There is a consensus that the effects of medical brain drain, especially in the Sub-Saharan African countries, ought to be perceived as more than a simple misfortune. Temporary restrictions on the emigration of health workers from the region is one of the already existing policy measures to tackle the issue—while such a restrictive measure brings about the need for quite a justificatory work. A recent normative contribution to the debate by Gillian Brock provides a fruitful starting point. In the first (...) step of her defence of emigration restrictions, Brock provides three reasons why skilled workers themselves would hold responsibilities to assist with respect to vital needs of their compatriots. These are fair reciprocity, duty to support vital institutions, and attending to the unintended harmful consequences of one’s actions. While the first two are explained and also largely discussed in the literature, the third requires an explication on how and on which basis skilled workers would have a responsibility as such. In this article, I offer a vulnerability approach with its dependency aspect that may account for why the health workers in underserved contexts would have a responsibility to attend to the unintended side effects of their actions that may lead to a vital risk of harm for the population. I discuss HIV/AIDS care in Zimbabwe as a case in point in order to show that local health workers may have responsibilities to assist the population who are vulnerable to their mobility. (shrink)

Background: More and more adults in their fifties and sixties are confronted with the need to support their ageing parents. Although many aspects of filial caregiving have been researched, a well-documented and comprehensive overview of the caregiving experience is lacking. Aim: This study aims for a better understanding of the caregiving experience of adult children by generating an overview of main themes in international research. Method: A literature review of qualitative studies, focusing on the experiences of adult children caring for (...) their ageing parents, was performed. The electronic EBSCO databases Academic Search Premier, CINAHL and PsycINFO, and Google Scholar were searched to identify relevant qualitative studies published between 2000 and 2017. The ‘SPIDER’ eligibility criteria directed the approach. The quality of studies included was screened with the assessment sheet designed by Hawker and colleagues. The experiences reported were analysed and themes were synthesized. Ethical consideration: Ethical requirements were respected in every phase of the research process. Findings: Nineteen qualitative studies met the inclusion criteria. The quality of the relationship with the parent appears to be an important determinant of the children’s caregiving experience. Within this context, three themes were found: caregiving as an emotional rollercoaster, a normatively demanding experience and an opportunity for personal development. Discussion: Children caring for their ageing parents have to deal with a wide range of contradicting and conflicting norms and values. Implications for healthcare professionals and future research have been discussed. Conclusion: Caring for ageing parents is a continuous quest for giving the best possible care and living up to one’s personal values, within the context of the parent’s declining health. Professionals who support filial caregivers should address not only practical responsibilities but also the normative questions and moral considerations caregivers are dealing with. (shrink)

An aging population is often taken to require a profound reorganization of the prevailing health care system. In particular, a more cost-effective care system is warranted and ICT-based home care is often considered a promising alternative. Modern health care devices admit a transfer of patients with rather complex care needs from institutions to the home care setting. With care recipients set up with health monitoring technologies at home, spouses and children are likely to become involved in the caring process and (...) informal caregivers may have to assist kin-persons with advanced care needs by means of sophisticated technology. This paper investigates some of the ethical implications of a near-future shift from institutional care to technology-assisted home care and the subsequent impact on the care recipient and formal- and informal care providers. (shrink)

Dieser Beitrag untersucht die Frage, ob erwachsene Kinder ihren Eltern als deren Kinder etwas schulden. Ich argumentiere, dass sich entsprechende filiale Pflichten nicht begründen lassen, und zwar weder i.) mit Verweis auf Güter, die Kinder im Laufe ihrer Kindheit von ihren Eltern erhalten haben, noch ii.) vor dem Hintergrund der aktuellen Beziehung zwischen Eltern und ihren erwachsenen Kindern, noch iii.) mit Blick auf das positive Potential dieses Verhältnisses für Eltern wie Kinder. Zwar haben Kinder also keine filialen Pflichten, doch sind (...) sie iv.) dennoch in ihrer filialen Freiheit eingeschränkt. Diese Einschränkung ergibt sich aus der speziellen relationalen Vulnerabilität, welche die Eltern-Kind-Beziehung prägt und die Kindern Grund gibt, sich in ihrem Verhalten ihren eigenen Eltern gegenüber von dieser Verletzlichkeit leiten zu lassen und auf sie Rücksicht zu nehmen. (shrink)

The COVID-19 pandemic has exacerbated many social problems and put the already vulnerable, such as racial minorities, low-income communities, and older individuals, at an even greater risk than before. In this paper we focus on older adults’ well-being during the COVID-19 pandemic and show that the risk-mitigation measures presumed to protect them, alongside the generalization of an ageist public discourse, exacerbated the pre-existing marginalization of older adults, disproportionately affecting their well-being. This paper shows that states have duties to adopt and (...) put into practice redress measures to compensate for the negative consequences of COVID-19 public health policies on older adults’ overall well-being. These duties flow from the minimal ethical requirement of respect for persons. We show that respect is a morally basic attitude that presupposes taking the others’ interests into account, with the aim of advancing their well-being. This duty is not limited to kinship, relatives, and friends but it extends to states and the rest of the civil society. In the conclusion, we draw lessons from the COVID-19 pandemic and sketch some redress measures that could compensate for the decrease in older adults’ well-being as a result of the adoption of measures to contain the spread of the virus. (shrink)

Ausgehend von einem im Februar 2014 ergangenen BGH-Urteil, das die Unterhaltspflicht von erwachsenen Kindern gegenüber ihren Eltern auch im Falle des einseitigen Kontaktabbruchs bejaht, werden in diesem Beitrag Überlegungen zur Struktur und den normativen Implikationen der Eltern-Kind-Beziehung angestellt. Zum einen wird dafür plädiert, die Eltern-Kind-Beziehung als nichtsymmetrisch, d. h. als Komplex aus symmetrischen und asymmetrischen Beziehungen zu verstehen. Zum anderen wird hinsichtlich der normativen Implikationen der Eltern-Kind-Beziehung dafür argumentiert, dass Verpflichtungen innerhalb dieser Beziehung nicht vom bloßen Bestehen, sondern vom Wert (...) der Beziehung abhängig zu machen sind. Aus diesem Argument wird gefolgert, dass die im BGH-Urteil sowie im in der einschlägigen Literatur diskutierten „Past Parental Sacrifices Model“ unterstellte Symmetrie der Eltern-Kind-Beziehung zu einer inadäquaten normativen Analyse führt. Damit wird der Rechtfertigungsstrategie filialer Verpflichtungen, die auf ein Quidproquo bezüglich zurückliegender elterlicher Versorgungsleistungen gestützt ist, eine Absage erteilt. (shrink)

One of the most basic understandings of nursing is that a nurse is a caregiver for a patient who helps to prevent illness, treat health conditions, and manage the physical needs of patients. Nursing is often presented as a caring profession, which provides patient care driven by ideals of empathy, compassion and kindness. These ideals of care have further been foregrounded through the development and implementation of stress on patient centred care (PCC) and/or person‐centred practice (PCP). Although the idealisation of (...) nursing as a caring profession is common, and one certainly seen as integral by nurses and written into the heart of regulatory documentation, we contend that the actual delivery of care is being undercut by the very regulatory climate that strives to professionalise care. As we outline, with specific reference to the context of Australian Nursing, this transformation delivers a commodified, even McDonaldized, model of patient management rather than care. It seems that even with its explicit stress on PCC and PCP, Australian Nursing cannot live up to its own care ideals. Having outlined this problem, the paper then demonstrates the ways in which PCC is thwarted at the coal face of nursing practice and that there must be an institutionalised change to be able to provide genuine patient‐centred care. (shrink)