Is it generally rational to defer to official stories? On the affirmative view exemplified by Neil Levy, grounds for scepticism cannot outweigh the epistemic authority of the experts presumed to generate them. Yet sociological studies of how expertise is mediated into official communications reveal the epistemic potential of citizens’ collaboratives. These may include, or advocate hearing, dissident experts. Such groups’ epistemic position is arguably analogous to that of the ‘other institutions of civil society’ that Levy sees as underwriting the authority (...) of official stories. An added advantage is that they are able to adhere to deliberative methods of inquiry. By contrast, an official story presupposes that deliberations have concluded, and what remains is to promote the agreed story. This is achieved by strategic communication, which can involve extensive coordination by organisations committed primarily to persuasion rather than truth-seeking. Sometimes it includes blocking dissidents’ deliberative challenges. A case study highlights how even an organisation of indisputable epistemic authority can be politically influenced to block the testimony of its own scientific experts, while uncritical support for its official story is maintained by other institutions of civil society. Hence, an appropriate attitude towards official stories is critical receptiveness rather than automatic deference. (shrink)

In the past decade, numerous ethical frameworks have been developed to support public health decision‐making in challenging areas. Before the COVID‐19 pandemic began, members of the authorship team were involved in research programmes, in which the development of ethical frameworks was planned, to guide (a) the use of new technologies for emerging infectious disease surveillance; and (b) the allocation of scarce supplies of pandemic influenza vaccine. However, as the pandemic evolved, significant practical challenges emerged that led to our questioning the (...) value of these frameworks. We now believe that a normative instrument, such as a framework, cannot adequately or reliably provide the ethical guidance that needs to be incorporated into public health decision‐making during natural disasters or infectious disease emergencies. Recently it has been suggested that there are potentially more dynamic, flexible, and effective ways to navigate decisions involving complex considerations entailed in policies and practices during a public health emergency. In this paper, we first outline the key functions of a public health ethics framework, before describing why we believe it would not be fit for purpose during a crisis. We end by considering whether proposed alternative methods to promote ethical public health decision‐making goals have the potential to meet these objectives. (shrink)