Editorial: Bioethics Amidst the COVID-19 Pandemic

March 2020 witnessed the WHO’s declaration of COVID-19 as a global pandemic. It is a date that has imprinted history. Almost 2 years later and the pandemic remains in many ways a global mystery: how did it come to be? Will there be new waves and additional mutations? Is it man-made and thus a form of biological warfare or is it released to trick governments and people into buying vaccines to increase the profit of pharmaceutical companies with trillions of dollars that will be used to subsidize more wars? Almost 2 years now and a plethora of questions continue to be raised in connection to the vaccine: which one is better? Should there be a booster shot? Will it tamper our DNA? Does it really protect from the pandemic? Does it work with new variants? Scarcity of resources, beds, and ventilators brought to light newmoral conundrums for clinicians and ethicists: How should scarce medical resources be allocated? Should the elderly be sacrificed? Is a unilateral Do-Not-Resuscitate (DNR) acceptable from the moral standpoint? etc. The above were enough for us to see the cruciality of delving more into bioethical concerns during pandemics which led to a call that we issued on May 2020 at the earliest stages of the pandemic. We received global contributions tackling different issues or similar ones from different cultural backgrounds. Their contributions made the content rich with information and triggered more thinking about ethical dilemmas and how to solve them. Most importantly, it made us realize how important bioethics is during pandemics globally and how ethical concerns became more central in medical care globally, regardless of the economic divide, cultural differences, and/or political ideologies. The contributions were divided into six main entries/themes:


Bioethics Amidst the COVID-19 Pandemic
March 2020 witnessed the WHO's declaration of COVID-19 as a global pandemic. It is a date that has imprinted history. Almost 2 years later and the pandemic remains in many ways a global mystery: how did it come to be? Will there be new waves and additional mutations? Is it man-made and thus a form of biological warfare or is it released to trick governments and people into buying vaccines to increase the profit of pharmaceutical companies with trillions of dollars that will be used to subsidize more wars? Almost 2 years now and a plethora of questions continue to be raised in connection to the vaccine: which one is better? Should there be a booster shot? Will it tamper our DNA? Does it really protect from the pandemic? Does it work with new variants?
Scarcity of resources, beds, and ventilators brought to light new moral conundrums for clinicians and ethicists: How should scarce medical resources be allocated? Should the elderly be sacrificed? Is a unilateral Do-Not-Resuscitate (DNR) acceptable from the moral standpoint? etc.
The above were enough for us to see the cruciality of delving more into bioethical concerns during pandemics which led to a call that we issued on May 2020 at the earliest stages of the pandemic. We received global contributions tackling different issues or similar ones from different cultural backgrounds. Their contributions made the content rich with information and triggered more thinking about ethical dilemmas and how to solve them. Most importantly, it made us realize how important bioethics is during pandemics globally and how ethical concerns became more central in medical care globally, regardless of the economic divide, cultural differences, and/or political ideologies.
The contributions were divided into six main entries/themes: in smartphone use becomes a concern, as 27.6 and 57.2% reported an increase and great increase, respectively, of their smartphone, with around 42% using theirs for more than 6 hours a day. Of interest, students' living environment proved significant in this study, as those, e.g., who lived in rural areas or in a home with a garden rather than in an apartment experienced lesser increases in their mobile phone use. Of interest, Yadav et al. also address the "Anxiety and Depression among Health Sciences Students at Home Quarantine during COVID-19 Pandemic in selected Provinces of Nepal" again addressing similarities of concerning issues in different countries. They too found, among other things, that factors such as place of residence significantly affected respondents' levels of depression and anxiety. Saaddeh et al. also look into the "Effect of COVID-19 quarantine on the sleep quality and the depressive symptom levels of university students in Jordan during the spring of 2020, " when the long-term lockdown was imposed on the country. The sleep quality of three-quarters of the participants was negatively affected by the extended quarantine. In addition, depressive symptoms were reported in 71% of participants, including 34% with moderate and 37% with high depressive symptoms scores. Meanwhile, Li et al. investigate the "Psychological distress, social support, coping style, and perceived stress among medical staff and medical students in the early stages of the COVID-19 epidemic in China." Guo et al. elegantly performed a systematic review and meta-analysis on the "Depression and coping styles of college students during COVID-19 epidemic." The number of articles under this theme clearly indicates the ethical obligation toward implementing effective measures to help mitigate the psychological effect of the imposed quarantine and lockdown, particularly among college and university students. 6. The role states and governments played during the pandemic.
Some of these interventions were ethically disputed. Dave and Gupta address an essentially debatable issue of policies mandating tracking systems that were used during the pandemic and how ethical these were. Through deploying the Faden-Shebaya framework, which is used to justify public health interventions, the authors argue that while theoretically justified, it is difficult to defend a mandatory policy in practice. Freitas et al. write A reflection on the main ethical obstacles related to the strategic action "o brasil conta comigo." Edlinger et al. ask "Is it legitimate for society to intervene in the way citizens live their lives when the cost of health care has to be borne by the general public?-General considerations and special implications during the Covid-19 pandemic." Lastly, Odeh et al. came up with an interesting classification "iOntoBioethics: A Framework for the Agile Development of Bioethics Ontologies in Pandemics, Applied to COVID-19, " a unique and unprecedented work that will set the stage toward an artificial intelligence-based classification of the (bio)ethical published literature, which might contribute toward setting the stage for "Bioethics Informatics." It was an immense pleasure for us to co-edit this Frontier's issue. Nonetheless, bioethical dilemmas continue to arise almost every day along with ethical discussions, and debates. As long as