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Dying individuals and suffering populations: applying a population-level bioethics lens to palliative care in humanitarian contexts: before, during and after the COVID-19 pandemic
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  • Published on:
    Dying in abandonment during the Covid-19 pandemic: the silent tragedy of misthanasia and the urgent need to avoid it
    • Sergio Britto Garcia, Associate Professor of Medical Ethics and Legal Medicine Department of Pathology and Legal Medicine. Faculty of Medicine of Ribeirão Preto. University of São Paulo
    • Other Contributors:
      • Marco Aurelio Guimarães, Associate Professor of Legal Medicine
      • Waynice Neiva de Paula Garcia, Assistant Professor of Anesthesiology

    The excellent essay published by Wynne et al (2020) in the journal of Medical Ethics 1 provides a timely reflection on the urgent need for improvements in the “provision of palliative care in humanitarian and emergency contexts” emphasized by the current Covid-19 pandemic. Regarding this issue, we would like to add some reflections from a developing country perspective about the death in abandonment that may support the authors proposal.
    In 1343 Giovanni Boccaccio wrote about the patients with the Bubonic Plague in The Decameron: “Most of them remained in their houses, either through poverty or in hopes of safety, and fell sick by thousands. Since they received no care and attention, almost all of them died”. It is staggering that these words fit to describe the current situation of many patients with severe forms of Covid-19 that do not find places in hospitals. They are being denied even a palliative care and eventually die in their homes or elsewhere in a state of abandonment. This dramatic situation is unprecedented in modern times in wealthy societies. Unfortunately, it is not a novelty in many developing countries that chronically suffer from inadequate health systems, which are now crumbling with the current pandemic. In 1989, Marcio Fabri dos Anjos, a brazilian bioethicist proposed the term mysthanasia (from the Greek: mys = unhappy, thanathos = death) to characterize the death in state of abandonment (Ferreira & Porto, 2019). 2 It was attributed to the h...

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    Conflict of Interest:
    None declared.

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