EJAIB Vol. 31 (6) September 2021
www.eubios.info

ISSN 1173-2571 (Print) ISSN 2350-3106 (Online)

Official Journal of the Asian Bioethics Association (ABA)

Copyright ©2021 Eubios Ethics Institute(All rights reserved, for commercial reproductions).

29 August 2021 - 2 September 2021

Abstracts
29 August 2021 (Sunday)
Opening words and Welcome- Prof. Darryl Macer, Ph.D., Hon. D.
Secretary, Asian Bioethics Association
Email: darryl@eubios.info

Thanks to the cooperating organizations: Asian Bioethics
Association (ABA); Eubios Ethics Institute; American
University of Sovereign Nations; Center for Science,
Technology and Society, Chulalongkorn University,
Thailand; and the International Peace and Development
Center @ Kaeng Krachan, Thailand.
Self-introductions
Vaccine Justice and Bioethical Re lections of COVID-19
Immunization in Malaysia- Ravichandran Moorthy, Ph.D.
President, ABA; Asia Paci ic Forum on Ethics & Social Justice;
Universiti Kebangsaan Malaysia
Email: drravi5774@gmail.com

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With almost 800,000 Covid-19 positive cases and morethan 5000 deaths, Malaysia registered the fastest rate of
infections in Southeast Asia. The National Immunization
Programme, which commenced in late February 2021,
was riddled with a particularly slow rate of vaccination,with only 4 percent of the targeted group vaccinated inthree months. The delay, coupled with publicdissatisfaction over allegations of vaccine injustice,unclear prioritization, queue jumping by people in theposition of power and other aspects of the vaccination

process, have sparked a lot of public debate and concern.
This paper examines the ethical issues that arise in thevaccination discourse in Malaysia using an interpretativesocial science approach, focusing on vaccine justice andthe bioethical principle of "respect for autonomy." Theindings show that despite several shortfalls in the
immunization process, most Malaysians are still
optimistic and support the government immunization
initiatives. Building public trust crucial in ensuring the
success of the immunization programme.
Keywords: Covid-19, Immunization, Malaysia, Bioethics, Justice,
Autonomy, Public-debate

How did the media mislead public opinion during the
COVID-19 pandemic in South Korea?
- Manjae Kim, Ph.D.
Professor, Dept. of Urban Planning and Real Estate, GWNU;
Vice President for Korea, Asian Bioethics Association (ABA)
Email: mjkim@gwnu.ac.kr- Bang-Ook Jun, Ph.D.
Emeritus professor, Dept. of Biology, Former President, ABA
Gangneung-Wonju National University (GWNU), Republic of Korea

Scienti ic indings play a crucial role in getting through theCovid-19 pandemic, but it is political leadership that
determines how to bring them to policies. In uncertain
times, it is perhaps the safest way to establish a policy thatre lects scienti ic results to overcome new problems thathave never been experienced. When scienti ic results
themselves are constantly changing and new experiments
are producing new results, however, it is not easy to judge
which policies are most appropriate. Therefore, the role ofmedia is also important to recognize the in luence ofpolicies from various perspectives.
While the provision of false information was mainly
through SNS in other developed countries, it was the
major media that played such a role in South Korea.
Among others, the Chosun Ilbo, the JoongAng Ilbo, and theDong-A Ilbo are particularly infamous for criticizing thegovernment's policies based on unscienti ic information.
For example, they criticized the supply, timing and type of
vaccine, which tended to be over-politicized and misledpublic opinion during the pandemic.
Therefore, this paper tries to analyze some newspaper
articles that are far from scienti ic discoveries and show
how politically motivated articles play a negative role inovercoming the pandemic.

s

21st Asian Bioethics
Conference (ABC21):
Bioethics in the
COVID-19 Eraff

Eubios Journal of Asian andInternational Bioethic

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Eubios Journal of Asian and International Bioethics 31(6) (September 2021)

Keywords: Covid-19, major media, false information, pandemic
policy, South Korea

Inappropriate Advertisements Related to COVID-19 inIndia: Ethical and Policy Perspectives- Abhik Gupta, Ph.D.
Former Vice Chancelor, Assam University, Silchar, India; Past Vice
President for India, Asian Bioethics Association
Email: abhik.eco@gmail.com

The COVID-19 pandemic has exposed diverse faces of thehumankind ranging from sel less service and sacri ice forfellow beings to unethical pro iteering, rumor-mongeringand other inhuman acts. One such area of concern is the
publication of misleading advertisements around
COVID-19 claiming false cures and preventive measures.
The more blatant ones have professed a cure for
COVID-19 by consuming certain medicines, using “anticorona fabric”, wearing shirts that “kill 99 % of the
COVID-19 virus”, and sleeping on an “anti-corona virus
mattress”, among others. In the case of the COVID-curedrugs, the Ministry of Ayush, Government of India, has
stopped the advertisement of the said drugs till all details
about their chemical composition and clinical trials are
examined by competent agencies. The AdvertisingStandards Council of India (ASCI) has reviewed over 500
advertisements making COVID-19 related claims. These
include regular consumption of chicken and a speci ic
bread brand to boost immunity against the coronavirus.
The ASCI has subsequently issued guidelines forappropriate advertising of products making COVID-19
related claims. Perhaps such regulatory action has led tosubtler advertisements involving products claiming toincrease immunity to ight against COVID-19 in an
attempt to in luence the consumers. For instance, aparticular product talks of the formation of “nutriimmuno” complexes after its consumption, while anotherprofesses its role in boosting immunity among health care
professionals. Consequently, these advertisements raise
two issues, the irst being the adequacy of institutional
mechanisms and legal instruments for curbing suchpractices. The second is the more fundamental issue ofself-imposed adherence to ethical standards among thepharmaceutical, nutraceutical and other industries. We
may need to develop a concept like the ‘Corporate EthicalResponsibility’ to promote ethical practices by companies,
coupled with a renewed focus on ethics education at alllevels of our education system.
Covid-19 and Mental Health: A Survey of Global Dataand Information- Layne Hartsell, Ph.D.
Chulalongkorn University, Thailand; Bangkok Asia Institute,
Washington D.C.
- Alexander Krabbe, MD
Havelhohe Hospital, Berlin, Germay
Email: hartsell.mlh@gmail.com

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One of the major public health recommendations at the
beginning of the Covid-19 pandemic that continues up to
today is the recommendation and at time, wide impositionof social distancing. In our 2020 paper on biopolitics, wegave mention and questioned this public health practiceforeseeing the potential for isolation in a world that has
experienced massive in lux of people to urban centers andyet already isolated due to the breakup of social bonds
and an economy that has experienced serious problems
requiring a number of bailouts during the past decade. We
had thought that the Pandemic response would increase
isolation if social distancing would prevail over physicaldistancing. Physical distancing, while still being social,would likely have been a better policy. Today, an opiod
crisis continues in the United States, eating disorders arewidespread, and general anxiety and depression areaffecting many. We will discuss the literature and media toarrive at a viewpoint on the conditions of mental health in
the Covid-19 pandemic, where we now see variants andwave after wave of infections and deaths, such as thecurrent record breaking numbers in South Korea andIndonesia after 19 months. Even with vaccines thePandemic shows no signs of abating. We suspect that not
only will mental health continue to be affected as thePandemic continues into its second year, but problems
will continue into the future, after the pandemic subsides
and the virus becomes endemic.
Citizen Science for Planetary Health- Alexander Waller Ph.D.
AUSN Visiting Professor of Education and Environmental
Ethics, American University of Sovereign Nations; Thailand
Email: Arwaller1@hotmail.com
Citizen science has increased during recent decades fromparticipatory data collection, to developing researchquestions and methodologies, analysing results, reporting
outcomes and recommending actions. Projects cover a
very wide range including; simple species observationsa n d e c o l o g i c a l a n d b i o d ive r s i t y a s s e s s m e n t s ,environmental monitoring such as air and water quality,
epidemiological surveys, food consumption andagricultural process evaluations. The indings from citizen
science has been used to inform nature conservation
practices urban planning decisions, agricultural andhealth policies. This paper reviews the major bene its andpitfalls of citizen science, with particular reference tosome ethical issues. It draws some comparisons tocommunity education and proposes somerecommendations for promoting more citizen engaged
research in bioethics projects to promote planetary
health.
The Role of Narrative in Bioethics; Covid as a Disaster,and the Beyond- Hasan Erbay, MD, Ph.D, MBGPH
Afyonkarahisar Health Sciences University, Faculty of Medicine,History of Medicine and Ethics. Afyon,Turkey
Vice President for Asian Ethnic Minorities, ABA
Email: hasanerbay@yahoo.com

There are many approaches to bioethics, and narrativity
may be an alternative way of “doing ethics” andunderstanding moral thinking. Narrative ethics means theuse of literary narratives to inform ethical deliberations;for others, it involves a close listening to individuals’
stories. Narrative ethics is also one that views narrative as
foundational to ethical practice. A narrative may not focus
specially on the basic issues of bioethics such as principles
and rules. Of course, this does not mean that a personal

Eubios Journal of Asian and International Bioethics 31(6) (September2021)
narrative (even implicitly) is independent of an ethicalsensibility.
In particular, in mass disasters like Covid, people becomelonely and thus more individualized. For an individualized
person, being alone with herself also opens the door to
realize moral values or to be a chance to challenge thesevalues. The narrative is also a kind of rehabilitation
process so that it is seen that the narrative and the efforts
related to the narrative come to the fore in the processes
in which suffering or all kinds of negativity areexperienced. When the effort to tell and express the
feelings inside is accepted as one of the basic
psychological needs of human beings; the re lection of
moral elements in this narrative is inevitable. Especially inbiological disasters such as Covid, it will be noticed that
this narrative is also of interest to bioethics, and even if
the basic ethical values are not taken into account at irst,
but ethical inquiries are included in this narrative with adeep analysis.
This study focuses on the function of the narrative indealing with bioethical issues in the event of a disasterlike Covid.
Keywords: Narrative ethics, story, disaster, awareness of moral
values.

Research Ethics: Did Scienti ic Research Let a VirusOut?
- Nader Ghotbi, Ph.D.
Ritsumeikan Asia-Paci ic University, Beppu, Japan; Vice President
for Japan, Asian Bioethics Association
Email: nader@apu.ac.jp

The mere possibility that the new coronavirus causing the
pandemic might have leaked out of a research lab createsa heavy burden on the science community all around theworld over the position of research ethics and their senseof ethical responsibility as researchers. Although theexperience of unethical research during the World War II
led to the development of principles over medical
research on humans, and these have been complemented
over the years with more stringent protocols, still a lot ofshady research is being done under the curtain of militaryresearch, with such designation used as a tactic to blindobservers from research activities and committing
researchers to silence and secrecy. This presentation will
examine the bits of news leaking over the incident that‘possibly’ caused a pandemic which resulted in the deathof millions of people and the suffering of tens of millions
more with tremendous economic and social maladies that
may continue well over a decade. It seeks an answer to thequestion of ‘responsibility’ and ‘transparency’ inbiological research.
Bioethical Principles Revisited in the COVID-19
Pandemic Era: Harmonizing Epidemiology Data andClinical Experiences- Duujian Tsai M.D., Ph.D.
Pintung Christian Hospital; Social Empowerment Alliance;
National Central University; Academia Formosanica, Healthy Asia;
Taiwan; Vice President for Taiwan, Asian Bioethics Association
Email: duujiantsai@gmail.com

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Proportionality could easily be regarded as the mostessential principle for regulating public policy andindividual behaviors under the Pandemic Era. We argue

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that urgent responses to emergent public health eventsshould follow the ethical principle of proportionality, in
harmonizing various aspects considering restriction andliberation at different balances between individual as well
as societal concerns.
Nevertheless, sophisticatedinterdisciplinary approaches should be in command lest
individual liberty and economic growth be unduly
sacri iced in the name of public health considerations-various large-scale lock downs are cases in point. It is
critical to bring in clinical experiences in managing publichazards for public good.
This paper, with a historic comparative approach andnarrative inquires, will explore the initial lock-down in
Wuhan, the controversial control measures from major
western countries, and the recent pandemic outbreaks in
the Southeast Asian countries.
Five key factors attributing to the global COVID-19
outbreaks will be identi ied and evaluated—namely,
weather condition, population density, religious culture,socio-political system and infection-control measures.
Whereas some epidemiology studies seem to dominate
the scene in developing regulatory frameworks, we indthat it is very important to contextualize epidemiology
evidence with clinical experience so as to ensure
regulatory justice, ef iciency and effectiveness.
Bioethical principles should be applied to cope with theparadox of health policy regulations and individualautonomy. The crucial approach to bioethical principles
could be well in place by harmonizing epidemiology dataand clinical experiences. This paper will then conclude
and recommend that bioethical principles be developedwith lessons learned from clinical ethics and just publichealth policies.
Keywords: proportionality, historical comparative approach,narrative inquiries, public health policy, individual liberty,
bioethical principles, just public health policy.

Covid 19 pandemic; Evaluation from an
ophthalmology perspective- Sibel Inan, MD,
Associate Professor, Afyonkarahisar Health Sciences University,
Faculty of Medicine, Department of Ophthalmology, Turkey
Email: drinan33@gmail.com

The rapid spread of the Covid 19 pandemic has affected
healthcare globally. There were also regulations ino p h t h a l m o l o g y p r a c t i c e s . H o w e v e r, w h i l e
ophthalmologists continued their clinical activities inaccordance with these measures in private or publichealth institutions throughout the country, they also took
part as active personnel in pandemic polyclinics.
During the pandemic, the follow-up of patients withchronic eye disease was disrupted in general. Mostly, thisdisease group included patients with age-related maculardegeneration (AMD) and diabetic retinopathy. Thesediseases generally affect the elderly population, which isamong the high-risk groups for COVID-19. This age grouphas been advised not to go to hospitals except inemergencies.
During the restriction period, it was observed that patient
follow-up could not be carried out due to factors such as
travel restrictions, accompanying diseases, fear of
COVID-19 contamination from public transport, etc.

Eubios Journal of Asian and International Bioethics 31(6) (September 2021)

The rapid progress of the pandemic, the mobility in the
low of information, the changing conditions, and theoccupational stress they are in have affected the mental
health of health workers. Support processes should beinitiated before healthcare professionals experiencemental health deterioration due to changing conditions.
Health management organizers should actively provide
mental health support to ophthalmologists as well asother health professionals.
To ensure sustainability in healthcare, additional
measures for infection control can be taken to make eye
clinics more practical. With further research, it will guide
evidence-based practices for healthcare in pandemic
conditions. Algorithms that include the evaluation ofvarious eye diseases such as glaucoma and diabetic
retinopathy can be used. It is necessary to pay more
attention to telemedicine innovations.
Sustainability of clinics is the primary goal in tackling the
problems accompanying this pandemic or any possible
future pandemic. Therefore, solutions are needed.
Developing an equitable guide with the principles ofbiomedical ethics will guide us in tackling thesechallenges.
The Impact of COVID-19 Pandemic on PsychologicalWell-being of African Students in Chinese Universities- Uwimana Alexandre, M.Sc., MBGPH
Dalian Medical University, China; Rwanda
Email: alexukimumu@gmail.com

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The novel Coronavirus disease 2019 (COVID-19) was
irstly reported in Wuhan, in December 2019, and rapidly
spread throughout China and worldwide. To contain
COVID-19 pandemic, we were forced to change our waysof living, and to get accustomed to the new way of livingsuch as social distancing, restrictions on social gatherings,
lockdowns, travel restrictions, online studying, and so on.
Living as a university student is generally associated withhigh level of stress, so additional stressors worsen theirvulnerability. Many studies have showed thatinternational students are prone to develop mental
disorders due to several challenges they face while living
in a foreign country far away from their family.
This is a cross-sectional study conducted using WeChatbased online survey questionnaires. The main objectivesof the present study was to evaluate the impact of
COVID-19 pandemic on mental health of some African
students in some Chinese universities, and to explore thelevels of mental well-being, stress, depression, andanxiety. The study sample comprises 134 students from29 African countries, scattered in 4 provincial-levelmunicipalities, 18 provinces in 27 cities, and 54 Chinese
universities. WEMWBS-14 scores showed that 9 (7%) and18 (13%) participants had very low mental well-being
and below the average mental well-being, respectively.
PSS-10 scores revealed that 114 (85%) and 6 (4%)
participants had moderate stress and high stress,
respectively. PHQ-9 scores indicated that 39 (29%), 45(34%), 33 (25%), and 7 (5%) participants had minimal
depression, mild depression, moderate depression, andmoderately severe depression, respectively. GAD-7 scoresfound that 74 (55%), 41 (30%), and 19 (14%)

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participants had minimal anxiety, mild anxiety, andmoderate anxiety, respectively.
Mental health distress of African students in China wassigni icantly associated with age, marital status, educationlevel, being or knowing someone who tested positive for
COVID-19, knowing someone who died, behavior changes(increased alcohol consumption, tobacco smoking andsexual activity), loss of job for parents or inancial
supporters, decreased income, dif iculty to pay tuition fee,
dif iculty to pay basic needs, online studying, and being in
lockdown.
Universities, everywhere, are called to pay close
attention to African, and foreign, students, and provide
psychological support to all those in need. These indings
may have implications for prevention, psychosocial
intervention and future research.
Keywords: mental well-being, stress, depression, anxiety, African
students, China.

30 August 2021 (Monday)
COVID-19 Vaccine Nationalism is Self-Defeating- Ann Boyd, PhD.
Hood College, USA
Email: boyda@hood.edu

SARS-CoV2 (Severe Acute Respiratory SyndromeCoronavirus 2) emerged in late 2019 and within a few
months was declared a viral pandemic, COVID-19(coronavirus disease 2019). Public health mitigation
responses varied within and among countries.
Government sponsored inancial incentives for vaccine
development enhanced the process of creating vaccines
based on several platforms. Before approval for
emergency use, signi icant quantities of vaccine wereadvance ordered by the United States, United Kingdom,and Canada. To ensure global distribution COVAX(COVID-19 Vaccines Global Access Facility) formed as aninternational agency to distribute vaccine. The purchasing
power of COVAX depends on high and moderate income
countries buying vaccine through the consortium so that
low income countries can be subsidized in purchasing
doses. The goal of distributing vaccine to front line
workers and the most vulnerable in all countries sought
to mitigate mortality from COVID-19.
That a few
countries advance purchased more vaccine than needed
was identi ied as vaccine nationalism. There are moral
reasons for national partiality based on duty of
governments to its residents. Being a community member
has bene its and burdens and shared responsibilities.
Limits however should be set in national vaccine
acquisition and distribution that also recognize a duty to
the global community. Based on equality of persons and a
global perspective during a pandemic, it is prudent todevelop policies that respond to duties to nation-citizens
and global-citizens. Failure to respond globally during apandemic is self-defeating because viral variants emerge
to escape immune defenses making it imperative toachieve not only local herd immunity, but also global herd
immunity.
Keywords: Vaccine nationalism, global herd immunity, COVAX,
viral variants.

Eubios Journal of Asian and International Bioethics 31(6) (September2021)
Bioethical Re lections on Technology
Engagement in the Post-COVID ERA (120 Minute
Panel)
Should individuals deserve a choice of vaccine in
Taiwan?
- Yuchia Chen
National Central University, Social Empowerment Alliance &Healthy Asia
Email: yuchia@sea2003.org.tw

Could we justify the underground usage of ginseng
extract to avoid vaccine side-effects and to elevatepossibly its COVID-19 therapeutic implications?
- Bunrong Kouy
National Central University, Academia Formosanica; Cambodia
Email: bunrong.k@gmail.com

Is it regarded as individual empowerment or
con inement when one is wearing a smart device tomonitor the preclinical status?

- Bunrong Kouy, National Central University, Academia
Formosanica- Duujian Tsai, President, Social Empowerment Alliance and
Healthy Asia

To what extent do we consider it ethically justi iable
when we use smart technology for personal or
surrounding surveillance?
- Estela Lu
Vice General Manager, Healthy Asia & Social Empowerment
Alliance
Email: estela@sea2003.org.tw- Duujian Tsai,
President, Healthy Asia
- Simon Szu-Shan Fan,
Deputy-Superintendent, Pingtung Christian Hospital

What are some lessons from Community Engagement
Efforts during the COVID-19 pandemic in Taiwan?
- Mignonne Man-Jung Chan,
Chief Strategy Of icer, Healthy Asia Co. Ltd.

Is there a feasible ecological horizon in the making
with telemedicine beyond technology con inements?
- Michael Hsu, CEO, Curdoctor Information Service Corp.

Is it a Utopia or Hope when we are designing thesecond-generation smart hospital HIS system?
- Kwong-Leung Yu,
Superintendent, Pingtung Christian Hospital,- Shi-Chuang Chang,
Chair Professor, Pingtung Christian Hospital- Duujian Tsai,
President, Social Empowerment Alliance and Healthy Asia

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Panel Abstract
This is seemingly an era of embracing technology incoping with the COVID-19 pandemics.
Technology
engagement could be rather painful since on the one handthe pandemic threats substantively hurt the most intimate
human interactions with severe horror and unexpected
damages, and on the other hand the pandemic generatessocial and economic catastrophes
On a global scale. Public policy considerations linger
between public con inement and individual liberty.
Various national health policy frameworks are cases inpoint--for instance, the national large-scale vaccination
project is irstly implemented in Israel; monitoring
individuals with surveillance devices at the expense ofprivacy in China; various therapeutic trials withrevitalizing or combining herbal, traditional, and modern

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medicines and certifying or nullifying by experts
treatments of sorts in Taiwan, and the inclination of only
legitimizing or prioritizing the use of message-RNA
vaccine in the US, etc. It is nearly a world of jungle
phenomena with various degrees of popularity around theglobe. Embracing technology so as to resume normal
public life has become the dominate national ideology andthereby legitimate authoritarian/ centralized policies
with little room for individual choice or diversities. The
usual respect for diversity and human choice has beensigni icantly dented or disregarded or ignored. This is atime for re lection on the dilemma we are facing between
an embedded diverse nature and a desired instrumental
culture. Could we cope with the epic COVID-19 global
threat and its rapid mutation nature by such a universal
tendency of one-dimensional instrumental rationality?
This panel will be presented with interdisciplinary
approaches by major partners of Healthy Asia, andillustrate our commitments and re lections on
instrumental regulatory mentality with some questions:
Re lections on the Handling of the Pandemic in
Thailand- Ananya Tritipthumrongchok, Ph.D.
Professor of Leadership Development, American University ofSovereign Nations; Thailand;
Vice President for South East Asia, Asian Bioethics Association
Email: ananya@eubios.info

T h e COV I D - 1 9 p a n d e m i c h a s re s u l te d i n a nunprecedented education crisis. The uncertainty aroundhealth risks and demand for infection prevention andcontrol measures such as physical distancing have led tomassive and recurrent school closures. Governments aregrappling with the complexity of providing education
continuity remotely and how to enable children to safely
return to school after lockdowns are lifted.
School closures have clear negative impacts on childhealth, education and development, family income and theoverall economy.
The decision to reopen schools should include
consideration of the following benefits:•
Allowing students to complete their studies andcontinue to the next level•
Access to essential services, nutrition, child welfare•
Preventing violence against children•
Social and psychological well-being•
Access to reliable information on how to keep
themselves and others safe•
Reducing the risk of non-return to school•
Benefit to society, such as allowing parents to work
Over the past few months, Thailand has seen its latest
wave of student protests rise across the country. The
students -- most of whom are high-school andundergraduate students -- organised themselves under
different banners and made demands that ranged fromending harassment and intimidation against critics of thegovernment, scrapping outdated school rules andreforming the whole education system, to holding newelections, amending the constitution, and even reforming
the monarchy itself (this demand is widely seen as themost radical and is unheard of in recent Thai history).

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Eubios Journal of Asian and International Bioethics 31(6) (September 2021)

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The spread of disinformation and misinformation
alongside COVID-19 is a growing concern worldwide. It isvital to reinforce media professionals' capacity, especiallyin developing countries where access to accurate
information is limited. To this end, UNESCO and WHO
have joined forces to overcome at a local level thechallenges face by media professionals to provide reliable
health information and deconstruct myths on COVID-19
and related vaccines. WHO experts have developed shortaudio messages.
I will also discuss financial stimulus measures, economic
impacts, and the situation of COVID-19 in Thailand. The
history of epidemics in human society is related to healthand food security, that is, humankind has gone throughperiods of epidemic problems and crises that affectdifferent dimensions of social, cultural, economic,
political, state security, health and food. For example, thefall of the Machu Picchu of the Incas was due to theplague. The Incas at that time had no written record. This
combined with colonial invasions led to a change of rulers.
resulting in the erasing of historical memories. Or in the
Bible, Exodus, the Jews, was a nation of religion and God.
There is a record of epidemics and great disasters in the
Ten Commandments. In Asia, there were also great
epidemics that had a great impact on society.
The history of epidemics in Thai society has happened
many times. lead to crises in various dimensions bothsocial, economic, political, and health security resource
security and food security, etc., reflected through at least 3
dimensions of the worldview as below. Understanding"worldview" leads to deeper understanding of people's
thinking systems and perspectives during the epidemiccrisis.
1) Worldview towards rituals and supernatural powers
2) Worldview towards the Covid-19 Crisis
3) Worldview towards family members, people in thecommunity and society
In addition, various traditions reflect the worldview andrelationship between “human” and “nature” and“utilization” of each other. Do we learn anything from
history?
Impacts on public health, social, economic and national
security is expanding and becoming more and moreworrisome from the panic splitting the ideas of the local
people leading to condemnation neglecting necessary
assistance and lack of encouragement for vulnerable
groups living in crowded environments amid this newwave of COVID-19 pandemic.
What happened did not reinforce the government's strict
containment measures to prevent the spread of thedisease from harming people in the area. and expanding
throughout the country but it will make it even moredifficult to control and prevent the spread of the disease.
We may not be able to have a correct understanding.
Lack of trust and lack of cooperation among government
agencies, citizens, migrant workers and those infectedwith COVID-19 in local areas.
“Thailand will defeat this virus and get out of the crisis
again.” Because of the power of our cooperation, all
network partners and the role of the people who areaware in the area will lead to the trust and cooperation
between the government and the people. To control the

new wave of Covid-19 outbreak, which will be an
important factor that will help Thailand get through thisnew crisis.
Issues of justice and equity experienced by student
nurses for continuing education during COVID-19
pandemic- Sumaira Khowaja-Punjwan, PhD (USA), CPB (USA), MBEth (Pak)& BScN(Pak)
Founding Principal & Associate Professor
Saifee Burhani School of Nursing, Saifee Hospital Trust
ST-1, Block F, North Nazimabad, Karachi-74700 Pakistan
Email: sumaira.khowaja@yahoo.com; skpunjwani@sbson.edu.pk

During COVID-19 pandemic the major issue that students
has faced is closure of school and continuation of
education via online mode as the students and faculty
members were asked to remain at home considering theirsafety as well as public health safety. Students hold adistinctive position in society and are morally special
because they are dependent on educators, parents andstake-holders for their well-being and protection.
Therefore, the decisions regarding students requires
special obligation that society owe to children and it
should be based on the standard of best interest.
The foremost concern that students has experienced byclosure of school is pertinent to justice and equity as thestudents from disadvantaged background haveexperienced inconsistent impact on their education.
Inability to access online learning resources due to low
economic factor has posed a greater risk on students
learning because the abrupt transition to distancelearning required high-speed internet and technology
resources. This paper discusses about the challenges that
nursing students has experienced for continuing
education during COVID-19 pandemic especially, theissues pertinent to justice and equity.
Duty-bound: Ethical Roles and Responsibilities of the
LGU-Malungon in the Implementation of DepEd’s
Radio-Based Instruction- Khyres Gell M. Nineza
khyresgellnineza@g.cjc.edu.ph- Rogelio P. Bayodrogeliobayod@g.cjc.edu.phCollege of Education, Arts and Sciences (CEDAS)Cor Jesu College, Inc. Digos City, the Philippines

The COVID-19 pandemic has caused so many changes inpeople’s way of life. One thing is the adjustment it hascaused in the ield of education--- the shift fromtraditional face-to-face instruction to new methods andplatforms. As the national government enforces publichealth measures to ight against the virus’ transmission,
learning institutions are faced with the challenge ofdelivering quality education with the new norms.
Teachers are challenged in inding ways to address thechanges responsive to the current situation. As part oftheir campaign for effective distance learning, theDepartment of Education has come up with the Radio
Based Instruction (RBI). In the Municipality of Malungon,
RBI has already been started in some parts, however, its
ef icacy doesn't reach certain remote areas in themunicipality. This paper discusses the ethical roles andresponsibilities of the Local Government Of icials ofEubios Journal of Asian and International Bioethics 31(6) (September2021)
Malungon as the main implementers of the said program.
Anchored on Kant’s Deontological Ethics and Bentham’s
Utilitarian Ethics, this paper argues that those responsiblefor imposing the RBI in Malungon should be duty-bound,have the value of integrity, and take into consideration thegood of the people.
Keywords: Education in the new normal, Radio-Based Instruction,
Ethical Responsibilities of Government Leaders, Deontological
Ethics, Utilitarian Ethics.

To intervene or not? Dutch and Indonesian ethics
teachers’ ideas on how to respond when hearing
alarming cases from medical students in class- Amalia Muhaimin1,2, Maartje Hoogsteyns2, Derk L. Willems2
1 Department of Bioethics and Humanities, Faculty of Medicine
Universitas Jenderal Soedirman, Indonesia
2 Department of Ethics, Law, and Humanities, Amsterdam
University Medical Centre, The Netherlands,
Email: amalia.muhaimin@gmail.com,
m.hoogsteyns@amsterdamumc.nl

Introduction: Ethics case discussions in medical schools
are normally con idential so everyone can speak freely
and safely. But what should teachers do when a student
brings forward a case that they consider to be outright
alarming, e.g. potentially harmful for patients or students?
Should they hold back from action or should theyintervene? This study aims to explore how ethics teachers
in medical schools (would) respond to an alarming casebrought forward in class.
Methods: We used qualitative methods with purposive
sampling and conducted in-depth interviews with 17
ethics teachers in Indonesia and 18 in the Netherlands,
from 16 medical schools. The studies were notcomparative in its design. However, for this occasion, we
will compare the results and bring forward some issues
that might explain the differences between the twocountries.
Results: Teachers mentioned alarming cases ranging frompower abuse, fraud and deception, violation of patient’s
rights and autonomy, to sexual harassment. Most Dutch
teachers said they will address the issue in class but are
reluctant to take action outside of class. In Indonesia, on
the other hand, teachers were generally convinced of theneed to take action, despite the numerous barriers they
identi ied.
Conclusions: What counts for both countries is thatteachers carefully have to consider the risks andconsequences before taking action, and that support fromhigher authorities can be crucial. It is important that
ethics teachers start to acknowledge and explore the(im)possibilities of addressing unjust situations fromtheir speci ic positions in medical institutions.
Egg yolk and risk and severity of COVID 19

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- Shamima Lasker 1, Md Abdul Jalil Ansari 2, Md Jafurullah 3, Arif
Hossain 4
1. PhD, MPH, MPhil, EMMB, MSc; Professor & Head of Anatomy,
Shahabudddin Medical College; Vice President (Bangladesh) ,Asian Bioethics Association ( Bangladesh), Email:splasker04@yahoo.com
2. MBBS,MD, MCPS; Principal and Professor of Endocrinology;
Shahabuddin Medical College & Hospital, E-mail:ansariabduljalil@hotmail.com

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3 MBBS, MD; Director & Professor of Biochemistry; Shahabuddin
Medical College, Email: jafarullah2020@yahoo.com
4. PhD; Professor & Course Co-coordinator; International Affairs
and Human Rights, Etrat University; Vice President, Asian
Bioethics Association (South Asia); Vice President of Bangladesh
Bioethics Society; Email: ahosssainbbs@yahoo.com

Abstract
Vitamins, A, E, D & K; zinc and selenium gives immunity
toward infection. Research showed that people withcompromised immune systems are at greater risk withnovel coronavirus. Egg yolk contains full of vitamins, A, E,
D & K; zinc and selenium. A lot of coronavirus quarantine
facilities around the world, patients in recovery andhealthcare workers are offered eggs with their daily meals
to boost up immunity. General people are asked toconsume Vit A D C K and Zink to boost up their immunity.
There may have relation between micronutrientsconsumption and early recovery or not infected fromCOVID 19 at all. This article explains the previous food
habit of egg yolk and risk and severity of COVID-19. It will
be ethical to physician to develop a new medical
treatment schedule if positive correlation is found. Our
result may also have impact on policy initiative.
Key Words: Fat Egg yolk, immunity, COVID 19 pandemic

Ethical re lections on COVID-19 in Thailand-Soraj Hongladarom, Ph.D.
Director, Center for Ethics of Science and Society,
Chulalongkorn University, Thailand
Email: Soraj.H@chula.ac.th2021 ABA General Meeting (Planned subject
to all ABA Board members schedule)

31 August 2021 (Tuesday)
Re-Purposing Transportation Providers to Provide
Emergency Medical Services in the Low- and MiddleIncome Asian Settings During COVID-19- Peter G. Delaney BA1,2,3, Zachary J. Eisner BS1,2,3, Krishnan
Raghavendran MBBS2,4
1University of Michigan Medical School, Ann Arbor, Michigan
2Michigan Center for Global Surgery, Ann Arbor, Michigan
3LFR International - Sierra Leone
4University of Michigan Department of Surgery
Email: zeisner@me.com; petergde@med.umich.edu

Objectives: In 2019, the World Health Assembly declared
emergency care essential to achieve Sustainable
Development Goals. However, many Asian low- andmiddle-income countries (LMICs) have yet to develop
robust and inancially sustainable approaches to deliver
prehospital emergency medical services (EMS) at scale, as
existing systems are widely heterogeneous and traditional
high-income country models are infeasible. Innovatively
re-thinking EMS delivery in resource-limited settings isnecessary, as timely access to emergency care cansubstantially reduce mortality.
Description: We created the Lay First Responder (LFR)
model by leveraging pre-existing transportation
infrastructure. We launched pilot LFR training programsof motorcycle taxi drivers in sub-Saharan Africa andCentral America between 2016-2019. Our LFR curriculum

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Eubios Journal of Asian and International Bioethics 31(6) (September 2021)

focuses on scene management, airway/breathing
management, bleeding/hemorrhage control, fracture
splinting/immobilization, and patient transport by
motorcycle. We simultaneously studied knowledge
improvement and retention, longitudinal skills usage,changes in emergency coverage, program cost,socioeconomic effects, and patient clinical impact.
Lessons Learned: Across 2,171 patient encounters, LFRs
provided prehospital care and transport, decreasingnecessity for traditional ambulance usage by 92.5%,
avoiding costly infrastructure spending, and increasing
emergency care access. Locally sourcing irst-aid
materials reduced cost to ensure long-term essential item
availability, as per trainee cost was $6.54USD. Medianpre-/post-test scores improved by 43.5 percentage points(34.8% vs. 78.3%, p<0.0001), with signi icant knowledge
retention at six months (60.9%). Deploying a "Training-oftrainers" (TOT) model increased sustainability andeffectively taught thousands of LFRs. LFRs reportexperiencing a professional identity change, increasing
local stature and customer acquisition (24.39% greater
income than non-LFR motorcycle taxi counterpart
controls), incentivizing voluntary long-term LFR
involvement of 75% of initial participants after 3 years.
Future Steps: The LFR model may be a sustainable
alternative to formal ambulance-reliant EMS that are costprohibitive in LMICs. Additional, large-scale LFR programs
should be piloted across Asian LMICs to ensure modelcompatibility and cost-effectiveness.
COVID-19 PPE Waste Management: A looming
Ecological Crisis in the Philippines?
- Aldrin F. Quintero
Notre Dame of Marbel University, Philippines
mengzi.khun@gmail.com

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Presently, the world is focusing to combat COVID-19,
however, we can foresee the issues of economic crisis andecological imbalance. We have to prepare ourselves tomeet the challenges which are forcefully imposed by the
COVID-19 pandemic, so as to maintain sustainability.
Researchers are working on the development of different
aids to cure and prevent the disease. Personal protection
equipment (PPE) has become an essential prerequisite forhealthcare workers. PPE kits are reported to provide
suf icient protection against pathogens but their disposal
can be devastating to environment.
The Philippines has generated 52,000 metric tons of
medical waste since the start of lockdown March 2020.
This is equivalent to 2 million sacks of rice, with each sackcontaining 25 kilograms of rice, according to Departmentof Environment and Natural Resources (DENR). This
paper asserts the following; irst, that the wrong disposalof the PPE could become a growing problem for theenvironment and public health in the Philippines. Second,that the public authority specially the policy maker needs
to lay out new waste disposal standards for the generalpublic and promote reusable PPE whenever possible.
Third, the wrong disposal of waste also involves
environmental risks and raises issues of justice. Just like
COVID-19, our waste, plastic, and PPE pandemics cannot
be solved overnight. But knowing our moral obligation
how to pivot to sustainability, responsibly dispose ofwaste, and recycle as much as humanly possible is half thebattle.
Keywords: Environmental Ethics, Public health, Sustainability,
Waste Management,

Hydropower Induced Displacement Challenges after
the COIVD-19- Ribesh Khanal
PhD. Student in Resettlement Science and Engineering, China
Three Gorges University, Yichang, Hubei Province, PRC. China
Email: khanal.ribesh@hotmail.com

Development Induced Displacement and the ethical issues
surrounding the large projects have been at the forefrontof the discussion for many years. Typically, the issues on
the hydropower development and large dams have been
debated for many years. World Bank even stopped
funding the mega-dam projects with the negative issues
and effects of these projects on both the ecological andhumanitarian point of view. However, after the 2000
World Bank invested in the hydropower and iscontinuously investing. In 2015, the International
Consortium of Investigative Journalists estimated that in
the decade between 2004 and 2013, 3.4 million people
were displaced physically or economically in World Banksupported projects. Not only did the Bank cannot ensurethat displaced people were adequately compensated, it
did not even know about their fate.
Hydropower resources are a renewable energy and canhelp our efforts to reduce the Co2 emissions, as it is a low
carbon technology (Greenhouse gas emissionsInternational Hydropower Association). Hydropower
generates over 4000 terawatt hours of electricity globally
every year enough to supply over 1 billion people withclean energy. However, hydropower represents about only
17% of total electricity production according toInternational Energy Agency. Understanding bene it ofhydropower and with the technological advancement the
recent surge in the development of hydropower projects
has brought up the economic bene its for many
developing countries such as Laos, Nepal, Cambodia andso on, however, because of the weak formal and social
welfare system in these countries the concern on
sustainability of these projects are genuine. The challenge
for hydropower developers is to create projects which are
not only environmentally sustainable but also sociallysustainable. For Example: Nepal has the potential toproduce over 43 thousand megawatts of hydroelectricity.
Currently, there are over 91 hydropower plants thatgenerate 600 megawatts of hydroelectricity. Nepalese
government has planned to increase its current 67.3%
access to electricity to 1426 MW (87%), by 2022. Anysuch projects are likely to displace thousands of people
and have severe effects on the ecology.
However, once the population is displaced from theoriginal habitats, it is likely to rise the risk of being forced
to the live outside of their networks and worrying aboutfood security, health security, etc. The balance is likely toshift after the COVID-19 as the risks of people who werealready vulnerable after being displaced from their
original settlement are likely pushed towards theimpoverishment. Several researches have found thatduring the time of crisis people are likely to rely on their
networks for any solace or support. In case of theEubios Journal of Asian and International Bioethics 31(6) (September2021)
displaced people, the support is likely to be less than
before as they are already forced to leave apart from theirfamily and relatives? Hence, minimizing the negative
effects of these projects for the greater good of the nation
is an ethical and moral challenge. Several researchers
have proposed various theories on how to minimize thisrisk hence we can carry a more fair development projects
without harming the environment and settlements
around the project areas. Among these theories,
environmental justice has the potential to reduce thenegative risk and provide justice to both from theecological and human point of view. In this paper, we will
discuss how we can apply the how environmental justicein order to mitigate the negative effects of hugeinfrastructures development and ethically provide justiceto those affected also after the COIVD-19.
Keywords: Development Induced Displacement, Hydropower,
Environmental Justice

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Sacred Groves in India: An amalgamation of
Ecocentrism and Anthropocentrism (Repository of
Ethical Worldview on Nature Name)- Ganga Raghavan
HOD-Co Curricular Department; Coordinator - Theory Of
Knowledge,IBDP, Lalaji Memorial Omega International
School, 79, Omega School Road
(Pallavaram Road),
Kolapakkam, Kovur Post, Chennai - 600128, India
Email: gangar@omegaschools.org
The environmental value system practiced by Indians wasa pragmatic combination of anthropocentrism andecocentrism giving it a holistic outlook. An ecocentric
viewpoint integrates social, spiritual and environmental
dimensions into a holistic ideal and prioritizes biorights,
emphasizes the importance of education and encourages
self-restraint in human behaviour. An anthropocentric
viewpoint argues that humans must sustainably manage
the global system which might be through the use of taxes,
environmental regulation and legislation. Sacred groves inIndia are patches of natural vegetation protected by acertain community due to religious reasons that reveal an
example of what’s known as social fencing, a combined
action and sense of accountability, that safeguards theforests. From the rain forest of the Western Ghats, to thescrub forests of the deserts of Rajasthan, sacred groves
range from a few square meters to many hectares. The
local communities tend to take responsibility to protect
and nurture the area as the area is usually dedicated to a
local deity.
Sacred groves are valuable in numerous ways – fromsoil and water conservation to being reservoirs ofimportant, rare, and endangered species, and are critical
wildlife corridors and refuges in a fragmented landscape.
Human societies have bene ited both directly andindirectly from these ecosystems for centuries. From clean
air to drinking water; weather and climate control tonatural crop pollination, nature provided us with criticalservices for our wellbeing. Due to modernisation andurbanisation, the belief people have in religious concepts
has declined, in turn reducing the belief in the sanctity ofsacred groves. However, people are also more cautious of
the environment and hopefully that thought balances out
the care given to these lands. An investigation of the309

various principles and practices that governed themaintenance of these sacred groves throughout India for
centuries would help us understand and evaluate the
ef icacies of them and may guide us in conservation ofnature.
Bioethics in Art: Graf iti and Fashion as Freedom ofExpression- Mahta Baratipour, CCP, MBGPH
Research Fellow, American University of Sovereign Nations; IranEmail: maniyaa1998@gmail.com

Art is a language for re lecting the deepest humanemotions which sometimes words cannot express. Art isan inseparable part of life in any culture, and it has thepower to bring people from different cultures together.
Artistic activities and their impacts can affect societies inmany various ways and there is much more potential to
explore the linkage between art and bioethics. Visual art
is about saying what you think and what you feel without
using direct words and can convey messages acrosslanguages and cultures so it is also a fruitful avenue toconsider universal ethics. Art can an escape for the artist,and the observers, from the harsh realm of reality.
Freedom of expression is a basic human right. People
protest when they want a change, they protest to express
their disaffection caused by exacerbation of their
exclusion, frustration or a perceived injustice, and thispresentation will discuss some examples of protest art
through examples such as graf iti and fashion. Protest Art,
especiallyinbigcities, isused as away forminorities
or people
who do nothave otherways toa c c e s sadvertising
media toexpresst h e i r
opinions.
Figure 1: Torn jeans were popularized in popular culture
Fashion is closely linked to social, inancial and cultural
factors of a society. Fashion is not a mere indication of
personal taste, but it’s a re lection of political effects on
people in a society and their level of freedom. Fashion canbe a big help to protest against social class divisions,poverty, sexism and other social problems in direct andindirect ways. One of the biggest clothing problems thatpeople from working class all over the world face iswearing old and ragged clothes because they don’t haveenough money to buy new ones. To help reducing thesocial class differences, the fashion industry offeredripped jeans, which were perfectly welcomed by the310

Eubios Journal of Asian and International Bioethics 31(6) (September 2021)

public, to help low income families. As a result, when the
af luent strata of societies started wearing torn clothes it
was also considered fashionable.
Humankind has recorded our thoughts and wishes fromthe irst steps of our cultural evolution through different
media and objects. Wall paintings are the most primitive
aspect of human art that we can see, and some are as old
as the Paleolithic Age. The ancient animal paintings on
Lascaux cave (France) and the cave of Altamira (Spain)
are dated twenty thousand years in antiquity, and aremementos of primitive art.

Figure 2: An example of graf iti by a1one (Source: Photoby the author)

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One of the most popular subdivisions of protest art is
graf iti. According to American Heritage Dictionary, theword ‘Graf iti’ is derived from an Italian word
‘graf iato’ (scratched), it also could be taken from theGreek word ‘graphein’ (to write).Graf iti ranges from
simple written words on walls which have been existed
since ancient Egyptian times four millennia ago to modern
spray painting on street walls and other public surfaces.
Modern graf iti considers as a public art which can be auseful tool for social liberation and advancing politicalgoals.
One of the most popular subdivisions of protest art is
graf iti. According to American Heritage Dictionary, theword ‘Graf iti’ is derived from an Italian word
‘graf iato’ (scratched), it also could be taken from theGreek word ‘graphein’ (to write). Graf iti ranges from
simple written words on walls which have been existed
since ancient Egyptian times four millennia ago to modern
spray painting on street walls and other public surfaces.
The modern graf iti considers as a public art which can bea useful tool for social liberation and advancing politicalgoals.
The irst signs of graf iti in Iran can be found in mottos
written on walls through 1963-1973, but the irst of icial
graf iti movement started on 1995 by an artist called‘ECNCE'.
An art student called ‘alone' made a lot of graf iti arts onwalls in the west of Tehran since 2003. In some of his arts,
he depicted a child or a teenager among rules andsuppressed by a lot of shoulds and should nots, mischiefs,
and poverty. ‘Eyes' and ‘kids' are the frequent elements in
his art.

Figure 3: Black
Hand's Graf iti,
supporting
Iranian women
who werebanned fromgoing tofootballstadiums towatch matches
Self-censorshipand avoiding
e x p l i c i t
criticism is an
o bv i o u s a n d
c o m m o nfeature in
Iran’s graf iti and it’s because of limitations on all forms ofpolitical criticism in the country. Unlike westerncountries, which are using graf iti in subways and buses
alongside city walls, graf iti in Iran is generally limited to
the walls of public places.
Graf iti arts can be appreciated like regular wall
paintings and can make cities beautiful by expressing
interests of a speci ic society. But the important questionis, ‘Is Graf iti an artistic innovation or just publicharassment?

Figure 4: Jaqua Fragua, This is Indian land (2016)
The irst dedicated academic research institute on
graf iti was the Scandinavian Institute of Comparative
Vandalism founded in 1961. According to their research,
the irst theories of graf iti are rooted in subversive ideas.
Graf iti is commonly considered as a crime and a kind ofcultural deviation because of a supposed connection with
subcultures and criminal gangs by many city of icials andreligious followers. Some criticize it for destruction of
public property while others consider the content ofimages to be promoter of a false culture. Somegovernments laid down irm punishments for these artists(in Singapore there is a jail penalty for graf iti).
During the 1980s and 1990s, a lot of jurisdictions werelooking for a way to reduce and eliminate graf iti from thesociety. They were either afraid of political revolution orthe degradation of society by this art. A huge amount of
resources are used to remove graf iti from city walls andother public places yearly. For example, during 1975 to1980, New York city transit authority outlaid about 100 to
150 million dollars to remove graf iti art from transport
network property, which ended up being ineffective. The
cost was extravagant, cleaning a graf iti with dimensionsof one square meter could be charged USD 750, thus thetotal aggregate cost of cleaning a single railway car could
be USD 78,000. Also, this procedure failed in old wagons(which were built in the 1950s) and lat cars. In thosecases just a part of graf iti was removed and the rest ofthese steel cars were exposed to rusting, so they even got
nastier looking.
To reduce the aesthetic damage caused by graf iti, somecity’s of icials introduced special programs or virtual
graf iti walls for artists to have a legal chance to show
their art. Furthermore, some special places in the city
have been assigned for graf iti arts. However, allocating
speci ic and legal locations for graf iti would take graf iti’s
rebel soul from it and it’s in contrary to graf iti’s nature.
Displacing graf iti arts from public places to speci ic
places will make it more like an outdoor gallery, whichless citizens may witness. The spirit of protest in graf iti,just like other protest arts (such as street theater) isbounded to streets.

Figure 5: Graf iti by Buff Figure 6: Graf iti by Jean
Diss (Berlin)
Dubuffet

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However, there are some possible solutions for effective
messaging transmission without destroying the city’s
aesthetic or public property. By changing the artistic tools
from spray paints, marker pens (and other stuff that arecommonly used in graf iti) to more removable tools, thebudget for cleaning the walls can be signi icantly reduced.
Buff Diss is a non-traditional Australian graf iti artist
who applied masking tape instead of spray paint andmarkers for making his big drawings. He started to use
tapes as his main art tool in 2005 and since then not only
the process of creating art goes faster but also he could
ind a way to deal with legal problems (many countries
have laws against using spray on walls but none have said
anything about masking tape). In the end, although using
tapes makes the artwork more vulnerable, but it causes
the minimum destruction of the background wall.
There are many other ields of art that I do not have time
to explore in this paper, such as music, photography,
cinema, poetry and dance. I encourage all of you to
exercise your talents to express your ideas and to build amore ethical world. We have to know when to protect theprivacy of vulnerable persons, while also changing thesituation. Probably one of the most famous photographsof the twentieth century was of a naked girl burnt fromf

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311

napalm in Vietnam. Yet the same subject matter can bevulgar pornography decreasing the respect of so many
children. Art has a social context.
In conclusion we need to be ethical in all professions,
including in art. Freedom of expression is a human right,
as is creativity. All rights need to be exercised responsibly.
Each action we take has an effect, and art can be achampion of change to improve our world.
Recognizing the Importance of Indigenous
Knowledge and Practices for Early Warning Systems
for Disaster Preparedness and Response in Uganda- Michael Mawadri, Ph.D. and Darryl Macer, Ph.D.
American University of Sovereign Nations (AUSN); Uganda
Email: mmawadri@gmail.com

Purpose: Indigenous communities have always had
their own approaches towards disaster management
using their indigenous knowledge and practices. This
thesis argues that indigenous knowledge (IK) andpractices can save lives from disasters but need to berecognized and documented to provide concrete
evidence to managing disaster and enhance integration
with modern approaches for multi-hazard early
warming for disaster preparedness.
Method: This was a cross-sectional study conductedusing qualitative techniques of FGDs and KIIs in
randomly selected districts of disaster-prone Subregions. These include Amudat and Moroto in Karamoja,
Kitgum and Lira in Acholi and Lango, Adjumani and Arua
in West Nile in the Northern Region; Amuria andKatakwi in Teso, Bududa and Butalejja in Mt. Elgon in
Eastern Region; Kasese and Kibale in Albertine, Westernregion; Rakia and Wakiso in Central Uganda respectively.
The study conducted 56 FGDs with elders, and 56 KIIs
with members of district disaster management
committees (DDMCs) and another 28 KIIs with NGO
partners. Principal Content Analysis, or PCA was used fordata analysis.
Findings: Common hazards identi ied were classi ied ashydro-meteorological and geological, biological andtechnological or anthropogenic in nature. Indigenous
knowledge identi ied were mostly of ecological (orphonological) and meteorological nature. There issimilarity in the use of meteorological signals for early
warning monitoring across regions and sub-regions ascompared to the ecological signals, which varied due totheir uniqueness to the localities. Not strong variation
points cultural and ecological differences in observations
and predictions. Blending indigenous knowledge withmodern-approaches will strengthens and enhances
equitable early warning communications for disaster
preparedness and response.
Keywords: Indigenous knowledge, Early warning,
Uganda, Disaster preparedness and response, Resilience,
Climate312

Eubios Journal of Asian and International Bioethics 31(6) (September 2021)

New biodiversity-based therapeutic treatments forcovid-19 and its potential ethical dilemma: Case study
in Indonesia-Endang Sukara 1), Safendrri Ragamustari 2), 3)
1) Universitas Nasional, Jakarta, Indonesia; Vice-President
for Indonesia, Asian Bioethics Association
2) Research Center for Biology – Indonesian Institute of
Sciences
3) School of Government and Public Policy
Endang.sukara@civitas.unas.ac.id

Many strategies have been tried for combating the
COVID-19 pandemic. An overlooked strategy is theutilization of plant-derived medicines, including that of
traditional origin. There are many potential traditional
plant-based therapeutic methods that can be tried,
standardized, and developed. Traditional plant-based
medicines can lead to the identi ication of active
compounds for new antivirals, which makes plantbiodiversity an important resource. Being a country thathas high biodiversity, in addition to a signi icant history ofusing traditional medicines, Indonesia can potentially playa dominant role in elucidating new plant-derived
medicines and antivirals. However, at the same time, thepotential also needs to consider ethical dimensions.
Among them are proper attribution to the source oftraditional knowledge and bene it sharing fromcommercialization, which what we highlight in this paper.
24/7 Librarians: The Hurdles, Strategies and Rewardsof Rendering Online Library Services- Diane Mejia-Villacura, RL, MLIS
Periodical Librarian, Ramon Magsaysay Memorial Colleges,
Beatiles St., General Santos City
dianevillacura30@gmail.com- Maria Lorena M. Abangan, Ph.D.
BLIS Program Head/Reader’s Services Librarian, Cor Jesu College,
Digos City, Davao del Sur, the Philippines
email: lorenabngn75@gmail.com

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Academic librarians are rendering online library services
especially amidst trying times. Since online services havebecome essential in their profession, the purpose of thisphenomenological qualitative research was to explore
their hurdles, strategies and rewards of rendering
different online library services. Ten (10) registeredacademic librarians were purposely chosen to participate
in this study through Key Informant Interview (KII).
Findings revealed that their hurdles included thestrenuous round-the-clock online library services,internet connectivity problems, technological challenges
and issues, transition process to online platforms and thelimitations in acquisition of library resources. Librarians
strategically rendered the online library services throughcreation of online library platforms, provision of online
literacy programs, development and improvement of
online library services and resources, and the strategic
work assignment and distribution. The rewards that they
have received and felt were professional ful ilment andemotional satisfaction, professional development,
convenience amidst trying times and the instructional
support. Academic librarians must realize the importanceof doing constant library innovations in order toeffectively and ef iciently render online library services

that are deemed essential in supporting the online
teaching and learning in today’s digital world.
Keywords: Library and information science, Academic librarians,
Online library services, Phenomenology, Philippines

Ivermectin as Propylaxis and Treatment of COVID-19:
A Bioethical Evaluation- Latifah Amin, Ph.D.
Professor, Universiti Kebangsaan Malaysia; Vice President(Malaysia), Asian Bioethics Association
Email: nilam@ukm.edu.my

Over two hundred million Covid-19 infections have beenreported worldwide with ive million deaths. The trend is
still ascending in 61 countries. Several countries areahead with vaccinations efforts but only 12.3% have been
fully vaccinated by 2nd July 2021 (Pharmaceuticaltechnology.com).
Additionally, only 14 countries
worldwide have exceeded 50% vaccination rate, a long
way to establish herd immunity status. Effectiveness ofthe current covid-19 vaccines have been found to varyfrom 50% (Sinovac) to 95% (P izer & BioNTech) in
preventing infection. It is also worrying that although thevaccines are effective against the original virus, but havebeen shown to be less so against the variants of concerns.
More worrying, there is very few effective treatments for
infected Covid-19 patients to reduce hospitalizations, andprogression to critical stage and death.
Ivermectin is an essential and safe medicine for humanuse which has been approved by WHO and widely used totreat worm infection, scabies and lice for around 20 years.
Additionally, it has been found to exhibit antiviral andanti-in lammatory properties. The Front Line COVID-19
Critical Care Alliance has reviewed and summarized 43
studies on the effectiveness of Ivermectin to treat
Covid-19 infection and concluded that Ivermectin is
effective as treatment and prophylaxis. Another recent
meta-analysis by Bryant at al (2021) reported ofmoderate-certainty evidence on the possibility of
Ivermectin to reduce large numbers of Covid-19 deaths
and progression to severe disease. The drug also has theadvantage of proven safety and cheap. On the other hand,
WHO and majority of health regulatory bodies worldwide
insisted that there are insuf icient data to recommend theuse of Ivermectin and only recommend its uses in clinical
trials. In this study, a bioethical analysis using the ethicalmatrix will be carried out to assess whether Ivermectinshould be supported for use.
Keywords: Ivermectin, Covid 19, Bioethical analysis, Ethicalmatrix
Teaching Bioethics for the SDGs and current
environmental challenges in Schools and Universities
using Online Educational Resources- Suma Parahakaran, Ed.D.
Professor of Environmental American University of Sovereign
Nations; Malaysia
Email: sumjayan@gmail.com

The sustainable developmental goals (SDGs) were
formulated as a blueprint in 2015 at the United Nations
General Assembly, which has seventeen interlinked goals.
The SDG’s are intended to be achieved by the year 2030.
This review explores speci ic contents to be integrated
into Online Educational Resources integrating a bioethicalEubios Journal of Asian and International Bioethics 31(6) (September2021)
perspective and how it could lead to larger possibilities
and new frameworks which can be brought together toexplore new insights. The review of documents forcreating content for OER includes; Co constructions ofknowledge based on management processes using OER;
Integrated pedagogies related to topics based on research;
Education of ESD and for SDG’s include views of thelearning communities through OER
The involvement of learning communities online will
help learners to provide a broader meaning to transdisciplinary studies and meaningful outcomes for asustainable society. Solutions to the effectiveness of tasks
rendered to achieve the SDGs goals require value andethical oriented actions, which are participatory, inclusive,
Universal and at the same time actions which arecontextually dependent on the local and global situations.
There are highlights in the reports by SDG scholars on theneed to build co-dependency of the SDG’s throughcomprehensive assessments with cross- sectoral systems.
With the exception of a few SDG’s, the interdependency
between SDG’s require to be organised in terms of how
they are operationalized. They require more clarity withregards to the 169 targets of the 2030 Agenda. This
exploratory study of co-construction of such learning
content using OER may look challenging but it will havebene icial effects in the long run.
A documentary analysis of a case study and practicalsolutions to the present environmental challenges andstrengths in teaching and learning will be conducted.
Findings will be presented in tables. This study is part ofa larger study conducted at the AUSN on integration of
OER for schools and Universities.
Keywords: Sustainable developmental goals, OER, Bioethics,
Online Learning, environmental education

Online Sexual Exploitation of Children in thePhilippines during COVID-19 Lockdowns:
An Ethical Analysis- Bernardo N. Caslib, Jr.
University of the Philippines Manila
Email: bncaslib@up.edu.ph

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Abstract
As COVID-19 continues to wreak havoc across the globe,
one potentially neglected social ill aggravated during the
pandemic is the proliferation of online sexual exploitationof children (OSEC). OSEC is a variation of commercial
sexual exploitation of children (CSEC). The latter “occurs
when people under the age of 18 engage in or are forced
into prostitution and pornography in exchange for moneyor material payment.” When the commercial sexual
exploitation of children occurs, is facilitated, or mediatedthrough the internet or any online platform, it is morecommonly referred to as OSEC. As lockdowns in thePhilippines persist, businesses close down, andunemployment rate continue to rise, many poor Filipinos
have turned to OSEC despite legislated Philippine laws
against human traf icking. Early this year, the Philippine
Center for Investigative Journalism (PCIJ) reports that
more than 1.29 million images and videos of child abusematerials were produced in the Philippines in 2020, thrice
the number in 2019. Why do the numbers continue torise? How can the victims be helped? This multi-layered
ethical problem invites us to consider potential solutions

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to curb the incidence of online sexual exploitation ofchildren. Employing Angeles-Palma’s framework forethical decision-making, this paper will consider four
possible course of action that may be taken to address thesocial menace that is online sexual exploitation ofchildren.
Tri-people Hybrid Con lict Resolution Approach:
Enabling A Culture of Peace in Alamada, North
Cotabato, Philippines- Mark Anthony N. Lataza, MA
Asst. Prof., Pamantasan ng Lungsod ng Pasig, the Philippines
Email: marklataza@gmail.com

The paper is focused in the Tri-people hybrid con lictresolution approach adopted in Alamada, North Cotabato
as a model for enabling a culture of peace in Mindanao,
Southern Philippines. Alamada is a municipality of North
Cotabato, Mindanao. The population is comprised of
Iranon (Muslim), Christians and other indigenous/ethnic
groups (Lumad). The greatest challenge encountered
were on peace instability resulting from territorial anda n c e s t ra l l a n d d i s p u te ; i d e n t i t y a n d c u l t u ra ldiscrimination; environmental threats, criminality andpoverty.
Peace instability are armed con lict which cause theanimosity brought about by the history of ighting in
Mindanao. Land dispute is a con lict in Alamada but it
could spills over to rido and armed con lict. Rido/clan
con lict is a Muslim term for feuds, referred to a sporadic
outburst of retaliatory violence between families andkinship groups as well as between communities andenvironmental issues.
To address the societal con lict and strengthen thealliances of “Tri-people”, peace building practices isessential. This is to effectively settle longtime issues andconstitute best practices among the community from acon lict-torned to a zone of peace municipality. By
combining the informal customary procedures of the
Muslim people and Indigenous community, settling gaps
within the community is more effective.
As result, there were at least 23 clan con licts whichwere settled under the approach, including one clan
con lict in the municipality which has been preserved for
50 years. The effective implementation of thereconciliation mechanism limited in the declaration ofZone of Peace in Alamada. The government and its local
partner gathered about more than 10,000 signatures fromvarious consultations and discussions in the municipality
to gather support for the declaration. The peace building
should be mechanism converged with public service tocraft a sensitive and hybrid initiative to address societal
problems. There is a need to intensify and concretize an
effective tool to promote a culture of peace.
Keywords: Alternative Dispute Resolution (ADR), Culture ofPeace, Hybrid Con lict Resolution Approach, and Tri-people.

Eubios Journal of Asian and International Bioethics 31(6) (September 2021)

Opinions and recommendations of medical school
students on the stigma of the diseases and health care
professionals- Sukran Sevimli
Chair, Department of Medical History and Medical Ethics, Van
Yuzuncu Yıl University Faculty of Medicine, Zeve Campus, Van,
TurkeyEmail: sukransevimli@gmail.com

Aim: The aim of this study is to explore medical students'
views of both stigmatizations against diseases andhealthcare professionals, as well as to examine critics, andsolutions in their framework of medical students' views ofstigmatization.
Method: This was performed as a qualitative study
utilizing sole interviews. This interview was conductedwith 21 medical students. The views of medical students
were explored via interviews which covered four basic
questions: Can you give an example of this stigma andexplain why?; What problems does the stigma developed
against diseases such as infectious diseases (Covid-19,
HIV/Tuberculosis) trigger?; What kind of plan programand measures should be taken to minimize stigma?; andHave you encountered any stigmatization during Covid-19
due to you are a medical student?. The interviews wereanalyzed through qualitative content analysis.
Result: The issue of stigmatization against healthcare
professionals is not very clear on the agenda of society
therefore students do have not enough knowledge andopinion about stigmatization. However, the students
stated very clearly that during the epidemic, healthworkers from all professions have undertaken a dif icultand suffocating task under extraordinary conditions while
treating patients diagnosed with COVID-19, as well as
facing an intense risk of infection. Finally, in order for the
medical students in this team to evaluate the issue from a
versatile and ethical perspective, a special course oncommunication skills and better-equipped teamwork withpsychiatrists, psychologists, and ethicists are required.
Conclusion: The study shows that adding lessons that
include stigma and the problems caused by stigmatization
to the medical education program in order to increase theawareness of medical students is important. Further, thisclass also contributes students to understand virtue ethics
and medical ethics values.
Keywords: Contagious diseases, stigmatization, medical students,
medical ethics

A Study to Evaluate the Community Health Worker
Led Program Approach Result and Way forward
Dr. Nazneen Akhter; Dr. Imrul Mohammad Sifat; Mr. Md. Abdul
Hannan; Mr. Md. Arifur Rahman Dr. Kash i Pandit; Dr. Sangeeta
Halder; Bangladesh
Email: nazakhter705@gmail.com

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Introduction & Background: This research work is there lection summary of a very innovative community based
health care program implemented by Good Neighbor
Bangladesh (GNB). In 2015, Good Neighbor has initiated avery innovative and maternal health responsive“Community managed health care program” throughCommunity Health Worker (CHW) approach in order tobridge the health care information and services between
the facility and the ield. This approach has been piloted
and scaled up in six different places like (Birganj, Nalka,

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Kalai, Bocha ganj, Meherpur, Moulovibazar) where theintervention has created opportunity for the community
mothers specially married women of reproductive age(MWRA) and their children’s to seek need base primary
health care advise from the community as and whenneeded, also helping women to gain awareness on
reproductive health knowledge and practices which
ultimately safeguarding many. The implementation cycle
followed the appropriate program planning logic, startingfrom a baseline need assessment, to prioritize program
needs and arrange implementation in a more simpli ied
community friendly approach.
Methodology: To obtain information of the CHW Program
result and implementation approach, a thoroughinvestigative approach taken following all the standard
procedure for an end line survey starting from desk
review, question formatting (Quantitative & Qualitative),
feasibility test, doing a cross sectional survey withsystematic random sampling closely representative to thecommunity also align to baseline format. Alongside thequantitative data collection, every places there were
providers and client IDIs, case story and FGD and also KII
s conducted with stakeholders which supported to give an
in-depth picture of the community changes also toauthenticate the quantitative indings.
Result based Lessons learnt: The CHW in the program
was the central catch of health workforce available in theield who have been trained appropriately to work as irst
line health care soldier to connect the community & GNB
clinics as a bridging means to access health care by thecommunity women and Children. In order to assess the
success of the implementation approach an end line
survey has been conducted following the comparability
with certain program indicators both at baseline and end
line level which signi icantly projected the positive
improvement and changes in end line in comparison tobaseline. The qualitative indings from FGD, KII, IDI also
reinforced the quantitative data alongside the Case story
which is a factual projection to echo the graphical data
projections of quantitative indings both baseline to end
line
Conclusion: This research report is the re lection of theevidence base lessons learnt, challenges and success storyof the Good Neighbors Bangladesh CHW Result &Implementation Approach.
Keywords: CHW, Good Neighbor, Implementation approach,
MWRA, Baseline, End line

1 September 2021 (Wednesday)Love is Ours: A living journey through love and life
across the world- Darryl R.J. Macer, Ph.D., Hon.D., MPH
Director, Eubios Ethics Institute, New Zealand, Japan and
Thailand; Secretary, Asian Bioethics Association;
President, American University of Sovereign Nations, USA
Email: darryl@eubios.info

I invite all participants to send me some signi icant story,
poem, experiences of love for a book I am currently
writing, called “Love is Ours: A living journey through loveand life across the world”. This book shares a journey of
discovery through the wonders of love and life. This isEubios Journal of Asian and International Bioethics 31(6) (September2021)
both a personal journey of my ontological development aswell as a re lection on my search for wisdom from aroundthe world on some questions that I ask about the meaningof love. In each chapter I will explore the meaning of lovefrom a different window (e.g. romantic love, relationships,
soulmates, child-parent relationships, marriage, divorce,
breakups, animals, spiritual aspects, to mention some of
the themes).
We are living through the COVID-19 pandemic which has
shaken the fabric of social ethics and perceptions of global
citizenship. This disease has taken the lives of many
people, and shattered relationships and people all aroundthe world. For most of human history until the past few
decades life has been regarded as a privilege, notsomething to take for granted. With COVID-19 we can see
the return of infectious disease as a major determinant oflife and death even for those in rich countries, and adeterminant of economic prosperity or poverty. We haveseen the return into poverty of over a billion lives, withless certainty about the future in the minds of everyone.
What's the place of love in the face of early death?
The vibrancy of my privileged life in over 70 countries of
the world, and my deep relationships and shared lovewith wonderful peoples across the planet shape this book.
I think this experience has something to offer for peopleof every age, gender and culture. Unlike my 1998 book
Bioethics is the Love of Life, in this book, Love is Ours: A
living journey through love and life across the world, I will
look at the question in more than an academic mannerand third party perspective, but also as a lived emotional
journey with ups and downs, broken hearts andover lowing happiness that only love can bring.
As well as addressing this book to my dear and loved
ones, this book is being written for everyone to think
about their own lives. I will also share feelings andemotions of my heart along my life so far, and try to pull it
all together under each chapter as I explore answers that
others have attempted. I have been blessed by being asensitive person with an open heart, however, I apologise
to all who were disappointed or devastated by my actions,and will be in the future also.
This book explores life in many ways, and it's addressedto people of every culture, all the people that I've met, all
my friends, all people that I have loved and continue tolove, and to those in the future. There is a lot of inspirationfrom everyone I love and have loved, and the complex
interrelationships of many people along with my own
identity shape the book.
Thank you to everyone who has inspired this book, who
has shown me love, laughed with me, cried with me,
prayed for me, in some cases made big sacri ices, andthose who have nurtured me. I have been moved by those
who agree that love is ours or was ours.
CRISPR-Cas/9: Regulation in Australia- Patrick Foong
Western Sydney University, Australia
Email: pckfoong@gmail.com

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Around the world, researchers are conducting various
methods, including the cutting-edged CRISPR-Cas/9(Clustered Regularly Interspaced Short Palindromic
Repeats) (CRISPR), removing gene variations that cause

315

heritable diseases and conditions. However, there are
multiple ethical and technical issues associated with thisinnovative technology. This presentation will explore
CRISPR science, the serious ethical, social and safetyconcerns surrounding this technique and a criticalanalysis of the current Australian regulation on humangenome editing. Claims that Chinese twins have been bornwith modi ied genomes could mean that the current
Australian law in this area may need to be updated. Before
determining whether revisions in the law is required, it iscritical to conduct public forums in Australia. Since 2011,
there has been no review of the current regulation. A
legislative review that entails in-depth discussions among
various stakeholders and open submissions are long
overdue. In this presentation, I strongly propose that it
ought to be conducted to explore the need for legal
updates to govern human genome editing in Australia
effectively.
Against All Odds: Local Government Corruption in thePhilippines- Jasmin Andrea Pacalna
jasminandreapacalna@g.cjc.edu.ph- Rogelio P. Bayodrogeliobayod@g.cjc.edu.phCollege of Education, Arts and Science (CEDAS)Cor Jesu College, Inc., the Phillipines

This pandemic is seen by some as an opportunity to takeadvantage of the emergency to misuse their power for
private gain. In this inimitable circumstance, it is perilous
that corruption is intentionally ignored. Furthermore,corruption typologies are done amidst this Covid19
pandemic, like the inadequate budget per patient in theisolation centers and the unequal treatment of thepatients there, the prejudiced wage of the job ordered
employees, the insuf icient payment to the contractors,
the biased treatment towards the VIPs during lockdowns
and vaccination process, and the lack of systematic
strategy for the vaccination. This paper argues theabandonment of ethical values that the horrid ways ofcorruption of some public of icials from Digos City
committed, and how such politicians have capitalized theoccurrence of disasters and the Covid-19 pandemic tosteal money from the government and the people.
However, it also argues that the public of icials of the city
had the good will to establish systematic strategies for thewell-being of the citizens during the Covid19 pandemic.
This paper discusses the effects of these strategies to thepeople. Lastly, the paper suggests that real-world measure
should be done to diminish opportunities for corruption
and the necessary shift of culture to a state where theDigos City citizens no longer consent corrupt act as justthe way government works in the city must be
established.
Keywords: Government Corruption, Corruption during calamities,
Ethical Governance316

Eubios Journal of Asian and International Bioethics 31(6) (September 2021)

Access, Equity and Quality of Education as Part of theUnited Nations Convention on Human Rights and theSustainable Development Goals (SDGs)- Amihan April M. Alcazar, Ph.D.,M.B.A.,Ll.B.,B.S.(cl)Immediate Past President (2012-2021), University of Pasig City,
Metro Manila, Philippines; Visiting Professor of Law, Educationand Human Rights, AUSN
Email: alcazar_amihanapril@plpasig.edu.ph

This paper focuses on the framework for access, equity
and quality of education as a re lection of the United
Nations Convention on Human Rights and the Sustainable
Development Goals. It provides the parameters by which
the educational system of each country may be evaluatedas being supportive of protecting the human right toeducation.
Access is de ined as the ability of all people to have equal
opportunity in education, regardless of their social class,gender, race, sexuality, ethnic background and physical ormental disabilities. Equity is the condition when personalor social circumstances such as gender, ethnic origin,family backgrounds are not obstacles to achieving
educational potential (de inition of fairness) and that allindividuals reach at least a minimum level of skills(de inition of inclusion). Quality in education is achieved
when it is delivered with outcomes that encompass
knowledge, skills and attitudes that are linked to national
goals for education and positive participation in society.
The research shall identify the laws in the country used
for analytical illustration, in this case, that of thePhilippines, based on the framework that support thedelivery of education as a human right. Based on thoseparameters, it will be possible to determine whether thelaws are supportive of the protection of the human rightto education.
The study has a policy impact in supporting future
legislation in countries as they movetowards
approximating the protection that needs to be accorded tothe human right to education. It is relevant as education is
the major driving force for development prioritized in the
Sustainable Development Goals for.
Keywords: human right to education, access, equity,
quality of education, framework, protection of humanrights, Sustainable Development Goals

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Introduction
The paper focuses on the framework for access, equity
and quality of education as a re lection of the United
Nations Convention on Human Rights and the Sustainable
Development Goals. It provides the parameters by which
the State of every country with an educational system canbe evaluated as being supportive of protecting the humanright to education.
The research is responsive to the call of the times as
many States around the world invoke emergency powers
or take extraordinary measures to meet the challenges of
the COVID pandemic. Regardless of the dif icult context
encountered, there is an ethical imperative that theprotection of human rights shall be paramount above all.
The conceptual framework proposed in the research canalso be expanded to evaluate other human rights
protected under different conventions. It then becomes apossibility that infringement of or violations of theprovisions of conventions as recognized under public
international law, can be the basis for legal or extra-legalmeans for enforcement by nation States.
Based on Article 26 of the United Nations Convention on
Human Rights, there are three elements towards theprotection of the human right to education. The irst
paragraph de ines the parameter of access to educationand the minimum required level which should beaccorded to all. It is provided that elementary educationand fundamental stages, usually identi ied as earlychildhood development education, shall be made free andcompulsory. Beyond such level, other types of education,
including, but not limited to, technical, vocational andhigher education, shall be made accessible depending on
the condition of every nation State.
The second paragraph provides the rationale foreducation as a tool for the development of humankind. It
provides the qualitative aspect of education to further theaspiration of the United Nations to promote world peace
through the mutual understanding between peoples ofdifferent nations, ethnic and religious backgrounds.
The last paragraph states that since elementary
education is extended to those of minority age, theparents have the prior right to determine the kind of
education provided to their children. It quali ies theparental authority exercised over their children,
indicating the content and manner by which they shall be
educated.
The Sustainable Development Goals 2030 are thedevelopmental aspirations which provide a time-boundinternational benchmark for countries articulated by theUnited Nations. This is the basis for the researchframework according to the principles of access, equity
and quality of education provided in the 4th Sustainable
Development Goal.
Access is de ined as the ability of all people tohave equal opportunity in education, regardless of theirsocial class, gender, race, sexuality, ethnic background andphysical or mental disabilities.
Equity is the condition when personal or social
circumstances such as gender, ethnic origin or family
backgrounds are not obstacles to achieving educational
potential (de inition of fairness) and that all individuals
reach at least a minimum level of skills (de inition ofinclusion).
Quality in education is achieved when it isdelivered with outcomes that encompass knowledge,
skills and attitudes that are linked to national goals foreducation and positive participation in society.
The research shall provide the framework to evaluate
the laws of the country to be analyzed. The case study
cited in the research is that of the Philippines. Expansionof the research can be done in the future by including datafrom different countries to comparatively analyze thevariance of each country based on the framework.
Utilizing such framework provides the conclusion todetermine whether a nation State supports the protectionof the human right to education or on the contrary,
possibly infringes or violates the right to education.
The study has a policy impact in supporting future
legislation for countries to accord protection towards thehuman right to education. It is relevant as education is theEubios Journal of Asian and International Bioethics 31(6) (September2021)
major driving force for development prioritized in the
Sustainable Development Goals 2030. It is an ethicalconcern when the human right to education is either
infringed or violated. The research can be the basis forwhich a nation State can be enjoined to refrain from theinfringement of thew right to education or to restore theright when there is a violation.

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CASE STUDY: THE PHILIPPINES
In illustrating the use of this framework, the irst inquiry
would be the identi ication of the laws of a country that
support the human right to education.
In the case of the Philippines, the irst law which can becited is the fundamental law of the land, the Constitution
promulgated in 1987. According to Article XIV Section 1,
the State shall support education at all levels and shallprovide appropriate steps to provide access to sucheducation.
Section 2 further quali ies the parameters by which
support to education is extended by the State. It provides
in the irst paragraph, the mandate of the State to provide
a complete, adequate and integrated educational system
responsive to the needs of the Filipino society. In thesecond paragraph, it then provides that the State shallsupport free education in the elementary and secondary
levels. Based on the parameters set in the U.N. Convention,
this is already over and above that indicated as theminimum level considered as inclusive education. But
every nation State in the exercise of its sovereign selfdetermination can provide for a higher level of support.
This is what is indicated in the Philippine Constitution.
The third paragraph goes on to provide that the State shallestablish a system of support in the form of resources
being allocated through scholarships, subsidies and otherincentives, qualifying those who are deserving of suchsupport.
The fourth paragraph is an option which can be adopted
by the State, providing for the encouragement of nonformal and indigenous learning systems, as well as
independent learning systems, if deemed feasible. The lastparagraph states that the State shall provide its adultcitizens education limited to the content of civics,
vocational ef iciency or other similar skills. Therefore, thewhole section indicates the quality of education to beaccorded to its citizens on the basis of content.
The next level of laws that can be evaluated are laws
passed by the Congress of the Philippines, which arenational in scope.
In Republic Act 9155, the governance system for basic
education is strengthened by providing for principal
empowerment based on the principles of transparency
and local accountability. The law supports access to
education by providing expanding principals decisionmaking authority in their schools.
The next illustration is a landmark law passed by
Congress, Republic Act 10533, which provided for the
adoption of the K-12 basic educational system in thePhilippines. The country was only one of two remaining
countries in the world that had not yet adopted thesystem when the law was passed in 2013. By joining thestandard basic educational system adopted in the world,
the country is better able to provide access to education,317

not only in the Philippines, but possibly for its nationals toaccess other countries’ educational systems as well.
The following two laws is the differentiation of the basic
education regulatory agency from the regulatory agencies
with authority over higher education and technicaleducation. It provides the support extended to higher
education to have autonomy and exercise academic
freedom. In the case of technical education, the law
identi ies the agencies’ thrust towards middle-level
human resource training and development.
By analyzing the laws, the data can indicate whether
nation States are compliant with the parameters of access,equity and quality for the protection of the human right toeducation. Then, by utilizing the Sustainable Development
Goals, the laws can indicate whether the time frame forachieving the goal can be accomplished. Lastly, theframework is able to determine whether the Stateinfringes or violates the right to education. The
differentiation between infringement is the gradual noncompliance with elements of the exercise of the right toeducation vis-à-vis outright denial of the right which is aviolation.
In conclusion, there can be four possible conditions thatcan be identi ied as hampering the access to the right toeducation and which may require action to be undertaken
to address the ethical concern of protecting human rights.
The irst possible condition is that laws themselves need
to be changed. For example, af irmative action is a lawthat promotes the admission of students in higher
education belonging to a particular identi ied group. The
law proved untenable and was eventually abolished as it
was determined to be against equity of student applicants
when the criterion of merit for admission should be theprime determining factor for admission, rather thanethnicity of the student applicants. This was articulated in
the case of Grutter vs. Bollinger decided by the UnitedStates Supreme Court in 2013.
The second probable condition is that there might beenvironmental factors outside of the legal system that
hamper the promotion of the right to education. Even if
there are laws ensuring access to education, cultures ofparticular communities may prevent those belonging to
the female gender to access education, such as earlymarriage, prioritization of familial obligations or physicalimmobility. The probable solution is to promote theprotection of the right to such communities in order toeventually change the culture.
The third condition is resource allocation that requires
prioritization to address the constraints due to limited
resources. During the pandemic, many students
experienced the phenomenon of education or learning
loss. This was brought about by the imposition of
lockdowns that prevent students from the conduct of faceto-face classes. Therefore, alternative means of delivering
the academic programs were adopted. However, some of
the means can prove to be ineffectual to the point that it istantamount to denial of the access to education. For
example, in the Philippines, since 90% of the basic
student population are in the public educational system,
the government may need to provide for budgets toenable students to have gadgets and connectivity toensure delivery of academic programs virtually. If

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Eubios Journal of Asian and International Bioethics 31(6) (September 2021)

government does not prioritize such resources, it may be
determined to be infringing the right to education because
school children are unable to access the education due totheir lack of means.
The fourth condition is the State adoption of prohibitionon the exercise of the right of education which can beconsidered as a violation to the right to education. When
the Taliban irst came into power in Afghanistan, thesegment of the population belonging to the female genderwere prohibited from access to education. Thus, the State
policy can be considered as a human right violation.
Pressure from the international community may be ameasure which can be adopted to change the State policy.
Recognition of advocates for the exercise of the right toeducation, such as the 2014 Nobel Peace Prize, canhighlight the need to change the State policy.
References“Girls Education in Afghanistan at Risk from U.S. Withdrawal”,
July 7, 2021, TIME Magazine
Grutter vs. Bollinger June 23, 2003 539 US 306 (2003)“I Won’t be a Doctor and One Day You’ll be Sick”
Girls Access to Education in Afghanistan, October 17, 2017,
Human Rights Watch
Nobel Peace Prize Organization Press Release
Nobel Peace Prize 2014 Kailash Satyarthit and Malala Yousafzai
Republic Act 7722 Congress of the Philippines, May 18, 1994,
The Of icial Gazette
Republic Act 7790 Congress of the Philippines, August 8, 1994,
The Of icial Gazette
Republic Act 10533 Congress of the Philippines, August 11,
2011, The Of icial Gazette
Republic Act 9155 Congress of the Philippines, May 15, 2013,
The Of icial Gazette
Sustainable Development Goals 2030 (Adopted in September
2015 by the United Nations)
United Nations Declaration on Human Rights (Adopted in
December 1948 by the United Nations)

Awareness Raising and Responsibilities of Scientists
in the Life Sciences- Nasyrova Firuza
IBPPG TNAS, Tajikistan
Email: iruza_nasyrova@mail.ru

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Biological sciences have experienced enormous growthover the last 30 years, as biotechnology has become a
global enterprise; they offer tremendous promise formeeting many 21st century challenges. Under thesecircumstances, it is very important to modernize
education in the ield of life sciences and biotechnologies.
Scientists in the ield of life sciences and professionals of
public health must acquire the sense of responsible
science at the very beginning of their professional
education.
In developing countries, the level of biosafety andbiosecurity education needs improvement, newdisciplines must be introduced in the curricula of highschools and universities, giving the students’ knowledge
on codes of conduct for life scientists, dual use concerns,
and biorisks. This goal can be reached by cooperation
among universities, lecturers, through the informationexchange on international standards and good laboratory
practices, improving biosafety of society andenvironment, fostering the social and civic role ofscientists in society, with special attention to the “nextgeneration of scientists”. The life sciences are inherently
inextricably linked to concerns about their dual use. Dualuse dilemmas arise when the same scienti ic work can beused for peaceful or hostile purposes.
The scienti ic community generates knowledge andeducates students. Working with the scienti ic community
and raising awareness within the community is critical tothe proper implementation of any technology oversight.
Raising awareness of the potential for misuse and the
responsibility of scientists to address the challenges ofdual-use materials, knowledge and technologies as anintegral part of formal education is an important irst stepin this process.
This responsibility includes critically examining ethicaldilemmas and engaging in public dialogue as key
strategies. All scientists—especially those working in thelife sciences—are called to cultivate among themselves aculture of responsibility with regard to the conduct andthe achievements of their research. Foundational values ofan organizational culture that emphasizes biosafety,
biosecurity, and responsible conduct: research excellence,bioethics, biosafety and biosecurity.
Keywords: biosafety, biosecurity, dual use and responsible
conduct.

Defending Moral Obligation: Duterte’s Dauntless War
Against Drugs- Faisha Mae D. Tangog
faishamaetangog@g.cjc.edu.ph- Rogelio P. Bayodrogeliobayod@g.cjc.edu.phCollege of Education, Arts and Sciences (CEDAS), Cor Jesu College,
Inc., Digos City, the Philippines

As the mainstream media describes Rodrigo Roa Duterte,
the 16th President of the Republic of the Philippines,
widespread generalizations emerged. He was thecountry's irst Mindanaoan president and acquired
popularity among Filipinos by working on platforms to
reduce drug addiction, corruption, and criminality, andreceived 39 percent of the vote in the 2016 Presidential
election. Back on the year 2016, during the irst
presidential debate, Duterte had sworn that he will
eliminate the extensive propagation of drugs in the
country with his irst six months of authority. With theadvent of his presidential campaign, arises the issue ofextra-judicial killings from the President’s ‘lawless’ huntfor drug pushers and users which is highly criticized by
the Human Rights devotee. This was the cornerstone of
Duterte's presidential campaign and the crime solution
hallmark of his 22-year period as mayor of Davao City.
While the president’s critics state that this is unjust andimmoral, this paper argues that Duterte’s radical politics
is necessary in the lessening if not total eradication of
criminality and corruption that the country had been
experiencing. Using the lens of Deontological Ethics andUtilitarian ethics, this paper tries to explain Duterte’s
radical politics and why it is necessary in thecontemporary Philippine society.
Keywords: Radical Democracy. Duterte’s War on Drugs andCriminality. Deontological Ethics. Utilitarian Ethics.

Eubios Journal of Asian and International Bioethics 31(6) (September2021)
The Experiences and Challenges in Teaching Ethics
during the COVID-19 Pandemic in the Faculty of
Medicine Universitas Jenderal Soedirman, Indonesia- Miko Ferine, Raditya Bagas Wicaksono, Ar i Nurul Hidayah,
Diyah Woro Dwi Lestari, Amalia Muhaimin
Department of Bioethics, Faculty of Medicine, Universitas Jenderal
Soedirman, Indonesia
Email: miko.ferine@unsoed.ac.id

The COVID-19 pandemic has had a huge impact on
medical education systems worldwide. Various efforts toprevent disease transmissions have resulted in
restrictions on face to face learning activities, both in theclassroom and in the community. This situation become achallenge in teaching ethics because the keys to teachethics effectively include the balance between the active
engagement of students with issues and critical analysisof choices in to be made in real life situations and also
managing the learning process to experiential (re lectiveexperientially) learning activities. Interactive lectures
which usually colored with lively discussion tend to bequieter due to online learning limitations. Moral games
are conducted virtually which may affect the learning
atmosphere which in turn in luence students’
understanding of moral values conveyed in the games.
Fieldwork are replaced with various virtual activities that
may not be the same as direct interaction experienceswith the community. Experiences and challenges inteaching ethics during COVID-19 Pandemic faced bylecturer in Faculty of Medicine Universitas Jenderal
Soedirman are re lected in this paper.
Keywords: COVID 19 Pandemic, ethics teaching, medical
education, experience, challanges

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Human Decency in the time of the Covid-19 Pandemic- Christopher Ryan Maboloc, PhD.
Associate Professor, Ateneo de Davao University; Visiting
Professor for Global Justice, AUSN
ryanmaboloc75@yahoo.com
Abstract
I intend to explain two prominent perspectives in terms of
the behavior of societies at the height of the coronavirus
public health crisis. The irst is about the idea of collective
responsibility, which focuses on rules and basic protocols
that are meant to control the behavior of the population.
The second refers to the notion of individual
responsibility, which is rooted in the need for people toappeal to their sense of accountability. There is a divide
between a person’s sense of autonomy and the moral
obligation not to harm others. I argue that the concept ofdecency is in favor of the latter.
Keywords: Covid-19 Pandemic; Governmentality;
Autonomy; Moral Obligation; Decency
Introduction
The irst human to human transmission of Sars-Cov2 virus
was irst reported in Wuhan, China in December 2019.
(Peng et al. 2020) It immediately spread across the globe.
(Tanabe 2020; Maboloc 2020) The World HealthOrganization renamed Sars-Cov2 into Covid-19 on
February 11, 2020. People of all ages are vulnerable to thedisease, as shown by rising infections among children inrecent weeks, although a higher mortality rate has beenreported for older people and patients with comorbidities.

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Asymptomatic patients do not develop any manifestationof the presence of the virus in their bodies. In contrast,
patients with a severe condition develop AcuteRespiratory Disease (ARD), which can be fatal. It has beenreported that “the elderly and the in irm seem to be more
susceptible to the infection of the virus and die ofsecondary severe respiratory problems or other diseases.”(Schijns and Lavelle 2020, p.932)
A study done in China by (Shen et al. 2021) concludes
that “under quarantine measures, the number of all-cause
deaths fell and the number of deaths from respiratory
causes declined most signi icantly.” Public of icials reason
out that the control of the spread of the coronavirus is bymeans of restricting the movements of people. Police
power is used to enforce the same. It is argued that public
interest has a priority over personal liberties. In thePhilippines, this means not only policy analysis, but astrong political will. The crisis has not changed theattitudes of many people who continue with their daily
lives as if there is no pandemic. This is actually observable
not only in the rural areas but also in city slums. A report
last year indicates that the pandemic has reached highdensity poor residential areas in Metro Manila (Smith et al2020, p.1).
Individual and Collective Responsibility
How can we help overcome this global health crisis? Whatis our responsibility? When it comes to the meaning of
this responsibility, Iris Marion Young (2011) makes acontrast between the “individual” and “collective.”Collective responsibility, on one hand, is meant to address
institutional problems and structural issues, which can
include matters pertaining to policy and law. The
government and its bureaucracy must respond to theneeds of the general public. At the institutional level,
every sector must be able to participate in the discussions
or help craft policy and law, and improve the dynamics
between the citizenry and the government.
Personal responsibility, on the other hand, refers to ourmoral obligation as persons. It is about that “sense ofaccountability” for the choices we make. For example, thewearing of mask is part of such. I wear a mask to protect
others. When I hold myself accountable for the well-beingof others, I am ful illing my duty not to harm them. It is
about what I must do. As an individual, I must put aside
my own comfort. It is about being considerate of thesituation of others. If I am conscious of the fact that notwearing a mask can put the lives of others in danger, thenI must be aware that the right thing to do is to wear one.
In Western Philosophy, Kant’s Categorical Imperative isclear as to the foundation of our moral obligation. For
Kant, the essence of morality is to follow the moral law
within. Since the human being legislates for himself themoral good, he is therefore duty bound to do the good. If
the same person digresses from this sense of obligation,then he is violating his inner nature. A person must do theright thing because he knows that it is the right thing toEubios Journal of Asian and International Bioethics 31(6) (September 2021)

do. (Kant 2002) The refusal to acknowledge this moral
obligation is simply a shortsighted way of understanding
the meaning of one’s autonomy.
But people have varying perspectives of this sense of
duty. This sense of duty can emanate from family
obligations. In communal politics, a leader must sacri ice
for the common good. The State invokes the good of the
majority over individual freedom. Democracy is not justabout the idea of legitimacy. It is also about persuasion. In
the case of the Covid-19 basic protocols, it must be
impressed on people that it does not really entail too greata sacri ice to wear a mask. When it comes to the vaccines,
the World Health Organization (2021) has stated thatvaccinations against Covid-19 are safer than not getting
vaccinated. The right thing to do then is to protect others
and oneself by getting the shots.
In a way, those who do not want to wear a mask use a
simplistic argument – they simply do not want to wear it.
While there are people who speculated that thecoronavirus is no more than the seasonal lu, the fact ofthe matter is that the number of cases, as of August 22,
2021, has reached 212, 095,743, in which deaths total
4,435,408 says the World Health Organization (2021).
This only proves that the Covid-19 pandemic is a major
public health crisis. Now, in the United States, Dr. Anthony
Fauci complains that the still unvaccinated 100 million
Americans are causing the latest outbreak due to the Delta
Variant (CBS News, 2021 August 1).
The problem is that there are people who consider theirinterests way ahead of society. The ones who do so aretaking advantage of those who are powerless. The
vulnerable individuals are most likely to die from thedisease because of the lack of access to ef icient medicalcare. The basic point is that the principle of autonomy, inthis regard, is not much of use when it comes to inding an
ending to the pandemic. People have to follow healthprotocols to protect themselves. While this might beinconvenient on the part of the individual who does notwant to let go of his everyday freedom, any decent person
knows that one has a higher moral obligation.

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The Meaning of Decency
What does it mean to be a decent human being? Albert
Camus (1947) presents the good character of Dr. Rieux,
whom he puts in a stark contrast with the priest Paneloux,
the latter trying to give a sermon to the people that the
pandemic is a sign that God is punishing them for theirmoral depravity. It must be recalled that in the samenovel, there are similarities between the priest andpoliticians in terms of how they want to manipulate themind of the people. Camus shows how the people of theimaginary city of Oran try to disregard the pandemic, inthe same way as the people today try to imagine thatdeath won’t come to them.
Alain de Botton (2020) expresses that for Camus, “whenit comes to dying, there is no progress in history, there isno escape from our frailty.” Being alive always was and

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will always remain an emergency. For Camus, death isalways there, lurking and ready to render human life
futile. In our time, a politician might take a different
approach when it comes to a public health crisis. He will
look at numbers and will prioritize his interests and his
good image or reputation when responding to the
problem. Indeed, instead of truly helping people,
politicians are more concerned about that false image of ahero who helps the vulnerable during a time of crisis.
Camus teaches us that life is absurd. But the proper
response when it comes to any crisis is neither hope nor
despair. In politics, some people look to others whom they
can blame. But there is no point blaming others. In thesame way, if society were to overcome the pandemic, thepoint is not to ind faults. The only way forward is that wemust all do our job to help those who are in need. Every
person must act out of his free will. The virus has nobrain. It cannot make a choice but it will try to survive byinding the next host. To defeat the virus, choosing tosurvive means doing the right thing. It is aboutcommitting ourselves to our moral obligation.
The special meaning of the word “commitment” is rooted
in the idea of an obligation. To oblige oneself is to be able
to profess that I will do my job well, truly, and willfully.
This is how the word profession was derived. To profess isto promise something. It involves a certain level ofdiscipline. A person who loves his job is able to do it
because of a high level of dedication to work. I will do myjob because it is what I am supposed to do. In this way, themeaning of moral obligation has a deeper context. To
renege on that commitment is to violate the essence of
one’s humanity. While I have the right to protect my rightto enjoy certain things, my responsibility to others as anindividual is more fundamental.
Raymundo Pavo explains the meaning of decency by
exploring the inner character of the protagonist in The
Plague. Pavo (2020, p.223) writes: “Why is he committed
then to the fate of the people in Oran? What Dr. Rieux
repeatedly mentioned is that he has seen many patientsdie and struggle in dealing with imminent death. He
explained that it is because of such experiences that hetries his best to not only save people from death but fromthe misery that comes with it.” A decent human being, inthis way, is that person who wants to help society survive
by ful illing his moral obligation to others. This person
follows a moral code, unlike the politician who is merely
concerned about building a good reputation.
Conclusion
The dif iculty on the part of the government to overcome
the Covid-19 crisis comes from the tendency to politicize
things. Politics divides people. Science, in contrast, does
not care about politics. While the nature of our problems
is complex, science has always been objective in its
assessments (Rezaei and Saghazadeh 2021). Humandecency is about people doing their jobs because it is theright thing to do. It has nothing to do with the projection

Eubios Journal of Asian and International Bioethics 31(6) (September2021)
of a good image. It is enough that I recognize my moral
obligation to others. More than a hundred years since thelast pandemic, the meaning and value of this obligation
remains. The source of hope for the world right now is
knowing that there many among us who recognize theimportance of doing the right thing.

Toquero, C. 2020. “Philippine teachers’ Practices to deal with
anxiety and Covid-19.” In Journal of Loss and Trauma 25 (4):1-7.
World Health Organization. 2021. Covid-19 Pandemic. https://
covid19.who.int/
Young, IM. 2011. Responsibility for Justice. Oxford: Oxford
University Press.

References

Ethical Issues Related to the Pandemic of
COVID-19 in Taiwan Panel

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BBC. 2021, August 17. “New Zealand enters into nationwide
lockdown due to one case.” https://www.bbc.com/news/
world-asia-58241619
CBS News. 2021, August 1. “Fauci says unvaccinated Americans
are propagating this outbreak.” https://www.cbsnews.com/
news/anthony-fauci-covid-19-unvaccinated-americans-deltavariant-face-the-nation/
Chen, J., Wang, C., Dong, C., Tang, Z., Sun, H., 2021. “Reductions inmortality resulting from Covid-19 quarantine measures in
China.” Journal of Public Health 43 (2): 254-260.
Botton, A. 2020. “Camus on the Coronavirus.” The New YorkTimes. https://www.nytimes.com/2020/03/19/opinion/
sunday/coronavirus-camus-plague.html
Camus, A. 1947. The Plague. Translated by Stuart Gilbert.
London: Hamilton.
Department of Budget and Management. 2020. “DBM releases
199.975 billion for DSWD Social Amelioration Program.”https://www.dbm.gov.ph/index.php/secretary-s-corner/press-releases/list-of-press-releases/1647-dbm-releasesp199-975-billion-for-dswd-social-amelioration-program
Foucault, M. 2007. Security, Territory, Population. Translated byGraham Burchell. London: Palgrave Macmillan.
Kant, I. 2002. The Categorical Imperative. Melbourne:
Wadsworth-Thomson.
Maboloc, CRB. 2020. “Globalization and Consumer Culture:
Social Costs and Political Implications of the COVID-19
Pandemic.” Eubios Journal of Asian and International Bioethics,
Volume 30 (3): 77-79.
Maboloc, CRB. 2021. “Indigenous Peoples in the Midst of
Covid-19: Populism and Vaccine Nationalism as Impediments
to Global Solidarity.” Handbook of Research on Impact of
Covid-19 Marginalized Populations and Support for the Future.
IGI Global, USA.
Mishori, D. 2020. “Medical Technocracy, Extreme Bio-power, andHuman Rights.” Social Ethics Society Journal of Applied
Philosophy. Volume 6 (2): 230-266.
Pavo, R. 2020. Camus’s The Plague and Covid-19: Some
Re lections. Social Ethics Society Journal of Applied Philosophy 6(2): 209-229.
Peng, Z, Xinglou, Y., and Wang, X. 2020. “A pneumonia outbreakassociated with a new coronavirus of probable bat origin.” Nature
579: 270-273.
Rezaei, N. & Saghazadeh, A. 2021. “Introduction on Integrated
Science: Science without Borders.” Integrated Science. Edited by
Nima Rezaei. Netherlands: Springer.
Schinjs, V. & Lavelle, EC. 2020. “Prevention and treatment ofCovid-19 disease by controlled modulation of innate
immunity.” European Journal of Immunology 50 (7): 932-938.
Smith, C., Villarama, E., Lopez, E., Sayo, A., Seposo, X., & Ariyoshi,
K. 2020. “Covid-19 moving into high density poor residential
areas in Manila, the Philippines.”
Tanabe, J. 2020. “Exploring a Post-Covid 19 Sustainable Peace
Model.” In Social Ethics Society Journal of Applied Philosophy.
Volume 6 (2): 73-103.

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Ethical Re lection of Covid-19 Pandemic andConstruction of Public Health Ethics- Wanling Chou
Lecturer, Medical University of Fu-chou- Shui-Chuen Lee
Director, Research Center for Chinese Philosophy; and Adjunct
Professor, Graduated Institute of Philosophy, National Central
University
Email: shuiclee@cc.ncu.edu.tw

The pandemic of Covid-19 caught the world in surprisewith a global spread within three months in 2019 andcaused closing to 200 million infections and more than 2.5
million deaths just one and half years since the beginningof 2019. What is more appalling is that it is still
increasing daily with more and wider spread throughout
the world without the possibility of coming to the end any
sooner. In this paper we try to gauge the reason of its
wide spread and seemingly uncontrollable as it unfolds.
The fact that it hits so hard and so early the countries withthe most advanced medical system and technology whileat irst so mild with Asian countries shows that cultural
background matters signi icantly for a global ethics ofpublic health, and a more closely knitted community andfamilial-like relationship between citizens is really what isneeded to combat such a contagious pandemic. It also
shows that the mentality of personal-choice- irst
individualism behind the western culture does fail thebattle against such a quick and wide spread pandemics.
We also argue that an idea of a new global citizenship for
all is needed for such global concerns of pandemics aswell as other issues such as global warming and others.
We support it with our experience of how it works in
Taiwan as a paradigmatic case. In addition to somecommon moral principles we stress in particular the
precautionary principle as the most basic one in line withthe basic idea of a public health policy. It is a communitybased principle, which grounds in our humanity andneeds the support of solidarity of citizens within andwithout any country for it to work in face of suchpandemics.
Keywords: Covid-19 pandemic, precautionary principle, global
public health ethics, individualism, Confucianism

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Eubios Journal of Asian and International Bioethics 31(6) (September 2021)

The Ethical Controversy and Legal Limitations on the
Refusal of Providing Cardiopulmonary Resuscitationor other Life- Sustaining Treatments to Terminally Ill
COVID-19 Patients in Taiwan- Wong Hon Chung
Project Assistant Professor, Department of Social Medicine, Schoolof Medicine, China Medical University, Taiwan
Email: honcwong1970@gmail.com

During the pandemic of COVID-19, many infected people
became critically ill patients in a very short time and mustbe given cardiopulmonary resuscitation (CPR) or otherlife- sustaining treatments (LST), otherwise they would
lose their lives. However, some of these patients may havea very poor prognosis and may even be terminally ill,
which means that they are likely to die within the near
future. CPR may only prolong their dying process.
According to Taiwan’s Patient Right to Autonomy Act,
adult terminally ill patients may withhold or withdraw
CPR or other LST if they have signed advance medical
decisions when they were competent. Even if they havenot signed advance decisions, consenting to withhold or
withdraw CPR or other LST may be obtained from theirfamilies according to Taiwan’s Hospice Palliative Care Act.
However, most of the families may ask for CPR for thepatient, even though it may not be in line with thepatient’s own wish or his or her best interests. It may not
only increase the patient’s suffering without improving
his or her health, but also waste extremely precious
medical resources during the epidemic and unnecessarily
increase the risk of infection among the medical staff
taking care of the patient. Moreover, there are substantial
dif iculties in obtaining consent from patient’s families
during the spread of the epidemic. It would also cause
considerable psychological pressure on them. Some may
think that it is equivalent to giving up the patient andleading to his or her death if they agree to DNR. This
article aims to explore whether it is ethically appropriate
for a doctor to unilaterally decide not to administer CPRor other LST without the patient’s or his or her families’
consent under the conception of medical futility, as well as
what restriction such a decision may faces in Taiwan's
current legal framework.
Keywords: Coronavirus Disease 2019 (COVID-19), Do-NotResuscitate (DNR), Cardiopulmonary Resuscitation (CPR),
Life- Sustaining Treatments (LST), Medical Futility

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The courage and signi icance of bidding farewell
during the spread of Covid-19 pandemic- Xiao Yu Shuang
During the spread of the Covid-19 pandemic, I
participated in a video farewell ceremony. Relatives andfriends participated in a simpli ied funeral ceremony on
the Internet. But can family, friendship, and grief of lovebe lessened at the end of the video? It is obvious now that
this pandemic has subverted human life and family
emotions, leaving life with emptiness, anxiety, fear andin inite regret. This kind of life issue, for the German
philosopher Dilthey, who believes that the central issue ofphilosophy is life, and only by the sharing of living
experience, expression and understanding of life in such
farewell ceremony, can we truly express our concern andlove to others. From the emotional low of empathy andre-experience, we ind the inner position of one's life
again, and thus respond to the needs of each other's lives.
In this paper, I try to employ this approach to clarify how
religious rituals and memories of shared emotions cansoften the inner sorrow, resentment, affection, and sorrowof life when life is over, and try to explore the eternal
companionship that still exists by feeling the love of thedeceased. Hopefully, we could achieve a state of calmnessby the release of grief and self-healing, and face the factthat our beloved one have passed away. Finally, it is
con irmed that the courage to say goodbye comes fromthe continuation and commitment to love, and promises
to cherish oneself, to be healed in the memory of love, andthe value thus obtained can ful ill the inal meaning of the
lives of oneself and the deceased.
Keywords: Covid-19 pandemic, bidding farewell at a distance,
Lived Experience, Expression of love and feeling, Understanding

The impact of Taiwan's ban on visits to palliative carewards during the period of Covid-19 pandemic andour proper response- Shi Zhao Liang
During the severe epidemic of Coronavirus Disease 2019
or covid-19 pandemic and in order to prevent hospital
infections, palliative care wards prohibit family members
to visit patients except for dying patient. To avoid
spending end-of-life dying alone in the hospital, many
terminal patients with multiple symptoms requiring
medical assistance would choose to have home palliativecare. However, the resources for palliative care at home
are relatively inadequate. If the patient has symptoms of
discomfort, it is dif icult to get good control at home, andfamily members will also face great care pressure. In
addition, during the pandemic, the ban on visits not only
affects the chances of family members to accompany thepatient, but also affects the medical team helping family's
medical decision-making discussion and the expected
grief of the family. Since this policy of prohibiting visits topatients in palliative care wards may continue inde initely,
and the above-mentioned impact will continue. Therefore,
home palliative care resources should be adjusted more
quickly and adequately to meet such needs of patients at
the end of life. It is suggested in this paper that the
medical team should make good use of video equipment
to help hospitalized patients and their families making
effective emotional connections, and to hold family
conferences when necessary. In addition, video equipment
can also be used for remote diagnosis and treatment tohelp home palliative care of patients to reduce symptoms
of discomfort.
Keywords: COVID-19 PandemicHospital, Palliative care,
Prohibition for visiting palliative patients, home palliative care,
medical resources(End of Panel)

BIOHACKING COVID-19: Upgrading One’s Body for
Health- Marlon Lofredo, Ph.D.
St. Paul's University, Quezon City, the Philippines

Email: mpplofredo@spuqc.edu.phEubios Journal of Asian and International Bioethics 31(6) (September2021)

2 September 2021 (Thursday)
Bioethics, “niche construction” and the COVID19´spandemic- Nilda M Diniz Rojas, Ph.D.
Biology Institute, Brasília University, Brasília-DF, Brasil
Email: niddiniz@gmail.com- Nilza Maria Diniz, Ph.D.
Biology Department, State University of Londrina, Londrina-PR,
Brazil Email: nzdiniz@gmail.com

A Study on the Parents’ and Guardians’ Availment of
an “Expanded Program on Immunization” amidst the
COVID-19 Pandemic- Maria Cyrilla Therese R. Evaristo, Ronald S. Burke, Alleli LucilleC. Luzano, Janarth Kalel P. Mangulabnan and Bea Maren T.
Tuazon,College of Nursing and Pharmacy, University of the Assumption,
City of San Fernando (Pampanga), The Phillippines
Email: 2b4evaristocyrilla@gmail.com

Abstract
This is a descriptive quantitative study on parents’ andguardians’ availment of “Expanded Program on
Immunization” amidst COVID-19 pandemic to determine
the factors that motivate them to avail of EPI. It describes
the reasons why parents and guardians choose to avail of
the EPI in this time of pandemic. This will be signi icant to
the future researchers and health of icials to understandbetter the different reasons on the parents’ and guardians’
availment of the various immunizations despite thesechallenging times. In this way, they can improve theexisting factors that contribute to the availment of EPI.
The valuable information gathered from this study may
also help other parents to understand and appreciatebetter the EPI. The study, which made use of purposive
sampling, is with a total of 101 respondents. It is
recommended that the data that this study gathered beutilized for the development of motivations that will help
child(ren) of the parents or guardians be safe fromparticular diseases and preserve their well-being. Given
the right information, the management of the facilities,
and the government, new regulations and ways tominimize the vulnerability of the child(ren) to diseases
can be implemented.
Keywords: availment, COVID-19 pandemic, Expanded Program on
Immunization, motivations

Physician Privacy and Patient Bene it- Saeedeh saeedi tehrani, MD, PhD. (Corresponding author)
Email:s.saeeditehrani@yahoo.com- Mina Forouzandeh,MD, PhD.
Medical Ethics Department, Iran University of Medical Science,
Tehran, IranEmail: foroozandeh.m@gmail.com- Nazafarin Ghasemzadeh, MD, PhD .
Department of Medical Ethics, Medical Faculty, Urmia Universityof Medical Sciences, Urmia, IranEmail: nazafarin.ghasemzadeh@gmail.com- Roya Rashidpouraie, MD
Medical Ethics Department, Tehran University of medical science,
Tehran, IranEmail: :dr.roya9@gmail.com

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Privacy is one of the fundamental human rights thatprovide a sense of security against the disclosure of one's

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personal life such as emotions, thoughts, and bodies.
Physician privacy should also be taken into account.
Ignoring physician's privacy while on duty can causestress to physicians. This causes their job burnout anddissatisfaction, which in turn reduces their ef iciency andhas a signi icant impact on reducing community healthservice.
Therefore, in the present study, we will irst explain theconcept of privacy dimensions and scope, then de ine thephysician privacy and privacy concerns for the community
and the practical challenges associated with physician
privacy and propose a solution to enhance privacy
management communication.
It seems that patients can play a major role in respecting
physician’s privacy and the privacy of medical community
as a whole. If this role is well played by patients and thesociety, it can improve the quality of the physician-patient
relationship, something which can undoubtedly bene it
the society.
Therefore some interventions may be considered forbetter understanding of the issue such as guidelines or
ethical codes devoted to each health system or the
Physicians Rights Charter. Accordingly our suggested
strategies for strengthening the process of communication
privacy management are presented in the present study.
Those strategies are divided into two types: A) educationand increasing awareness which contains six
interventions; and B) administrative policy which
includes three interventions.
Keywords: physician privacy, Communication, Patient,physicianKnowledge on general oral hygiene maintenance: It’s
impact on the disease process- Dr. Purushottam panday
MBGPH student, American University of Sovereign Nations(AUSN); Bangladesh
Email: purushottampanday110@gmail.com

Oral hygiene is very crucial for your overall health .It isenactment of keeping oral cavity devoid of disease. With
the rising of COVID-19 cases where many new variants ofcoronavirus are in the way; oral health, hygiene and its
maintenance is more concerned .The purpose of thispaper is to ind and correlate the impact on the disease
process due to poor maintenance of oral hygiene. This
would include basic of oral hygiene, importance of oral
health, oral health inequalities, knowledge and access tooral health services, mouth related disease, oral
manifestations of systemic infection and prevention.
Keywords: oral hygiene, mouth disease, knowledge, prevention

Admission to an Intensive Care Unit (ICU)- EthicalDilemmas and Considerations:- Dr. Dhastagir Sultan Sheriff,
Faculty of Medicine, Benghazi University, Benghazi, Libya
Email: drdsheriff@gmail.com

Introduction
The second wave of COVID 19 infection has challenged the
Health Professionals re lecting on
the Health status,
needs, equipment and the availability of Health experts.
The sudden surge of infections and the death toll havebrought great tragedy to the common man. The
lackadaisicalattitude in following personal protective

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Eubios Journal of Asian and International Bioethics 31(6) (September 2021)

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measures like wearing face masks, social distancing andhand hygiene have taken greater toll of lives.
The Health personnel were subjected to crazy schedule,
induced burn out syndrome and anxiety problems. There
was a sudden realization that medical equipment
including oxygen cylinders and oxygen supply are in short
supply in many countries including India which was mostaffected by second wave of COVID 19. (Shanafelt,etal.2002). The Italian healthcare system, which is one of
the most regarded in Europe with 3.2 beds per 1,000
people (the corresponding rate in the United States is 2.8
per 1,000 people), appears to be unable to provide healthcare to the increasing number of simultaneously criticallyill patients. (Karampelias , Spanidis , Roussakou ,2020)
An ICU Room
Admission to an ICU unit takes 90 to 120 minutes when
the patient has to be patient along with the relatives.
There is a speci ic number of visitors to visit the unit andin some countries one has to register one day before thevisit and visiting hours are speci ied. Two visitors can visit
the patient in a day.
A patient in the ICU unit is attached to medical devices
with a speci ic alarm system for each of the devise. The
type of alarm echoed are known to the nursing staff who
know what is the alarm mean to the state of the patient.
A visitor by touching and holding the patient’s hands,
talking with a smooth voice, making the patient knowwhat day and time it is along with newspapers withpictures may boost the patient’s spirit.
ICU Team of Health Professionals
The ICU team is led by a doctor who makes decisions
about the care of the patient who visits the unit twice aday. Few places have ICU Fellows, Resident Doctors, Nurse
Practitioners, Physician Assistants. All the healthcare
personnel are quali ied and competent team trained in
critical care. The team also include social workers who
manage emotional and practical issues. The unit may also
have respiratory therapists, clinical dietitian nutritionists,
physical and occupations .therapists to handle thepatients holistically. (Karampelias , Spanidis , Roussakou,2020)
Managing the Admission Process into ICU
To effectively manage the pandemic, two teams of doctors
and healthcare personnel are created: One team led by asenior doctor will manage resource allocation including
admission of patients, communication with family
members. Another team will handle providing standard
care to the admitted patients. The team takes care of the
medical emergency with preparedness and develops trust
between the patient and provider. (Oerlemans et al.2015)
Ethical Dilemmas
The standard ethical principles of bene icence, nonmale icence, just and respect for autonomy will be
replaced by triage, futility and greater good. (Rene etal.2020)
If someone seeks admission to the ICU the patient needs
to make a choice analyzing the advantages anddisadvantages of such a choice of admission. This recalls
the principle of resource allocation during scarcity ofresource availability. The patient has to know how
harmful the intervention will be including a long period ofrecovery and at times the chances of mortality. The futilityof such medical intervention has to take into account thequality of life and prognosis. The physician needs todiscuss candidly the medical condition of the patient andthe possible outcome. Therefore, apart from the decision
made by the physician to admit a patient, the patientneeds to be a part of decision making process
understanding the principle of futility.
The next step is the decision to make who should be
admitted or ventilated ( Triage) during scarce resources is
a complex problem. It is from different simple denial ofadmission. The process of who has to be admitted iscomplicated by:
1.
The uncertainty and lack of information about theclinical course of the disease2.
No clear-cut guidelines to follow
3.
The hostile response from social and media.
The principle of utilitarianism believes in how many
patients can be save, and egalitarianism, which believes ineveryone getting an equal opportunity.
Utilitarianism believes in greater good for the greaternumber juxtaposed to maximization of the number ofsurvivors. By this action certain groups of patients get
excluded from the ICU in times of scarcity. The principle ofunfairness and injustice comes into play due to suchexclusion. Therefore, building trust becomes one of theprime necessity between the care givers and the public.
(Rene et al.2020)
A lack of knowledge or education in health ethics is acommon cause of ethical dilemmas occurring in ICU. This
manifests when the health professional does not see asituation as being an ethical or moral problem. An
example is do not resuscitate (DNR) orders on chronicallyill patients. (Schroder et al.2009)
One of the common reasons for an ethical dilemma isreported to be, sometimes, inappropriate care,
psychological support and improper decision-making.
Many a time a patient dies in the hospital with loss ofdignity and respect.
The professional lack of communication skills led toinaccurate information about prognosis or outcome oftreatment leaving the patient with great mental stress.
This is true with terminally ill cancer patients with COVID
19 making them suffer more mental and physical agony inthe last stages of their lives. If the patient is told aboutpoor prognosis, palliative care and admission to ICU, thesurvival outcome was not in luenced. (Truog et al.2009)
In majority of cases of terminally ill patients with COVID
19 infection surrogate decision making do not help themental status of the patient or the patient’s end of life
interest,
The nature of the ICU environment makes it important for
healthcare professionals to be aware of the risk of overtreatment, re lect on why they do what they do, and be
mindful of a possible negative impact of over-treatment
on their patients. Early discussion of a patient’s wisheswith regard to treatment options is important inpreventing over-treatment.
The ethical concerns identi ied end-of-life decisions,privacy, interaction, team work, and health-care access as
emerging ethical issues that need more deliberations.

References
Angus DC, Barnato AE, Linde-Zwirble WT, Weissfeld LA, Watson
RS, Rickert T, et al. Use of intensive care at the end of life in the
United States: an epidemiologic study. Crit Care Med.
2004;32:638–643.
Guest G, Bunce A, Johnson L. How many interviews are enough?
An experiment with data saturation and variability. Field
Methods. 2006;18:59–82
Karampelias V, Spanidis Y, Roussakou E. Ethical Issues inIntensive Care Units during the COVID-19 Pandemic. Indian J
Crit Care Med. 2020;24(9):855-856. doi:10.5005/jpjournals-10071-23543
Longo DL, Fauci A, Kasper D, Hauser S, Jameson J, Loscalzo J.
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Oerlemans AJM, Van Sluisveld N et al. (2015) Ethical problems in
intensive care unit admission and discharge decisions: aqualitative study among physicians and nurses in the
Netherlands. BMC Medical Ethics 2015, 16:9 doi:10.1186/
s12910-015-0001-4
Piers RD, Azoulay E, Ricou B, Dekeyser Ganz F, Decruyenaere J,
Max A, et al. Perceptions of appropriateness of care among
European and Israeli intensive care unit nurses and physicians.
JAMA. 2011;306:2694–2703
René R, Nancy KB, Alexandre B, Alexandra L, Elie A and Jean R.
Ethical dilemmas due to the Covid 19 pandemic Ann Intensive
Care. 2020; 10: 84. Published online 2020 Jun 17. doi:
10.1186/s13613-020-00702-7
Schroder C, Heyland D, Jiang X, Rocker G, Dodek P Canadian
Researchers at the End of Life Network. Educating medical
residents in end-of-life care: insights from a multicenter survey.
J Palliat Med. 2009;12:459–470
Shanafelt TD, Bradley KA, Wipf JE, Back AL. Burnout and selfreported patient care in an internal medicine residency
program. Ann Intern Med. 2002;136:358–367.
Truog RD, Campbell ML, Curtis JR, Haas CE, Luce JM, Rubenfeld
GD, et al. Recommendations for end-of-life care in the intensive
care unit: a consensus statement by the American College[corrected] of Critical Care Medicine. Crit Care Med.
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2006;34:958–963.

3rd wave Covid19 divide: The lu shot and daily
exercise may help reduce the pneumonic variants’harmful infection in the coming winter of 2021
- Osama Rajkhan, Ph.D.
Professor of Bioethics and Integrative Health, American Universityof Sovereign Nations; Saudi Arabia
Email: osamarajkhan@gmail.com

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The coronavirus has left its mark on the world’s minds
and spirits and now it’s in the air we breathe in to stayalive. Oxygen levels in the atmosphere are at a historic
low, down from 35% in the air to 12%. Countries
responded with covid19 universal inoculation and many
are approaching vaccine-based herd immunity, which canlead to long-term natural immunity against Covid19.
Generally, vaccines induce enough antibodies and T cells
to reduce severe symptoms after infection by up to 90% in
the vaccinated population. However, research shows that
not everyone will develop this level of protection fromvaccination – 9% of the population fall in this category,‑fEubios Journal of Asian and International Bioethics 31(6) (September2021)

325

and another 5% may lose the protection within 6 months,
and both groups are susceptible to reinfection withcovid19, especially the new variants, like Delta, Gamma,
and Lambda; which are more transmissible than theearlier Alfa variant. Infections in young adults are soaring
again. Several factors can increase the risk of postvaccination infection like social mixing with theunvaccinated, possibly leading to a 3rd wave of SARs-Cov2
triggered by the emerging divide between those the twogroups. So if the array of covid19 vaccines aren’t perfect totackle the 3rd wave of SARs-Cov2 mutations, and experts
say an increase of infection is likely this winter, what else
can be done, besides the 3rd booster dose, especially for
those severely immunocompromised groups who will notdevelop the required levels of antibodies to ight viral
infections? Should we consider giving people the Flu shot
this coming season? Maybe, because it may help reducethe disease burden in both the rich and poor parts of theworld. We may also want to devise harm reduction
strategies like advising the public to denature the proteinsof the virus and render them inactive with daily exercise
and going out to nature.
Keywords: 3rd wave Covid, contamination, long-Covid, adaptation,
Delta, Lambda, economic hardship, evolution, biomes, bioethics.

Cyberpornography in the Philippines: An Ecofeminist
Reading- Mr. Richard Necesito, Dr. Joven Sepino, Dr. Maria Luz Villarante,
Fr. Rodel Magin, OSA
University of the Philippines Manila, Philippines
Email: richard_necesito@dlsu.edu.phAbstract
Hallare (2018) reported that Philippines appears to be theifth straight -longest viewers of Pornhub. Since then,Pilipino remained the top users (longest viewers of pornsite in global scale) from 2013 - 2018. Yet, UNICEP (2017)
warned that 80% of Filipino kids are at risk of online
sexual abuse (particularly women). It also cautioned that“one in 3 internet users globally is a child.” This panorama
is mind boggling - given that majority of Filipinos are
Catholics. What can be the challenges and opportunities ofthis phenomenon?
This paper aims to decolonize feminist reading of the
Phenomenon of Cyberporn in the Philippines. It seeks to
examine the analysis of social scientist on Cyberporn. It
enunciates the impact of this phenomenon among women.
In the process, since majority of the Filipinos are
Christians, it will scratch below the surface of the pastoral
letter of Catholic Bishops’ Conference of the Philippines(CBCP) on “Pornography.” Ultimately, through theintersections of the thoughts of Brazal and local Feminists
in the Philippines, this quest may provide an “Authentic
Feminist” reading of such Phenomenon.
Keywords: Cyberpornography, Effects of Cyberpornography,
Christian Sexual Ethics, Feminist Reading326

Eubios Journal of Asian and International Bioethics 31(6) (September 2021)

Challenges for organ recipients and recipient
candidates during the COVID-19 pandemic
Dr. Maria-Keiko Yasuoka,
Visiting researcher (Medical Anthropology, Medical Ethics), Otaru
University of Commerce, Japan
Email: yasuoka@otaru-uc.ac.jp

All immunocompromised patients require a higher levelof care in clinical and public health practice because theirrisk of contracting extremely infectious diseases such as
COVID-19 is far higher than that of healthy people. During
any pandemic, organ recipients and candidates face agreater risk of increased morbidity and mortality; thisleads to heightened stress and anxiety, which – ironically –can damage immune systems further, creating a deadly
cycle.
My research covers clinical care and cultural andbioethical issues, focusing on organ recipients – including
recipients of one or more transplanted kidneys – and on
candidates on the waiting list for a kidney transplant who
are also dialysis patients. During the COVID-19 pandemic,
the Japanese government has struggled to protect
people’s health, and has not created different strategies
for immunocompromised patients. As the number of
infected people increases, the health system runs the riskof becoming overrun and collapsing, as intensive careunits ill with COVID-19 patients, leaving no capacity fortransplant patients.
Organ recipients must take immunosuppressants daily
to prevent their bodies rejecting the transplanted organs,so they are permanently immunocompromised. They haveto avoid all infectious diseases via protective vaccinations,avoiding raw foods, wearing masks, avoiding large
gatherings of people, and staying in a cool, dry
environment. For organ recipients – especially those whohave received one or more transplanted kidneys and areundergoing dialysis – the second highest cause of death isinfectious diseases. To reduce this risk, the number oforgan transplant operations has decreased worldwide
during the pandemic.
Another high risk is pandemic clusters in hospitals.
Most kidney recipient candidates rely on blood dialysis;
they must commute to health facilities three days per
week and remain in a room with many other patients forfour hours. Arti icial intelligence and robotic technology
have therefore been introduced as an infection control
measure.
Keywords: Covid-19, immunocompromised, Organ recipients,
Recipient candidates, JapanCon licting choices: Primary health care physicians
dealing with ethical dilemmas during the second waveof COVID-19 pandemic in Indonesian rural area
- Raditya Bagas Wicaksono, Miko Ferine, Diyah Woro Dwi Lestari,
Ar i Nurul Hidayah, Amalia Muhaimin
Department of Bioethics, Faculty of Medicine, Universitas Jenderal
Soedirman, Indonesia
Email: r.bagas.wicaksono@unsoed.ac.id

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The second wave of the COVID-19 pandemic currently
impacting Indonesia has shown a drastic change inhealthcare. This phenomenon causes struggle within rural
areas of a developing country such as Indonesia, which
had low resources in healthcare facilities dedicated to
COVID-19. High bed-occupation rate, overwhelmed

healthcare workers, substandard vaccination rate,
combined with ongoing community transmission,
altogether had contributed to the collapsing of healthcare
centers in Central Java, Indonesia. Physicians working inprimary health care are facing numerous ethical dilemmas
as they are one of the very irst frontlines to deal withpatients. Currently, there is a limited amount of researchstudies that describe their experience dealing with ethicaldilemmas in COVID-19. Thus, qualitative research with aphenomenology approach was done to answer the
research question. Online in-depth interviews with semistructured questions were conducted with six general
physicians working in primary healthcare centers inCentral Java, Indonesia. Participants were chosen
purposively with a variation of age and gender. Data werethen analyzed by using thematic analysis. Member
checking and audit trail were done to ensure thetrustworthiness of the study. The main themes of ethicaldilemmas that emerged from our study were: 1) deciding
patient’s treatment plan; 2) ordering COVID-19 test; 3)maintaining altruism. Themes of actions taken by thephysicians were: 1) being persuasive; 2) being permissive;3) consulting to the authority. Most of the dilemmas
reported are closely related to the facility and humanresource scarcity as well as inancial dif iculties.
Keywords: ethical dilemmas, primary healthcare, physician,
COVID-19, Indonesia

Would a ‘Vaccine Passport’ Work in the Philippines?
- Joefer G Maninang
Associate Professor, University of Mindanao, Davao City,
Philippines
Email: joefer_maninang@umindanao.edu.ph

It has been over a year now since a novel coronavirus in2019 took the life of ‘patient zero’ and of over a million
others which alerted States to protect and secure the livesof their citizens. The coronavirus later known as the‘COVID-19’ disease had governments impose restrictions
on the freedom of movement or the right to travel in theform of the ‘community quarantine.’ But COVID-19’sserious adverse effects on the world and national
economies moved the governments to loosen thequarantine and then implement versions of the so-called‘vaccine passport,’ an international digital healthcerti icate proving COVID-19 vaccination status. One of
the uses of the vaccine passport is to expedite the safe andorderly traf ic of people in airports and other travel
terminals, and this use extends in essential andcommercial establishments or facilities. There are ethicalconcerns, however, such as the inequitable distribution of
the scarce supply of vaccines, among others. In this article,
I brie ly describe the vaccine passport idea, its uses, andethical concerns, and then apply these concerns in anational context through the pending Bills that aim tolegitimize a Vaccine Passport System in the Philippines. In
the end, I recommend that lawmakers (who represent the
moral interest of Filipinos) consider such concerns irst
before they cast their votes.

Eubios Journal of Asian and International Bioethics 31(6) (September2021)
Barriers to Physical Activity among Patients with
Diabetes Mellitus- Shahanaz Chowdhury 1, Moniruzzaman2, Palash Chandra Banik
3, M.S. A. Mansur Ahmed3 Maksudul Shadat Akash 4
1. Dept. of Community Medicine, Bangladesh University of Health
Sciences, Dhaka.
2. Centre for Epidemiologic Research in Asia, (CERA), Shiga
University of Medical Science, Otsu, Japan.
3. Dept. of Noncommunicable Diseases, Bangladesh University of
Health Sciences, Dhaka.
4. Department of Epidemiology, Bangladesh University of Health
Sciences, Dhaka.

Abstract
Aim: One of the most underappreciated parts of type 2
diabetes management is physical activity. The purpose ofthis study was to determine the barriers to physicalactivity among diabetic patients.
Methods: A cross-sectional study design was done in
BIHS hospitals among 401 diabetic patients to see by face
to ind out the barriers to physical activity by faceinterview and analysis was done by SPSS version 16.
Results: A moderate type of physical exercise was doneby 99.4%. The mean day of a week for exercise was
5.9(±1.6). Recommended level of physical exercise in aweek was done by 69.1% respondents. The BMI, mean
waist and hip circumference were 26.4 (±4.1) kg, 92±10.9
cm and 98.7±12.2 cm respectively. Male (25.4%) were at
risk (≥ 90 cm) whereas female (71.6%) were at risk (≥ 80cm). More than half of the respondents (57.2%) felt too
tired to do physical activity. Study found that 85.8% of the
respondent’s family members encouraged physicalactivity, (60.8%) of the respondent’s relatives orneighbors encouraged physical activity, and 47.4% of the
respondent’s friends encouraged physical activity.
Majority of the respondents (95.3%) depended on
outdoor facilities for their physical activities. Regarding
presence of favorable neighborhood characteristics 69.5%
had good road facilities, 63.5% and 63% had enjoyable
scenery and sidewalks, 49.9% had security, 43.9% had not
any vehicle on the street, 27.4% had access to shadyroads.
Conclusion:
Health care professionals should giveemphasis on educational intervention on health bene itsof physical activity.
Key words: Physical activity, educational intervention,
physical barriers, psychological barriers.
13:50

General Discussion and Closing

327

EJAIB Editorial Board
Chief Editor: Darryl R.J. Macer
Associate Editor: Nader Ghotbi
Editorial Board: Akira Akabayashi (Japan), Sahin
Aksoy (Turkey), Martha Marcela Rodriguez-Alanis(Mexico), Angeles Tan Alora (Philippines), Atsushi Asai
(Japan), Alireza Bagheri (Iran), Gerhold Becker(Germany), Rhyddhi Chakraborty (India/UK), Shamima
Lasker (Bangladesh), Minakshi Bhardwaj (UK),
Christian Byk (IALES; France), Ken Daniels (New
Zealand), Ole Doering (Germany), Amarbayasgalan
Dorjderem (Mongolia), Hasan Erbay (Turkey), Soraj
Hongladarom (Thailand), Dena Hsin (Taiwan), Rihito
Kimura (Japan), Abby Lippman (Canada), Umar Jenie(Indonesia), Nobuko Yasuhara Macer (Japan), Masahiro
Morioka (Japan), Anwar Nasim (Pakistan), Jing-Bao Nie(China, New Zealand), Pinit Ratanakul (Thailand), Qiu
Ren Zong (China), Hyakudai Sakamoto (Japan), Sangyong Song (Republic of Korea), Takao Takahashi( J a p a n ) , N o r i t o s h i Ta n i d a ( J a p a n ) , A n a nya
Tritipthumrongchok (Thailand), Yanguang Wang
(China), Daniel Wikler (USA), Jeong Ro Yoon (Republicof Korea).
EJAIB adopts and complies with the Committee on
Publication Ethics (COPE) Publication ethics andmalpractice policy. Our policy is on the EJAIB website.
All potential authors should have read these guidelines
and by submission of an article for publication you
acknowledge that you have complied with this policy.
Violations will be handled in proportion to the intention
and seriousness of the violation. Registered address of
EJAIB: P.O. Box 16 329, Hornby, Christchurch 8441,
New Zealand
Editorial address, and all correspondence to:Prof. Darryl Macer, Ph.D., Hon.D.
President, American University of Sovereign Nations(AUSN), https://www.ausovereignnations.org
Email: darryl@eubios.info

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Eubios Journal of Asian and International Bioethics 31(6) (September 2021)

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