News Release

New in the Hastings Center Report, March-April 2021

Confronting COVID-19 'family clustering'; COVID-19 research on prisoners; new model of consent

Peer-Reviewed Publication

The Hastings Center

"Family clustering is a confirmed phenomenon associated with Covid-19, and harrowing stories of this disease ravaging families continue to be reported," a new article explains in the March-April issue of the Hastings Center Report. In one extreme example, 28 extended family members in California reportedly tested positive for Covid-19. Two of the family members who quarantined together required hospitalization, and one of them died from the infection. In family clustering cases, multiple loved ones may suffer from the symptoms of Covid-19 and be hospitalized, in quarantine, or recovering; and family members may also have died from the infection.

Family clustering can so devastate a family that there are no healthy, qualified surrogates available to support decision-making, or it can render the emotional burden of decision-making almost unbearable, as it must now be borne in near isolation. In "Navigating Ethical Challenges Posed by Family Clustering during the Covid-19 Pandemic," authors Nicole R. Van Buren, Elijah Weber, Mark J. Bliton, and Thomas V. Cunningham cite cases resulting in death, for instance, when a floor nurse unwittingly transmitted Covid-19 to her elderly father, when an urgent care physician unknowingly transmitted it to his elderly mother whom he lived with and cared for, and when an airport worker transmitted it to his wife, who in turn inadvertently transmitted it to her elderly father. In cases like these, the others observed family members experience guilt and shame, stemming from their belief that they caused their loved one's infection and death.

The authors provide several strategies for patients, doctors, nurses, and families to apply when confronting this phenomenon.

The March-April issue also examines the ethical challenges of consent in a pandemic in several essays, including a piece that looks at calls for prisoners to participate in research on vaccines for Covid-19, in part because the disease has hit prison populations particularly hard. Another essay examines informed consent at the intersection of clinical care and research.

The table of contents of the March-April Hastings Center Report is available here:


For more information, contact:

Susan Gilbert
Director of Communications
The Hastings Center
845-424-4040 x244

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