The COVID pandemic was an exceptional public health situation – which brought with it unprecedented restrictions across the global populace. But what was it about this pandemic which caused us to implement such drastic restrictions on liberty? Much of the ethical debate on restrictive measures such as lockdowns and vaccine requirements focused on the potential harm that individuals cause to other individuals by the risk of infection. I will suggest that this may come from a reliance on J.S. Mill’s harm (...) principle as providing the ultimate justification for coercion – i.e., the well-accepted principle that state coercion is justified in order to prevent the imposition of unacceptable risk of harm to others. Though there have been attempts, in the wider public health ethics literature, to use the harm principle as a basis for restricting contribution to collective harms, I will suggest that these attempts cannot rely on the harm principle alone. I will then turn to the ways in which an individual-based line of reasoning does not capture a distinctive sort of harm posed by the COVID pandemic (and others like it): the potential failure of healthcare systems. I will draw out three ways in which a focus on the harm that an individual poses to another individual fails to capture the full scope of harm wrought by the collapse of healthcare systems. First, it can’t adequately capture the cumulative and “looping effects” of the harm caused by strained healthcare systems. Second, it fails to capture the widespread ripple effects the failure of a central societal institution can have on other institutions. And third, the failure of a healthcare system can impose “psychic costs”, affecting the moral character of all members of society, reducing trust in institutions, and potentially posing an existential threat to the fabric of society. Finally, I will sketch some implications of the recognition of this distinctive sort of harm for the justification of coercive public health measures. (shrink)

The COVID-19 pandemic has been the scene of several epistemic battles at the science-society interface, creating deadlocks that have been hard to overcome. To cut through the paralysing elements of these discussions, we present an analysis of three epistemic battles, concerning empirical evidence, expertise, and model projections. Our analysis singles out a crucial factor that drives unhelpful disputes like these: the contested prioritisation of specific types of scientific knowledge, which are considered adequate for policy only if they meet predetermined standards. (...) To move beyond these deadlocks, we introduce the conceptual tools of epistemic pluralism and contextualism, which give concrete indications in the three controversies we discuss and show us the way forward in debates on science-based policy. (shrink)

The Covid-19 pandemic was a world event on our intellectual doorstep. What were our duties to respond, and how well did we respond? We published papers, but we did not engage extensively or influentially in public debate. Perhaps we felt we were not experts. Yet in a health crisis, philosophers of medicine can offer not only “conceptual clarification,” but also domain-specific knowledge concerning structural properties of relevant sciences and their social-political uses. I set out three conditions for the kind of (...) contribution I felt was lacking: public, critical, and timely. And I call for us to do more of it. (shrink)