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Taking inspiration from liberation theology and physician Paul Farmer, the lead article in the March‐April 2024 issue of the Hastings Center Report offers a "cautiously idealistic" argument for surgeons to follow the ethic of accompaniment, opening themselves to the lives of patients and communities who are poor, disabled, directly harmed by racism, and otherwise marginalized. Among other work in this issue are pieces on the ethics of approaches to mental health care in the United States. One essay, for example, illuminates three main phenomena that are contributing to a rise in the number of people with serious psychiatric conditions that are untreated or given inappropriate treatment. An At Law essay criticizes recent proposals by the mayors of New York City and Portland, Oregon, for expanding the use of involuntary commitment among people experiencing homelessness. [ABSTRACT FROM AUTHOR]

This article considers key ethical, legal, and medical dilemmas arising for people with disabilities in the COVID-19 pandemic. We highlight the limited application of existing frameworks of emergency planning with and for people with disabilities in the COVID-19 pandemic, explore key concerns and issues affecting the health care of people with disabilities (i.e., access to information and clinician–patient communication, nondiscrimination and reasonable accommodations, and rationing of medical goods), and indicate possible solutions. Finally, we suggest clinical and public health policy measures to ensure that people with disabilities are included in the planning of future pandemic-related efforts. The devastation evoked by the COVID-19 pandemic raises challenging dilemmas in bioethics. It also speaks to social justice issues that have plagued historically marginalized communities in the United States. Responses to the pandemic must be bound by legal standards, principles of distributive justice, and societal norms of protecting vulnerable populations—core commitments of public health—to ensure that inequities are not exacerbated, and should provide a pathway for improvements to ensure equitable access and treatment in the future. [ABSTRACT FROM AUTHOR]

As COVID-19 crosses the globe, disabled people are subject to new medical and discursive realities. Focusing on the consequences of the latter, we utilize news reports from Canada and the UK to argue the current language of pre-existing conditions represents disability as non-life, explaining away the material realities facing disabled persons. This language ignores the distribution of care work in our societies, poverty, and other forms of exclusion facing disabled people and the population more generally. Work on ventilator users points to these existing inequalities, obscured as they may be. This story is not new. Outlining existing narratives within disability studies challenging disability as deadly biological and economic deficiency and situating the 'pre-existing' terminology therein, we look to work in disability studies and bioethics to challenge the disability-death equation. We end reviewing counter-narratives by and for disabled people, highlighting the ongoing and life-affirming resistance throughout the disability rights movement. [ABSTRACT FROM AUTHOR]

As more people with disabilities (PWD) participate in many different settings where they once may have been excluded, nondisabled folks have become more accustomed to both casual and commercial interactions with them. And yet, many of these same people may ask about the general and critical needs for healthcare that PWD will have from time to time and whether or not they should receive extraordinary levels of medical care in times of health crisis. The subtext of this whether-or-not thinking may be: aren't they better off dead? But, I wonder, are the standards of care for PWD really different from standards for the nondisabled? And, I question, whose quality of life is at stake in cases involving a person with disabilities? This essay explores the ethical implications of the questions of standards and quality that an imago Dei theological anthropology of radical dependence challenges. This anthropology is then used to unlock the content and context of human relationality in matters of human flourishing, particularly in terms of healthcare needs for PWD. [ABSTRACT FROM AUTHOR]

The ethical care and treatment of persons with disabilities is important both for society and the church, but it can be challenging and daunting. The Georgetown principles and the counsel of Scripture can provide appropriate guidance. Nevertheless, the issues often remain difficult and sometimes confusing. It is vital to show mercy to dying patients--including those with disabilities. Withdrawing and withholding life-sustaining treatment can in some cases, however, be made prematurely, especially for disabled patients, largely because of a history of devaluing such persons. John Kilner's book, Dignity and Destiny: Humanity in the Image of God, contends that the divine image in humans, contrary to many, was not marred, damaged, or destroyed by sin. The image likewise is not defined by certain traits and capabilities. Misunderstandings of this have resulted in the disadvantaging of people with disabilities and a denial of their dignity. The present study summarizes and explores this aspect of Kilner's thesis, including the biblical and ethical foundations. The case of a disabled patient, "Michael," applies this understanding of the image and offers assistance for end-of-life decision-making for persons with disabilities. [ABSTRACT FROM AUTHOR]

Copyright of Studia Universitatis Babes-Bolyai, Bioethica (2011) is the property of Babes-Bolyai University, Cluj-Napoca, Romania and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article discusses the pros and cons of the contemporary principles of bioethics in relation to care of people with disabilities. When there is a potential conflict of interest between parents and their child, the role of autonomy in the case of mentally disabled children poses a problem. A contemporary principle of beneficence shifts from the well-being of the few to that of the many. Changing definitions and applications of personhood can make justice irrelevant.

Background: Regionalised models of health care delivery have important implications for people with disabilities and chronic illnesses yet the ethical issues surrounding disability and regionalisation have not yet been explored. Although there is ethics-related research into disability and chronic illness, studies of regionalisation experiences, and research directed at improving health systems for these patient populations, to our knowledge these streams of research have not been brought together. Using the Canadian province of Ontario as a case study, we address this gap by examining the ethics of regionalisation and the implications for people with disabilities and chronic illnesses. The critical success factors we provide have broad applicability for guiding and/or evaluating new and existing regionalised health care strategies. Discussion: Ontario is in the process of implementing fourteen Local Health Integration Networks (LHINs). The implementation of the LHINs provides a rare opportunity to address systematically the unmet diverse care needs of people with disabilities and chronic illnesses. The core of this paper provides a series of composite case vignettes illustrating integration opportunities relevant to these populations, namely: (i) rehabilitation and services for people with disabilities; (ii) chronic illness and cancer care; (iii) senior's health; (iv) community support services; (v) children's health; (vi) health promotion; and (vii) mental health and addiction services. For each vignette, we interpret the governing principles developed by the LHINs - equitable access based on patient need, preserving patient choice, responsiveness to local population health needs, shared accountability and patient-centred care - and describe how they apply. We then offer critical success factors to guide the LHINs in upholding these principles in response to the needs of people with disabilities and chronic illnesses. Summary: This paper aims to bridge an important gap in the literature by examining the ethics of a new regionalisation strategy with a focus on the implications for people with disabilities and chronic illnesses across multiple sites of care. While Ontario is used as a case study to contextualize our discussion, the issues we identify, the ethical principles we apply, and the critical success factors we provide have broader applicability for guiding and evaluating the development of - or revisions to - a regionalised health care strategy. [ABSTRACT FROM AUTHOR]