[Ethical approach to the issue of confinement of the elderly in the context of the COVID-19 pandemic: Prevention of frailty versus risk of vulnerability].
Identifieur interne : 000035 ( Main/Exploration ); précédent : 000034; suivant : 000036[Ethical approach to the issue of confinement of the elderly in the context of the COVID-19 pandemic: Prevention of frailty versus risk of vulnerability].
Auteurs : M. Piccoli [France] ; T. Tannou [France, Canada] ; I. Hernandorena [France] ; S. Koeberle [France]Source :
- Ethics, medicine, and public health [ 2352-5525 ]
Abstract
COVID-19 pandemic particularly affects older people and exposes them to a higher risk of mortality. Containment, social distancing and isolation measures have been implemented to limit viral transmission. While there is a clear rationale for reducing the contagiousness of the infection through this means, the adverse consequences of this social isolation, especially for this heterogeneous, aged and frail people, are difficult to apprehend. In particular, the disruption of the usual support and care ecosystems at home or in institutions may paradoxically increase the frailty of these people and lead to adverse events we wanted to avoid. On the other hand, the risk of a decrease in the older person's empowerment regarding his or her own health and social life decisions requires particular vigilance to prevent the risk of societal ageism. Regarding this population in particular, a possible conflict of values between individual and collective protection on one hand and respect for autonomy and independence on the other hand could exist. This article proposes an ethical reflection on the issue of containment of frail ageing people, based on medical ethics principles, in order to open up positive approaches of vulnerability that guarantee respect for the dignity of the person and equity in care access.
DOI: 10.1016/j.jemep.2020.100539
PubMed: 32835057
PubMed Central: PMC7250767
Affiliations:
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Hernandorena</name><affiliation wicri:level="3"><nlm:affiliation>Département médico-universitaire de gériatrie, AP-HP, centre université de Paris, site Broca, 54-56, rue Pascal, 75013 Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Département médico-universitaire de gériatrie, AP-HP, centre université de Paris, site Broca, 54-56, rue Pascal, 75013 Paris</wicri:regionArea><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:affiliation>EA 4468 maladie d'Alzheimer, facteurs de risques, soins et accompagnement des patients et familles, université de Paris, 54-56, rue Pascal, 75013 Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>EA 4468 maladie d'Alzheimer, facteurs de risques, soins et accompagnement des patients et familles, université de Paris, 54-56, rue Pascal, 75013 Paris</wicri:regionArea><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Koeberle, S" sort="Koeberle, S" uniqKey="Koeberle S" first="S" last="Koeberle">S. Koeberle</name><affiliation wicri:level="3"><nlm:affiliation>service de gériatrie, CHU, 25000 Besançon, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>service de gériatrie, CHU, 25000 Besançon</wicri:regionArea><wicri:noRegion>25000 Besançon</wicri:noRegion><placeName><region type="region" nuts="2">Bourgogne-Franche-Comté</region><region type="old region" nuts="2">Franche-Comté</region><settlement type="city">Besançon</settlement></placeName></affiliation><affiliation wicri:level="1"><nlm:affiliation>Équipe « éthique et progrès médical », CIC Inserm 1431, CHU de Besançon, 25000 France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Équipe « éthique et progrès médical », CIC Inserm 1431, CHU de Besançon</wicri:regionArea><wicri:noRegion>CHU de Besançon</wicri:noRegion><wicri:noRegion>CHU de Besançon</wicri:noRegion></affiliation></author></analytic><series><title level="j">Ethics, medicine, and public health</title><idno type="ISSN">2352-5525</idno></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">COVID-19 pandemic particularly affects older people and exposes them to a higher risk of mortality. Containment, social distancing and isolation measures have been implemented to limit viral transmission. While there is a clear rationale for reducing the contagiousness of the infection through this means, the adverse consequences of this social isolation, especially for this heterogeneous, aged and frail people, are difficult to apprehend. In particular, the disruption of the usual support and care ecosystems at home or in institutions may paradoxically increase the frailty of these people and lead to adverse events we wanted to avoid. On the other hand, the risk of a decrease in the older person's empowerment regarding his or her own health and social life decisions requires particular vigilance to prevent the risk of societal ageism. Regarding this population in particular, a possible conflict of values between individual and collective protection on one hand and respect for autonomy and independence on the other hand could exist. This article proposes an ethical reflection on the issue of containment of frail ageing people, based on medical ethics principles, in order to open up positive approaches of vulnerability that guarantee respect for the dignity of the person and equity in care access.</div></front></TEI><pubmed><MedlineCitation Status="PubMed-not-MEDLINE" Owner="NLM"><PMID Version="1">32835057</PMID><DateRevised><Year>2020</Year><Month>09</Month><Day>02</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Print">2352-5525</ISSN><JournalIssue CitedMedium="Print"><Volume>14</Volume><PubDate><MedlineDate>2020 Jul-Sep</MedlineDate></PubDate></JournalIssue><Title>Ethics, medicine, and public health</Title><ISOAbbreviation>Ethics Med Public Health</ISOAbbreviation></Journal><ArticleTitle>[Ethical approach to the issue of confinement of the elderly in the context of the COVID-19 pandemic: Prevention of frailty versus risk of vulnerability].</ArticleTitle><Pagination><MedlinePgn>100539</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.jemep.2020.100539</ELocationID><Abstract><AbstractText>COVID-19 pandemic particularly affects older people and exposes them to a higher risk of mortality. Containment, social distancing and isolation measures have been implemented to limit viral transmission. While there is a clear rationale for reducing the contagiousness of the infection through this means, the adverse consequences of this social isolation, especially for this heterogeneous, aged and frail people, are difficult to apprehend. In particular, the disruption of the usual support and care ecosystems at home or in institutions may paradoxically increase the frailty of these people and lead to adverse events we wanted to avoid. On the other hand, the risk of a decrease in the older person's empowerment regarding his or her own health and social life decisions requires particular vigilance to prevent the risk of societal ageism. Regarding this population in particular, a possible conflict of values between individual and collective protection on one hand and respect for autonomy and independence on the other hand could exist. This article proposes an ethical reflection on the issue of containment of frail ageing people, based on medical ethics principles, in order to open up positive approaches of vulnerability that guarantee respect for the dignity of the person and equity in care access.</AbstractText><CopyrightInformation>© 2020 Elsevier Masson SAS. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Piccoli</LastName><ForeName>M</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Département médico-universitaire de gériatrie, AP-HP, centre université de Paris, site Broca, 54-56, rue Pascal, 75013 Paris, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>EA 4468 maladie d'Alzheimer, facteurs de risques, soins et accompagnement des patients et familles, université de Paris, 54-56, rue Pascal, 75013 Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tannou</LastName><ForeName>T</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>service de gériatrie, CHU, 25000 Besançon, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Équipe « éthique et progrès médical », CIC Inserm 1431, CHU de Besançon, 25000 France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>EA 481 Neurosciences intégratives et cliniques, université Franche Comté, 25000 Besançon, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Centre de recherche, institut universitaire gériatrique de Montréal, Montréal, Quebec, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hernandorena</LastName><ForeName>I</ForeName><Initials>I</Initials><AffiliationInfo><Affiliation>Département médico-universitaire de gériatrie, AP-HP, centre université de Paris, site Broca, 54-56, rue Pascal, 75013 Paris, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>EA 4468 maladie d'Alzheimer, facteurs de risques, soins et accompagnement des patients et familles, université de Paris, 54-56, rue Pascal, 75013 Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Koeberle</LastName><ForeName>S</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>service de gériatrie, CHU, 25000 Besançon, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Équipe « éthique et progrès médical », CIC Inserm 1431, CHU de Besançon, 25000 France.</Affiliation></AffiliationInfo></Author></AuthorList><Language>fre</Language><PublicationTypeList><PublicationType UI="D004740">English Abstract</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList><VernacularTitle>Une approche éthique de la question du confinement des personnes âgées en contexte de pandémie COVID-19 : la prévention des fragilités face au risque de vulnérabilité.</VernacularTitle><ArticleDate DateType="Electronic"><Year>2020</Year><Month>05</Month><Day>27</Day></ArticleDate></Article><MedlineJournalInfo><Country>France</Country><MedlineTA>Ethics Med Public Health</MedlineTA><NlmUniqueID>101681177</NlmUniqueID></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Ageism</Keyword><Keyword MajorTopicYN="N">COVID-19</Keyword><Keyword MajorTopicYN="N">Frailty</Keyword><Keyword MajorTopicYN="N">Geriatrics</Keyword><Keyword MajorTopicYN="N">Social isolation</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>04</Month><Day>29</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>05</Month><Day>16</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>8</Month><Day>25</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>8</Month><Day>25</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>8</Month><Day>25</Day><Hour>6</Hour><Minute>1</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32835057</ArticleId><ArticleId IdType="doi">10.1016/j.jemep.2020.100539</ArticleId><ArticleId IdType="pii">S2352-5525(20)30077-3</ArticleId><ArticleId IdType="pii">100539</ArticleId><ArticleId IdType="pmc">PMC7250767</ArticleId></ArticleIdList><pmc-dir>pmcsd</pmc-dir>
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