Class 11 - Global Health Flashcards
Harm Reduction - Defined
- A Public Health Approach
- Focusing on preventing the harms of substance use, not reducing substance use per se
- ‘Harm reduction refers to policies, programs and practices that aim to minimize the negative health, social and legal impacts associated with drug use, drug policies and drug laws.
- Harm reduction is grounded in justice and human rights. It focuses on positive change and on working with people without judgement, coercion, discrimination, or requiring that people stop using drugs as a precondition of support.’
Principles of Harm Reduction - CATIE (2022)
Practical and pragmatic
Focus on the health and rights of people who use drugs, not reducing drug use
Meaningful Participation of people who use drugs
Promotion of human rights
Public health & evidence-based approach
Non-judgmental (especailly because of the stigma present in healthcare)
Adaptive and Innovative
Harm reduction is really based on ______
Advocacy
Advocacy is defined by the CNA (2017) as “the act of supporting or recommending a cause or course of action, undertaken on behalf of persons or issues. It relates to the need to improve systems and societal structures to create greater equity and better health for all. Nurses endeavor, individually and collectively, to advocate for and work toward eliminating social inequities.” (p. 5)
4 Pillars of Emergency Management:
Prevention and Mitigation: minimizing risk related to disasters, reduce effects of disaster, or limit the impact of the consequences (mitigate)
Preparedness: looks at disaster management continuum, + current events + planning + readiness, ability to respond quickly to an event (i.e., protocol for code orange, evacuation protocols, etc.)
Response: immediate action, mobilizing responders, putting in place policies that have gone through, can last several days to weeks depending on the impact
Recovery: debriefing, and reviewing actions performed. Rehabilitation for those with trauma.
what is domain 8 of the ICN
Domain 8 = globally what are nurses expected to do and learn
Responses based on utilitarian principles : greatest good taking precedence over the individual at that moment, may be presented with a shift during a disaster like this.
All 4 steps of emergency responses are highlighted in this domain.
**Look at image in notes
Major Ethical Issues in Pandemic Planning
- Allocating scarce resources for both prevention and treatment
- Obligation of healthcare workers to provide care in the face of risk to self and family and reciprocal obligations of organizations to their workers
- Implementing coercive restrictions and social distancing measures on individuals & groups
- Obligations between countries in planning and response
Public health ethics framework: A guide for use in response to the COVID-19 pandemic in Canada
(5 steps)
Step 1: Identify the issue and gather the relevant facts in order to clearly understand the problem
Step 2: Identify and analyze ethical considerations, and prioritize the values and principles that will be upheld
Step 3: Identify and assess options in light of the values and principles
Step 4: Select best course of action and implement
Step 5: Evaluate
Framework Canadian government made for COVID-19.
a) what are the two key values underlying the framework?
b) 4 key principles
a) Trust and Justice
b) effectiveness, proportionality, reciprocity, precaution
*want to:
- respect for persons, communities and human rights
- promote well-being
- minimize harm
**reffer to image
is a nurse’s duty to care absolute?
No (according to CNA)
“During a natural or human-made disaster, including a communicable disease outbreak, nurses provide care using appropriate safety precautions in accordance with legislation, regulations and guidelines provided by government, regulatory bodies, employers, unions and professional associations.” (A9)
“Nurses’ employers have a reciprocal duty to protect and support them as well as to provide necessary and sufficient protective equipment and supplies that will “maximally minimize risk” to nurses and other health-care providers.” (P. 39)
are nurses allowed to be deployed from one work location to another one?
OIIQ highlights that this is the right of the employer
During COVID-19, people were seen alone and many without dignity
Actions to promote dignity:
- Advocacy (Recognize those that are at increased disadvantage; Promote and respect people’s wishes)
- Family-Centered Care
- Palliative Approach
- Taking into account structural vulnerability
Ethical Considerations for Contact Tracing and Data
Idea of consent = no active consent recruited for data monitoring
How much is the surveillance breaching privacy and confidentiality
why is there often resistance from the public when we attempt to initiate public health measures?
Often pushback from the public when policies reduce freedom; people say it is paternalistic
“…the justification for coercive public health measures that impede individual liberty is not paternalism – for the good of the person whose liberty is being curtailed – but rather the harm principle, namely the curtailment of our right and liberties to the extent that we pose a threat to others, and related to this, pose a threat to the greater good of society. In a sense we all become “patients” of public health.” (Yeo, Moorhouse, Khan& Rodney, 2020, p. 444)
does the CNA code of ethics promote whistle blowing?
Yes!
- helps develop a moral community
- part of our responsibility to contribute to a positive and healthy practice environment
- must support a climate of trust, sponsoring openness, etc…
- nurses should protect whistle-blowers
Moral imperialism
Humanitarian Action – Duties Across Nations – Nursing Globally
Moral imperialism: this is the right way to be, how to interact with the world (e.g.., in maternal health and abortion care, people have varying opinions). Imperialism imposes how we should see how it should be done (either pro, or against), brings up a lot of moral questions and broad ethical considerations.
