Education, Training, and Practice
Crisis Standards of Care: Protocols, Training, and Education
Telehealth and Online Medical Care
Changes in Clinical Decision-Making
Conclusions
References
Index
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