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Wild V, Frick M, Denholm J. WHO ethics guidance on TB care and migration: challenges to the implementation process. Int J Tuberc Lung Dis 2021; 24:32-37. [PMID: 32553041 DOI: 10.5588/ijtld.17.0882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
We summarise the current ethical guidance on tuberculosis (TB) care and migration, as set out in the WHO "Ethics Guidance for the Implementation of the End TB Strategy." Among other aspects, the Ethics Guidance states that there should be firm legal principles in place that ensure the enforcement of migration law on the one hand and the protection of human rights, including the right to health, on the other are separated from one another. As a challenge to the Ethics Guidance and its implementation, we describe two cases, each of which typifies particular problems. Case one describes the experience of a migrant worker in the United Arab Emirates who is deported when mandatory medical exams show evidence of current or prior TB. Case two raises the issue of providing more than TB care, which may also be needed for holistic care. The paper concludes with our suggestions for ways in which we could make progress towards ethically optimal TB care for migrants.
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Affiliation(s)
- V Wild
- Institute of Ethics, History and Theory of Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
| | - M Frick
- Treatment Action Group, New York, NY, USA
| | - J Denholm
- Victorian Tuberculosis Program, Melbourne Health, Melbourne, VIC, Department of Microbiology and Immunology, University of Melbourne at the Peter Doherty Institute, Melbourne, VIC, Victorian Infectious Diseases Service, Royal Melbourne Hospital, Parkville, VIC, Australia
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Eckenwiler L, Hunt M, Leach Scully J, Wild V. 4.11-P16Understanding and operationalizing vulnerability in International Humanitarian Health Organisations. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky048.181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - M Hunt
- McGill University, Montreal, Canada
| | | | - V Wild
- Ludwig Maximilians University, Germany
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Drewniak D, Krones T, Wild V. 5.4-O1Categorizing “race”, “ethnicity”, and “migration status” in clinical research. Challenges, pitfalls, and justifications from an ethical perspective. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky047.177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- D Drewniak
- Institute of Biomedical Ethics and History of Medicine, University of Zurich, Switzerland
| | - T Krones
- Institute of Biomedical Ethics and History of Medicine, University of Zurich, Switzerland
- University Hospital of Zurich, Switzerland
| | - V Wild
- Philosophy Department, Ludwig Maximilians University Munich, Germany
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Abstract
OBJECTIVES In this article, we outline the link between migration, public health and ethics. STUDY DESIGN Discussing relevant arguments about migration from the perspective of public health and public health ethics. METHODS Critical review of theories and frameworks, case-based analysis and systematic identification and discussion of challenges. RESULTS Migration is a core issue of public health ethics and must take a case-based approach: seeking to identify the specific ethical dimensions and vulnerabilities in each particular context. Public health as a practice, built upon the core value of justice, requires the protection and promotion of migrants' well-being (even if this produces tension with immigration services). Ethical analysis should take all phases of migration into account: before, during and after transit. We argue that migration policies, at least as they relate to migrants' well-being, should be founded upon a shared humanity, respect for human rights and on the idea that effective public health cannot and should not be confined within the borders and to the citizens of any host country. CONCLUSIONS We make the case for migration to be seen as a core issue of public health ethics.
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Affiliation(s)
- V Wild
- Institute of Ethics, History and Theory of Medicine, Ludwig-Maximilians-University Munich, Lessingstr. 2, D - 80336 Munich, Germany.
| | - A Dawson
- Sydney Health Ethics, School of Public Health, The University of Sydney, Australia
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Wild V, Jaff D, Shah NS, Frick M. Tuberculosis, human rights and ethics considerations along the route of a highly vulnerable migrant from sub-Saharan Africa to Europe. Int J Tuberc Lung Dis 2017; 21:1075-1085. [PMID: 28911349 PMCID: PMC5793855 DOI: 10.5588/ijtld.17.0324] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Migrant health is a critical public health issue, and in many countries attention to this topic has focused on the link between migration and communicable diseases, including tuberculosis (TB). When creating public health policies to address the complex challenges posed by TB and migration, countries should focus these policies on evidence, ethics, and human rights. This paper traces a commonly used migration route from sub-Saharan Africa to Europe, identifying situations at each stage in which human rights and ethical values might be affected in relation to TB care. This illustration provides the basis for discussing TB and migration from the perspective of human rights, with a focus on the right to health. We then highlight three strands of discussion in the ethics and justice literature in an effort to develop more comprehensive ethics of migrant health. These strands include theories of global justice and global health ethics, the creation of 'firewalls' to separate enforcement of immigration law from protection of human rights, and the importance of non-stigmatization to health justice. The paper closes by reflecting briefly on how TB programs can better incorporate human rights and ethical principles and values into public health practice.
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Affiliation(s)
- V Wild
- Ludwig-Maximilians-University, Munich, Germany
| | - D Jaff
- University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - N S Shah
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - M Frick
- Treatment Action Group, New York, New York, USA
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Drewniak D, Krones T, Wild V. Der Einfluss von Migration und Aufenthaltsstatus auf medizinische Behandlungsentscheidungen. Ergebnisse einer Studie unter Hausärzten in der Schweiz. Gesundheitswesen 2015. [DOI: 10.1055/s-0035-1562978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Fuß CT, Heinze B, Hirsch K, Lang K, Ronchi C, Wild V, Allolio B, Hahner S. High expression of C-X-C chemokine receptor type 4 in the zona glomerulosa and in aldosterone producing adenoma. Exp Clin Endocrinol Diabetes 2015. [DOI: 10.1055/s-0035-1547695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Altieri B, Sbiera S, Della Casa S, Steinhauer S, Wild V, Bekteshi M, Rosenwald A, Pontecorvi A, Fassnacht M, Allolio B, Ronchi C. Inhibitor of apoptosis proteins (IAP) in adrenocortical tumors. Exp Clin Endocrinol Diabetes 2015. [DOI: 10.1055/s-0035-1547638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Ronchi C, Sbiera S, Altieri B, Steinhauer S, Bekteshi M, Wild V, Fassnacht M, Allolio B. The notch ligand Jagged1 is up-regulated in adrenocortical carcinomas and might induce NOTCH1 signaling pathway activation. Exp Clin Endocrinol Diabetes 2015. [DOI: 10.1055/s-0035-1547635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Other K, Heinze B, Ronchi C, Hirsch K, Wild V, Fassnacht M, Hahner S. Chemokine receptor 7 is highly expressed in the adrenal cortex and in benign and malignant adrenocortical tumours but does not show prognostic relevance in adrenal cancer. Exp Clin Endocrinol Diabetes 2015. [DOI: 10.1055/s-0035-1547712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Henning E, Steinhauer S, Sbiera S, Wild V, Allolio B, Rosenwald A, Fassnacht M, Ronchi C. Evaluation of hENT1 expression in adrenocortical tumors: Correlation with clinical outcome and response to gemcitabine chemotherapy. Exp Clin Endocrinol Diabetes 2015. [DOI: 10.1055/s-0035-1547633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Bala M, Ronchi CL, Pichl J, Wild V, Kircher S, Allolio B, Hahner S. Suspected metastatic Adrenocortical Carcinoma revealing as Pulmonary Kaposi Sarcoma in Adrenal Cushing's syndrome. Exp Clin Endocrinol Diabetes 2014. [DOI: 10.1055/s-0034-1372309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Wild V, Ganguli Mitra A. Meeting the Authors: A Workshop on Social Justice in Public Health with Ruth Faden and Madison Powers. Public Health Ethics 2013. [DOI: 10.1093/phe/pht013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Simianer H, Wild V. Effect and treatment of misclassified samples in linkage analysis*. J Anim Breed Genet 2011. [DOI: 10.1111/j.1439-0388.1995.tb00565.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Wild V, Neuhaus Bühler R, Poulin H, Brockes C, Schmidt-Weitmann S, Biller-Andorno N. [Requests for online consultations on the operative reconstruction of the hymen--data from the university hospital Zurich and the children's hospital Zurich]. Praxis (Bern 1994) 2010; 99:475-480. [PMID: 20391352 DOI: 10.1024/1661-8157/a000093] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The "reconstruction of the hymen"consists in a surgical suture of the seam of a hymen that has been fissured due to vaginal intercourse or other causes. This intervention aims at triggering bleeding on the occasion of the next intercourse, a phenomenon often required as proof of virginity within certain traditions. Valid data regarding this ethically and medically controversial and predominantly tabooissue is scarce. In an effort to further explore this practice, we have collected information about hymenorrhaphy from the databases of two anonymous, medical, online counselling services provided by the University Hospital Zürich, and explicitly for teenagers by the Children's Hospital Zürich. We found a sample of 22 questions from women seeking advice, and the results vividly illustrate the psycho-social dilemma these women face, prompting us to suggest that further ethical discussion, collection of empirical data and broad public education on issues related to sexuality are necessary.
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Affiliation(s)
- V Wild
- Institut für Biomedizinische Ethik, Ethik-Zentrum, Universität Zürich
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Meissner A, Wild V, Simm R, Rohde M, Bredenbruch E, Morr M, Römling U, Häussler S. 78 Pseudomonas aeruginosa cupA encoded fimbria expression is regulated by a GGDEF and EAL domain dependent modulation of the intracellular level of cyclic diguanylate. J Cyst Fibros 2006. [DOI: 10.1016/s1569-1993(06)80069-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Biller-Andorno N, Wild V, Schauenburg H. [Living organ donors--a medical/ethical study of the current situation in Germany]. MMW Fortschr Med 2004; 146:40-41. [PMID: 18437868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- N Biller-Andorno
- Abteilung Ethik und Geschichte der Medizin, Universität Göttingen.
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