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Background: Care homes have been disproportionately affected during the COVID-19 pandemic. Practical challenges of enacting infection control measures in care home settings have been widely reported, but little is known about the ethical concerns of care home staff during the implementation of such measures.. Objectives: To understand the ethical challenges perceived by care home staff during the early months of the COVID-19 pandemic. Research design: An exploratory qualitative study. Participants and research context: A purposive sample of 15 care home staff in different roles and ranks in Hong Kong was recruited to take part in semi-structured interviews between June and August 2020. Ethical considerations: Ethical approval for this study was obtained. Participation was voluntary and anonymous. Participants had the right to withdraw from the study at any time without reprisal. Findings: Three themes were identified: unclear legitimacy regarding infection control measures, limited autonomy in choices over infection control measures and inevitable harms to residents' well-being. While the participants expected that they would have legitimated power to implement infection control measures, they were resistant when their right to self-determination of testing and vaccination was infringed. They also felt trapped between ethical duties to protect care home residents from infection risk and the anticipated detrimental effects of infection control measures. Conclusions: The findings of this study reveal tensions among the ethical obligations of care home staff in response to a public health emergency. They highlight the importance of strengthening ethical sensitivity and ethical leadership in identifying and resolving the challenges of pandemic responses. [ABSTRACT FROM AUTHOR]

This article aims to assess the feasibility of applying the Polluter-Pays Principle (PPP) to its fullest measure in counteracting ship-source pollution in Hong Kong (HK). Ship-source pollution is of chief concern for HK׳s marine environmental protection. A comprehensive legal and policy framework has already been established to control and remedy ship-source pollution; nevertheless, the costs of implementing measures under this framework are largely undertaken by the government or through the public avenue, leading to an inconsistency with PPP, which is a principle rooted in HK environmental policy. Through an intensive literature review and questionnaire survey, the results of this study have revealed that the adequacy and/or effectiveness of the existing legal and policy framework for controlling and remedying ship-source pollution are questionable. In addition, despite varied understandings of PPP, the industry also supports the adoption of innovative legal and policy measures to apply PPP to its fullest measure in order to better control and remedy ship-source pollution. These findings provide useful evidence, and enable meaningful reflection on the existing legal and policy framework covering ship-source pollution. [ABSTRACT FROM AUTHOR]