This paper comprises a case study illustrating ethical and practical challenges for a Ugandan hospital-based social worker early in the COVID-19 pandemic, followed by a commentary. The hospital was under-resourced, with staff and patients experiencing lack of information and panic. The social worker, Denis Adia, recounts his responses to new and ethically challenging situations, including persuading Muslim patients to stop fasting for the good of their health; deciding to keep a baby in hospital with parents although this was against the (...) rules; and supporting a stigmatised former patient in the face of intimidation by colleagues. He reflects on the importance of recognising each person’s unique needs and circumstances, seeing this as a vital role for social workers. The case is followed by a commentary from a UK academic (Sarah Banks), who notes the cognitive and emotional effort (‘ethics work’) undertaken by the social worker to: see the ethical aspects of particular situations; take account of patients’ specific needs; ensure they are treated with respect; promote their well-being; and perform as a good social worker. Banks draws attention to the key role of the virtue of courage in pandemic conditions, which involves working with new risks and facing fears with confidence. (shrink)

In many high-income countries, an initial response to the severe impact of Covid-19 on residential care was to shield residents from outside contacts. As the pandemic progressed, these measures have been increasingly questioned, given their detrimental impact on residents’ health and well-being and their dubious effectiveness. Many authorities have been hesitant in adapting visiting policies, often leaving nursing homes to act on their own safety and liability considerations. Against this backdrop, this article discusses the appropriateness of viewing the continuation of (...) the practice of shielding as a moral failure. This is affirmed and specified in four dimensions: preventability of foreseeable harm, moral agency, moral character, and moral practice (in MacIntyre’s sense). Moral character is discussed in the context of prudent versus proportionate choices. As to moral practice, it will be shown that the continued practice of shielding no longer met the requirements of an (inherently moral) practice, as external goods such as security thinking and structural deficiencies prevented the pursuit of internal goods focusing on residents’ interests and welfare, which in many places has led to a loss of trust in these facilities. This specification of moral failure also allows a novel perspective on moral distress, which can be understood as the expression of the psychological impact of moral failure on moral agents. Conclusions are formulated about how pandemic events can be understood as character challenges for healthcare professionals within residential care, aimed at preserving the internal goods of residential care even under difficult circumstances, which is understood as a manifestation of moral resilience. Finally, the importance of moral and civic education of healthcare students is emphasized to facilitate students' early identification as trusted members of a profession and a caring society, in order to reduce experiences of moral failure or improve the way to deal with it effectively. (shrink)

The positive psychology landscape is changing, and its initial identity is being challenged. Moving beyond the “third wave of PP,” two roads for future research and practice in well-being studies are discerned: The first is the state of the art PP trajectory that will continue as a scientific discipline in/next to psychology. The second trajectory links to pointers described as part of the so-called third wave of PP, which will be argued as actually being the beginning of a new domain (...) of inter- or transdisciplinary well-being studies in its own right. It has a broader scope than the state of the art in PP, but is more delineated than in planetary well-being studies. It is in particular suitable to understand the complex nature of bio-psycho-social-ecological well-being, and to promote health and wellness in times of enormous challenges and changes. A unique cohering focus for this post-disciplinary well-being research domain is proposed. In both trajectories, future research will have to increase cognizance of metatheoretical assumptions, develop more encompassing theories to bridge the conceptual fragmentation in the field, and implement methodological reforms, while keeping context and the interwovenness of the various levels of the scientific text in mind. Opportunities are indicated to contribute to the discourse on the identity and development of scientific knowledge in mainstream positive psychology and the evolving post-disciplinary domain of well-being studies. (shrink)

Research has suggested a fundamental connection between fairness and well-being at the individual, relational, and societal levels. Mattering is a multidimensional construct consisting of feeling valued by, and adding value to, self and others. Prior studies have attempted to connect mattering to both fairness and a variety of well-being outcomes. Based on these findings, we hypothesize that mattering acts as a mediator between fairness and well-being. This hypothesis was tested through Covariance-Based Structural Equation Modeling using multidimensional measures of fairness, mattering, (...) and well-being. Results from a Latent Path Analysis conducted on a representative sample of 1,051U.S. adults provide support to our hypothesis by revealing a strong direct predictive effect of mattering onto well-being and a strong indirect effect of fairness onto well-being through mattering. Results also show that mattering is likely to fully mediate the relationship between fairness and multiple domains of well-being, except in one case, namely, economic well-being. These findings illustrate the value of a focus on mattering to understand the relationship between fairness and well-being and to provide future directions for theory, research, and practice. Theoretical implications for the experience of citizenship and participation, along with cross-cultural considerations, are also discussed. (shrink)

Human connection is universally important, particularly in the context of serious illness and at the end of life. The presence of close family and friends has many benefits when death is close. Hospital visitation restrictions during the Coronavirus pandemic therefore warrant careful consideration to ensure equity, proportionality, and the minimization of harm. The Australian and New Zealand Society for Palliative Medicine COVID-19 Special Interest Group utilized the relevant ethical and public health principles, together with the existing disease outbreak literature and (...) evolving COVID-19 knowledge, to generate a practical framework of visiting restrictions for inpatients receiving palliative and end-of-life care. Expert advice from an Infectious Diseases physician ensured relevance to community transmission dynamics. Three graded levels of visitor restrictions for inpatient settings are proposed, defining an appropriate level of minimum access. These depend upon the level of community transmission of COVID-19, the demand on health services, the potential COVID-19 status of the patient and visitors, and the imminence of the patient’s death. This framework represents a cohesive, considered, proportionate, and ethically robust approach to improve equity and consistency for inpatients receiving palliative care during the COVID-19 pandemic and may serve as a template for future disease outbreaks. (shrink)