Zika Presentation 01-05 final version.pdf

The emergency of the Zika virus outbreak, with the risk of a presumed congenital syndrome and other events connected with its neurotropism, as well as unequal access to diagnostic and health care resources for the affected present a scenario with several ethical concerns. This paper discusses three ethical issues related to the Zika virus infection. The first one refers to the relationship between Brazilian states in a particular geopolitical context of " public health emergency of international concern ". The second one covers the balance between individual freedom and rights, and the need for State intervention. The third one refers to women's right to choose abortion, and to the assistance for a legion of children with neuropathic syndromes and their families. To cope with a possible pandemic disease in a world without boundaries, we should set up international cooperative teams, deal with different cultural approaches regarding the balance between individual and collective rights, and the consequences to assistance and public policies. Resumo Ética, saúde global e a infecção pelo vírus Zika: uma visão a partir do Brasil A emergência da epidemia pelo vírus Zika, com risco da síndrome congênita e outros eventos relacionados com seu neurotropismo, bem como o acesso desigual a recursos para diagnóstico e cuidados de saúde, constitui cenário com várias preocupações éticas. Abordamos três questões relacionadas com a infecção pelo Zika vírus. A primeira refere-se às relações entre os Estados nacionais num contexto geopolítico particular de " emergência de saúde pública de preocupação internacional " ; a segunda, ao equilíbrio entre liberdade e direitos individuais e a necessidade de intervenção do Estado; a terceira, ao direito das mulheres de escolher o aborto e a assistência para uma legião de crianças com síndromes neuropáticas e suas famílias. Para lidar com uma pandemia em um mundo sem fronteiras, devemos criar equipes internacionais cooperativas, lidar com diferentes abordagens culturais sobre o equilíbrio entre direitos individuais e coletivos e suas consequências para a assistência e políticas públicas. Palavras-chave: Bioética. Infecção pelo Zika vírus. Doenças transmissíveis emergentes. Saúde global. Brasil. Políticas públicas de saúde. Internacionalidade. Resumen Ética, salud global y la infección por el virus Zika: una visión desde Brasil La aparición de la epidemia por el virus Zika con el riesgo de síndrome congénita y otros eventos relacionados con el neurotropismo del virus, así como el acceso desigual a los recursos para el diagnóstico y cuidado de la salud constituyen un escenario con varias preocupaciones éticas. Este artículo analiza tres cuestiones éticas relacionadas con la infección por este vírus. La primera se refiere a las relaciones entre los estados nacionales en un contexto geopolítico particular de " emergencia de salud pública de preocupación internacional ". La segunda al equilibrio entre la libertad y los derechos individuales y la necesidad de intervención del Estado. La tercera al derecho de la mujer a aborto y la asistencia a una legión de niños con síndromes neuropaticos y a sus familias. Para hacer frente a una posible pandemia en un mundo sin fronteras, debemos crear equipos internacionales en base cooperativa, que trata de diferentes enfoques culturales para el equilibrio entre los derechos individuales y colectivos y sus consecuencias para la asistencia y la política pública. Palabras clave: Bioética. Infección por el virus Zika. Enfermedades transmisibles emergentes. Salud global. Brasil. Políticas públicas de salud. Internacionalidad.

Bangladesh Journal of Bioethics

This paper argues that Zika virus infection has its ethical implications beyond the reproductive health of women. It claims that Zika virus infection like public health emergency exposes the underlying health determinants and health status of women. Therefore, ethical mitigation of Zika like public health emergencies should consider these underlying health determinants and health status of women. For, undermining and overlooking these underlying determinants and health status of women, during the public health emergencies, enhance the health inequities. The recent Zika virus infection in Brazil has triggered different ethics consultation and has prompted to outline ethical recommendations. However, the recommendations have either focused on the reproductive health of women or on the core strategies of public health emergency. Considering this as a gap in perspective to prepare for Zika like public health emergencies, this paper argues that it is the underlying holistic health of wom...

Einstein (São Paulo), 2016

Philosophy, Ethics, and Humanities in Medicine, 2017

Much of the fear and uncertainty around Zika epidemics stem from potential association between Zika virus (ZIKV) complications on infected pregnant women and risk of their babies being born with microcephaly and other neurological abnormalities. However, much remains unknown about its mode of transmission, diagnosis and long-term pathogenesis. Worries of these unknowns necessitate the need for effective and efficient psychosocial programs and medical-legal strategies to alleviate and mitigate ZIKV related burdens. In this light, local and global efforts in maintaining fundamental health principles of moral, medical and legal decision-making policies, and interventions to preserve and promote individual and collectiveHuman Rights, autonomy, protection of the most vulnerable, equity, dignity, integrity and beneficence that should not be confused and relegated by compassionate humanitarian assistance and support. This paper explores the potential medical and ethical-legal implications of ZIKV epidemics emergency response packages and strategies alongside optimizing reproductive and mental health policies, programs and best practice measures. Further long-term cross-borders operational research is required in elucidating Zika-related population-based epidemiology, ethical-medical and societal implications in guiding evidence-based local and global ZIKV maternal-child health complications related approaches and interventions. Core programs and interventions including future Zika safe and effective vaccines for global Zika immunization program in most vulnerable and affected countries and worldwide should be prioritized.

Revista de Direito Sanitário, 2020

O presente artigo trata do reconhecimento ético e jurídico das relações de cuidado desenvolvidas no âmbito afetivo familiar. Parte-se da descrição da situação concreta de demandas por cuidados que se apresentam às famílias no contexto da epidemia da síndrome congênita do vírus Zika, incidente no Brasil em 2015 e 2016, para se analisarem as contribuições teóricas à discussão sobre a proteção das relações familiares de cuidado no campo da moral e do direito, respectivamente, pela ética do cuidado na abordagem proposta inicialmente por Carol Gilligan e pela abordagem jurídica das relações de cuidado, conforme formulações de Jonathan Herring e José Roque Junges.

Cadernos de saude publica, 2018

Recently, the Zika virus epidemic has caused a setting of health emergency in Brazil. This event has mobilized several stakeholders to look at this reality-where women, men and children born with the marks of these diagnoses are differently affected-as one with vectors, illnesses and obscure diagnosis situations. Recalling this recent memory means summoning the political realms to demand the commitment to the health of the population in contexts of health emergencies and their repercussions in the daily life. The Zika virus epidemic is characterized as a total social fact 1 , precisely because it synthesizes several determinations about epidemic processes by combining factors of economic and social inequality and revealing processes of vulnerability. This situation triggers a chronology of events that establish and dismiss the emergency: in November 2015, the Brazilian Ministry of Health issued a National Public Health Emergency 2 ; in February 2016, the World Health Organization (WHO) classified the Zika virus epidemic as a public health emergency of international concern 3 ; in March 2016, the Protocol for Surveillance and Response to the Occurrence of Microcephaly Related to Zika Virus Infection 4 was published; in November 2016, the WHO no longer considered the Zika virus as an international emergency 5 ; and, in May 2017, the Brazilian Ministry of Health declared the end of the emergency 6. These sequential events, responsible for inaugurating and ceasing emergencies, do not suspend the living experience: babies will grow up and need, in addition to rehabilitation services, nurseries and schools able to receive them; and parents and relatives will need to work and most likely will be burdened by their exhausting routines. The emotional vulnerability to which professionals and users of health system are submitted are equivalent within a chain of iniquities and search for knowledge. Moreover, this chronology delimits a process that risks sexual and reproductive rights in the name of securitization of epidemics 7 , reinforcing fears and stigmatization. If, on the one hand, international agencies and the Brazilian government position themselves and qualify emergencies, on the other, by anticipating them very closely, the scientific field-both clinicians and researchers-mobilizes itself for answers 8,9,10. Given this context, the National Network of Specialists of Zika and Related Diseases (RENEZIKA), among others, and studies on the biological and social aspects had the initiative of coming forward in a cooperation between national and international researchers to investigate and propose articulations for action.

J Hum Growth Dev, 2016

The zika virus is an emerging and important world health problem. In public health its harmful effects have stimulated various legal interests. The Federal Government of Brazil recently adopted several social and health surveillance measures, extending the instruments of possibilities to combating the virus transmitter in Brazil. Law No. 13.306/2016 brought incisive determinations about action awareness policies and educational campaigns, and at the same time authorizes the highest authorities of the Unifi ed Health System (SUS) within federal, state, county and municipal governments to establish and implement the necessary measures to control the diseases caused by the virus, i.e. dengue, chikungunya and zika. The published legislation has created a motivating environment for researchers to develop projects aimed at the mosquito that transmits the dengue virus, the chikungunya virus and the zika virus. Therefore, studies on A. aegypti have led to greater scientifi c knowledge about its habitat, reproduction and development and a description of means to combat it, as a precondition for the fulfi lment of the social purposes of Law No. 13.301, of June 27, 2016, mainly if researches about more effi cient management models and management of public fi nances, contributing to unveiling impacts on public health and growth and human development

Cadernos de Saúde Pública, 2016

Health, 2016

The current knowledge of the Zika Virus epidemic clearly lacks a comprehensive understanding of its determinants and clinical outcomes. Until recently regarded as a "simple" dengue-like infection, it nowadays turned into a real challenge to Public Health around the world. The Zika Epidemic shows a quick spread, affects unprepared health systems, and presents with severe neurological complications of newborns-a concrete threat to pregnancies. This re-emerging infectious disease is a source of deep doubts and harsh debates regarding Public Health and even bioethical issues. Several doubts still remain on how to deal with the various possible transmission ways of the disease, the surge of a generation of thousands of microcephalic newborns (and questions on how to handle them within limited health systems), and severe malformations concentrated so far in Northeastern Brazil. Finally, a debate is raised about how the "Endemic State" of Brazil, deeply merged in a health care crisis for almost 40 years now, currently confronts 3 current epidemics of the arboviruses Dengue, Chikungunya and now Zika, all associated with a lack of basic sanitation. Brazil must deal with these biological threats in the context of the Rio 2016 Olympic Games, since Chikungunya has probably been brought to Brazil during the FIFA Soccer World Cup (2014) and Zika Virus spread is associated with the Soccer Confederations Cup (2013).

Interface - Comunicação, Saúde, Educação, 2018

In this essay, we dialogue with themes launched in the post-epidemic debate of Zika Vírus (ZIKAV), on the lives of women and children. We analyzed 23 Brazilian papers published between 2016 and 2017, selected in Brazilian journals, in the fields of Social and Human Sciences. There is a mixed speech of claiming for rightsgrand narratives of social appeal and explanation by the social forces of a negligent State-associated with minor narratives of caring for a disabled child. We tentatively conclude that the contact zone is the movement of retrieval of the minor narratives in the translation of the iniquities produced by the State in the life of ordinary people.