On March 11, 2020, the World Health Organization (WHO) stated that the number of cases of COVID-19 multiplied by 13 outside China, with a threefold increase in the number of affected countries. The WHO expressed its concern about the alarming levels of spread and severity of the outbreak, declaring the pandemic. This pandemic context is generating a social pact that seeks to ensure collective protection over individual freedoms. To meet the challenge, Governments must make decisions based on the principles that govern the State- These should consider the differences and particularities of those affected, without diverting attention from collective social protection. The following is a proposal on the ethical principles that should guide a State that makes decisions in public health emergencies.

Background: Healthcare-associated infections (HAIs) significantly increase morbidity, mortality, and healthcare costs. Among HAIs, catheter-associated infections are particularly prevalent due to the susceptibility of catheters to microbial contamination and biofilm formation, especially with prolonged use. Biofilms act as infection reservoirs, complicating treatment and often requiring catheter removal, thus extending hospital stays and increasing costs. Recent technological advances in catheter design have focused on integrating antifouling and antimicrobial coatings to mitigate or prevent biofilm formation. Methods: We developed COPESIL^®, a novel silicone rubber embedded with PEGylated copper nanoparticles designed to reduce microbial contamination on catheter surfaces. We conducted in vitro assays to evaluate the antimicrobial and antibiofilm efficacy of COPESIL^® against pathogens commonly implicated in catheter-associated urinary tract infections. Additionally, the safety profile of the material was assessed through cytotoxicity evaluations using HepG2 cells. Results: COPESIL^® demonstrated substantial antimicrobial activity, reducing contamination with Escherichia coli and Klebsiella pneumoniae by >99.9% and between 93.2% and 99.8%, respectively. Biofilm formation was reduced by 5.2- to 7.9-fold for E. coli and 2.7- to 2.8-fold for K. pneumoniae compared to controls. Cytotoxicity assays suggest the material is non-toxic, with cell viability remaining above 95% after 24 h of exposure. Conclusions: The integration of PEGylated copper nanoparticles into a silicone matrix in COPESIL^® represents a promising strategy to enhance the antimicrobial properties of catheters. Future studies should rigorously evaluate the long-term antimicrobial efficacy and clinical safety of COPESIL^®-coated catheters, with a focus on their impact on patient outcomes and infection rates in clinical settings.

Death processes have been progressively transferred to hospital spaces due to biomedicalization and the use of technologies, generating important challenges for healthcare systems. The COVID-19 pandemic exposed the lack of unified criteria and principles for a dignified death in the hospital. This study corresponds to a narrative review using Higgins & Green's methodological framework as a reference. A systematized search was carried out with the question: What are the elements considered in the decision-making of hospital teams regarding access and use of life support technology and dying processes in adult critically ill patients? The searches conducted during October 2022 in MEDLINE/PubMed, Scopus, Science Direct, CINAHL, Biblioteca Virtual en Salud (BVS), Cochrane Library, and Scielo identified 1499 records for screening, and 148 were retrieved for full-text review. Eighty-four articles were included in the review, identifying seven categories. The evidence shows variability in decision-making associated with the clinical status of the patient, the criteria of the medical professional, added to structural elements of the health system and political-legal aspects. The literature recommends reflexive, dynamic, flexible, and individualized decision-making processes that consider the patient's preferences, clinical judgment, prognosis, and available resources. Communication, advance care planning, interdisciplinary discussions, external consultations, and the involvement of ethical committees are crucial throughout the process.