Ethical practice under Covid-19

Questions of ethics lie at the heart of government responses to Covid-19, professional reactions and citizens’ behaviour. Such questions include: Do we value health or the economy? Who gets the protective equipment, ventilators or food vouchers? Is combatting loneliness worth the risk of spreading or contracting the virus? During May 2020, a group of academics in partnership with the International Federation of Social Workers (IFSW) launched a qualitative survey, asking for details of the ethical challenges faced by social workers during Covid-19. We identified six main themes: Creating and maintaining trusting, honest and empathic relationships via phone or internet with due regard to privacy and confidentiality, or in person with protective equipment. Prioritising service user needs and demands, which are greater and different due to the pandemic, when resources are stretched/unavailable and full assessments often impossible. Balancing service user rights, needs and risks against personal risk to social workers and others, in order to provide services as well as possible. Deciding whether to follow national and organisational policies, procedures or guidance (existing or new) or to use professional discretion in circumstances where the policies seem inappropriate, confused or lacking. Acknowledging and handling emotions, fatigue and the need for self-care, when working in unsafe and stressful circumstances. Using the lessons learned from working during the pandemic to rethink social work in the future

Practising ethically during Covid-19: social work challenges and responses

This article draws on findings of an international study of social workers’ ethical challenges during COVID-19, based on 607 responses to a qualitative survey. Ethical challenges included the following: maintaining trust, privacy, dignity and service user autonomy in remote relationships; allocating limited resources; balancing rights and needs of different parties; deciding whether to break or bend policies in the interests of service users; and handling emotions and ensuring care of self and colleagues. The article considers regional contrasts, the ‘ethical logistics’ of complex decision-making, the impact of societal inequities, and lessons for social workers and professional practice around the globe

Ethical Challenges for Social Workers during Covid-19: A Global Perspective

This report summarises the findings of an international study of the ethical challenges faced by social workers during the Covid-19 pandemic, undertaken during 6th-18th May 2020. 607 responses from 54 countries were received via an online survey, additional interviews and local surveys. Six key themes relating to social workers’ ethical challenges and responses were identified: 1. Creating and maintaining trusting, honest and empathic relationships via phone or internet with due regard to privacy and confidentiality, or in person with protective equipment. 2. Prioritising service user needs and demands, which are greater and different due to the pandemic, when resources are stretched or unavailable and full assessments often impossible. 3. Balancing service user rights, needs and risks against personal risk to social workers and others, in order to provide services as well as possible. 4. Deciding whether to follow national and organisational policies, procedures or guidance (existing or new) or to use professional discretion in circumstances where the policies seem inappropriate, confused or lacking. 5. Acknowledging and handling emotions, fatigue and the need for selfcare, when working in unsafe and stressful circumstances. 6. Using the lessons learned from working during the pandemic to rethink social work in the future

Ursodeoxycholic acid inhibits hepatic cystogenesis in experimental models of polycystic liver disease

Background & Aims: Polycystic liver diseases (PLDs) are genetic disorders characterized by progressive biliary cystogenesis. Current therapies show short-term and/or modest beneficial effects. Cystic cholangiocytes hyperproliferate as a consequence of diminished intracellular calcium levels ([Ca2+](i)). Here, the therapeutic value of ursodeoxycholic acid (UDCA) was investigated. Methods: Effect of UDCA was examined in vitro and in polycystic (PCK) rats. Hepatic cystogenesis and fibrosis, and the bile acid (BA) content were evaluated from the liver, bile, serum, and kidneys by HPLC-MS/MS. Results: Chronic treatment of PCK rats with UDCA inhibits hepatic cystogenesis and fibrosis, and improves their motor behaviour. As compared to wild-type animals, PCK rats show increased BA concentration ([BA]) in liver, similar hepatic Cyp7a1 mRNA levels, and diminished [BA] in bile. Likewise, [BA] is increased in cystic fluid of PLD patients compared to their matched serum levels. In PCK rats, UDCA decreases the intrahepatic accumulation of cytotoxic BA, normalizes their diminished [BA] in bile, increases the BA secretion in bile and diminishes the increased [BA] in kidneys. In vitro, UDCA inhibits the hyperproliferation of polycystic human cholangiocytes via a PI3K/AKT/MEK/ERK1/2-dependent mechanism without affecting apoptosis. Finally, the presence of glycodeoxycholic acid promotes the proliferation of polycystic human cholangiocytes, which is inhibited by both UDCA and tauro-UDCA. Conclusions: UDCA was able to halt the liver disease of a rat model of PLD through inhibiting cystic cholangiocyte hyperproliferation and decreasing the levels of cytotoxic BA species in the liver, which suggests the use of UDCA as a potential therapeutic tool for PLD patients. (C) 2015 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserve