Opinion

Ethical Dilemmas in the Arab Population in COVID 19 Era

Kamal dahamsheh*

Nazareth academic school of nursing, Israel

Submission: April 27, 2024;Published: May 02, 2024

*Corresponding author: Kamal dahamsheh, Nazareth academic school of nursing, Israel Email id: kamaldahamsheh@nazhosp.com

How to cite this article: Kamal d. Ethical Dilemmas in the Arab Population in COVID 19 Era. JOJ Nurse Health Care. 2024; 13(3): 555863.. DOI:10.19080/JOJNHC.2024.13.555863

Abstract

Since the corona epidemic was discovered in December 2019, the words “isolation”, “closures”, “capsules” and “vaccination” have become commonplace words. Along with the new routine, many efforts began to prevent the spread of the epedemia, which gave hope to return to a previous life. The state’s constitutional authority used the law mostly to restrict of individual liberties in the overriding interest of public health. Arabic People Protest against the restriction of individual liberties and the freedom of occupation during the Corona period. And under these conditions, the question of the ethics of the violation of civil liberties was pushed aside. This review article emphasize the complex interplay between arab minority attitudes during The new pandemia and its effects on their daily life. emphasizing the impact of societal attitudes on rulls adherence, and healthcare behaviors. This review advocates for a concerted effort to break down barriers, combat stigma, and create inclusive systems that promote equitable access to workplace, partucipation on social events and facilitate support services for all affected populations.

Keywords: COVID 19; Ethical dilemmas; Vaccination; Healthcare, Liberties; Funeral; violation; pandemia; inclusive systems; public health; quarantine; infectious diseases; Health Ordinance; isolation place; aforementioned legislation; Corona crisis; health promoters; public good outweighs; pandemia of covid19; purification centers; corona trustee; appetite.

Introduction

Public discussion and debate on the subject of the «conspiracy regarding the truth of the disease» arose, and on the subject of public health being prioritized over individual rights. The imposition of lockdowns, in which people are required to stay in their homes, and the imposition of financial sanctions and fines on those who violate the isolation and quarantine instructions, were considered an infringement on the liberties of the ordinary citizen. The law that authorizes restricting the freedom of patients with infectious diseases was enacted in 1940, back in the days of the British mandate - the “People’s Health Ordinance”, in which the administrator may establish by order or instruction that any person (remove, detain, subject to supervision, medical examination) of infected person.

Section 15 of the Public Health Ordinance gives a government doctor the authority to transfer a person infected with an infectious disease to a hospital, or to another isolation place and to detain him there as long as he is infected with the disease and may infect his surroundings.The Minister of Health used his authority and declared the corona virus as a contagious and dangerous disease, and accordingly in 2020, section 20a was added to the ordinance, 8 subsections regulates the instructions and restrictions on the public due to the corona disease [1]. The Arab society in the country was required to make a drastic change in its behavior patterns and daily activities, something that is often done by virtue of the aforementioned legislation, and under these conditions the question of the ethics of the violation of civil liberties has been pushed aside.

Discussion

Although the decision to transfer people to isolation is made by the authorities, they do not personally know the circumstances of the person’s life, and the meaning of removal from the family framework and its consequences for them. Khateeb points out that the corona crisis in Arab society has challenged the values that are supposed to underpin the ethical codes in the healthcare field, and lead the decision-making processes related to dealing with the corona virus. Values of social justice, fairness, responsibility, transparency, partnership, autonomy and more were tested within the Arab society, as well as in the relations between the society and the state’s institutions and representative systems. The Arab population entered the Corona crisis from an inferior starting point of a difficult economic situation, in which about half of the Arab families are below the poverty line, and in a poor state of health (reflected in high rates of chronic disease, obesity and smoking). Beyond that, there are large gaps in the accessibility and availability of various health and social services [2].

Since the beginning of the epidemic, voices have been heard claiming that the Arab population is not acting responsibly and is, to a certain extent, a major factor in the spread of the virus. And especially due to the publication of videos of holding several weddings in large numbers and without applying the guidelines of the Ministry of Health. The people were “accused” of causing damage to their relatives, their environment and the public in general. Practically speaking, there is a problem of forcibly detaining a person who morally refuses any infringement of his freedom. Various bodies in this society mobilized to fight against Corona, with the medical, public health, health promoters, heads of local councils and clergy standing at the forefront. The Moslem clerics joined the information system and distributed religius rulings, in order to encourage the people to stay at home during the lockdown and to follow the guidlines of isolation and not to roam freely in the neighborhoods. The Arabs Christian clergy also asked the faithful people not to attend mass in churches on Sunday

For Muslims, the subject of risks minimisig was emphasized so that according to the religion the right of individual’s freedom recedes and is withdrown when there is interest of preserving the health of others. The Islamic Council for “Ifta” (religious ruling), headed by Dr. Mashor, called for all friday cermony in all the mosques in Israel,to talk abaut: “Extended weddings parties in light of the Corona crisis equal to contempt for lives of the invited people” (September 4, 2020). He asked people not to come to pray in mosques, including the Friday pray which is a major week ceromony, nor the night prays of the fasting month of Ramadan. Mashor points out and claimed: “Islam seeks to protect souls and considers this as a legitimate religious demand. On the other hand, Islam rejects everything that endangers this soul, and considers it selfishness that deserves moral condemnation. This is in accordance with the saying of the Prophet Muhammad (pbuh):”la darar wla dorar “ Not causing harm to other and Not causing self harm. the common public good outweighs the good of the individual, and therefore one should prepare for weddings with great sensitivity and limit the invitees to the small circle of close ones, and even limit the wedding to one night only [3]. Indeed stoping weddings and other social, religious and cultural events created dillemas for people because of lack of alternatives. A small group of people broke the law and disobeyed the instructions of the Ministry of Health and the instructions of the clergy, and attempted to bypass all instructions and to behave in a selfish way.

The second, controversial issue is whether it is ethically appropriate to impose the vaccine on the population as a whole, in order to promote public health interests. Is it permissible to justify conditioning certain rights on receiving a vaccine? In this ethical issue, the philosopher Julian Svolisco claims that compulsory vaccination can be ethically justified, in the sense of conditioning rights, when four conditions apply: There is a serious danger to public health; the vaccine is effective and safe; mandatory vaccination is better than any other alternative in terms of cost-effectiveness; The compulsion is proportional [4]. For COVID-19, forcing the vaccine should also take into account the public’s “appetite” and desire for vaccination. Under the right circumstances, mandatory vaccination can be ethically justified, if the punishment is proportionate and payment or compensation are offered for receiving the vaccine.

In Israel, a mandatory vaccination law cannot be justified when there is still a degree of uncertainty as to the duration of the vaccine’s effect an benifit, and whether it immunizes against the defferent mutations of the corona virus. Most of Arabic society as well as most of Orthodox Jews (HREDIM) refused vaccines for COVID 19 so the state, did not force vaccinations, but it offers to encourage and incentivize those who get vaccinated by issuing the “Green Passport” the vaccination certificate, which is a solution for many citizens who intend to travel to Mecca in Saudi Arabia, or to travel abroad and even to go to most of warkplaces.this action leaded to increase the nombers of vaccinated persons.

Another moral issue arised when dealling with the relative’s death and the process of separation from family members. which affecte the process of the grief. During the time of the pandemia of covid19 the medical staff were very busy and not free to communicate closley with the patients, have difficulty in bringing family members into the ward to protect them from infection with the corona virus. The subject became a distressing dilemma, so it was recommended to develope and use many technological means, such as smart phones and tablets, zoom veadios for better communication. Arab society, which is mostly a traditional society, the personal family relationship face to face with the patient is very important. While in some countries choosed to burn the dead bodies of the victims of the epidemic, The believers of all monotheistic religins sought to uphold the teaching of the purity of the dead and parting with him with due respect even in the shadow of the new challenges. Therefore, several centers were established for the treatment of corpses of the Jewish and Arab corona patients, with adhering to strict and meticulous procedures according to the instructions of the Ministry of the Interior. The treatment of the body, which included wrapping it in two sealed plastic bags after purification, and the execution was done by officials outside the family frame. Addition to this, there are also restrictions regarding the arrangements for the funeral and burial [5].

A funeral is a gloomy event, but the funerals of corona patients became more sad. At the beginning of the epidemic, funerals were very limited, and people were afraid to approach the deceased even though he was wrapped in several wrappings and did not pose a danger to anyone. Along with the guidelines for the treatment of Jewish deceased, the authorities were required to find solutions for members of the Muslim and Christians people as well. Then later, five purification centers were established for the Muslim people along the country. In each such purification center a “ corona trustee “ was appointed who is the responsible for the safety of the place and the safety of the staff handling the dead bodies. Until the purification centers for Muslims were approved, the families took the dead body from hospitals and and made “piratic” and secrete purification at homes. After funeral, the family returned to the mourning pavilion, and received visitors for three days. The condolence visit is a must good deed, and the people of the village and tawn often participate in it. Visitor’s tent been prepared, one for men’s and another for women’s. The visitors are respected by receiving only bitter coffee, and some people serve water and dates [6] .During the Corona condolence period, the family also presented face masks and bottles of alcohol-jel at the entrance to the tents.

Conclusion

The dillema surrounding covid-19 impeded progress in controlling the Epidemic, posing significant challenges at individual and societal levels. Throughout this review, the multifaceted impact of dillema on people life has been explored. Isolation among those affected; forcing vaccination; ristrictions re funeral process and otehrs. It is important to note that family, community, cultural, and psychosocial backgrounds affected peoples’ decisions to vaccinate themselves and their children. Public health authorities and healthcare providers must promptly address people’s concerns.

References

1. (1940) The1940 People’s Health Ordinance, Hebrew.
2. Khateeb M (2021) Ethical aspects in promoting health and the corona epidemic in Arab society.
3. Mashoor F (2020) Religious ruling: The extended weddings in light of the Corona crisis, contempt for life.
4. Savulescu J (2020) Good reasons to vaccinate: mandatory or payment for risk? J Med Ethics 47(2): 78.
5. (2020) Israel Ministry of the Interior. Guidelines for the treatment of a deceased person suspected or confirmed to be infected with the new corona virus 19-COVID in the non-Jewish sector, Hebrew.
6. Gatrad AR (1994) Muslim customs surrounding death, bereavement, postmortem examinations, and organ transplants. BMJ 309(6953): 521-523.