Conservative assumptions in medical ethics risk immense harms during a pandemic. Public health institutions and public discourse alike have repeatedly privileged inaction over aggressive medical interventions to address the pandemic, perversely increasing population-wide risks while claiming to be guided by ‘caution’. This puzzling disconnect between rhetoric and reality is suggestive of an underlying philosophical confusion. In this paper, I argue that we have been misled by status quo bias—exaggerating the moral significance of the risks inherent in medical (...) interventions, while systematically neglecting the risks inherent in the status quo prospect of an out-of-control pandemic. By coming to appreciate the possibility and significance of status quo risk, we will be better prepared to respond appropriately when the next pandemic strikes. (shrink)

A clear and provocative introduction to the ethics of COVID-19, suitable for university-level students, academics, and policymakers, as well as the general reader. It is also an original contribution to the emerging literature on this important topic. The author has made it available Open Access, so that it can be downloaded and read for free by all those who are interested in these issues. Key features include: -/- A neat organisation of the ethical issues raised by the pandemic. (...) An exploration of the many complex interconnections between these issues. A succinct case for a continued lockdown until we develop a vaccine. An original account of the Deep Moral Problem of the Pandemic, and a Revolutionary Argument for how we should change society post-pandemic. References to, and engagement with, many of the best writings on the pandemic so far (both in popular media and academic journals). -/- ISBN: 978-0-6489016-0-0. (shrink)

There is too much that we do not know about COVID-19. The longer we take to find it out, the more lives will be lost. In this paper, we will defend a principle of risk parity: if it is permissible to expose some members of society (e.g. health workers or the economically vulnerable) to a certain level of ex ante risk in order to minimize overall harm from the virus, then it is permissible to expose fully informed volunteers to a (...) comparable level of risk in the context of promising research into the virus. We apply this principle to three examples of risky research: skipping animal trials for promising treatments, human challenge trials to speed up vaccine development, and low-dose controlled infection or “variolation.” We conclude that if volunteers, fully informed about the risks, are willing to help fight the pandemic by aiding promising research, there are strong moral reasons to gratefully accept their help. To refuse it would implicitly subject others to still graver risks. (shrink)

This commentary further explores some of the ethical issues raised by Prof. Peter Singer in his Lanson Lecture “Pandemic Ethics: Five Lessons”. In the first part, I distinguish a prioritarian approach to the allocation of scarce medical resources, from the utilitarian one advocated by Singer. I suggest that the prioritarian view better matches common intuitions about fair distribution, even though it likely needs to be balanced with other principles if it is to have plausibility in contexts like vaccine (...) allocation. In the second part of the commentary, I take a global perspective (as Singer himself does regarding the ethics of lockdowns), and highlight the controversial implications of adopting a fully cosmopolitan ethical outlook when deciding how to distribute Covid-19 vaccines. I also raise justice-related concerns about Singer’s proposal to use well-being as a single metric for evaluating public health policies. (shrink)

The COVID-19 global pandemic has shone a light on several important ethical questions, ranging from fairness in resource allocation to the ethical justification of government mandates. In addition to these institutional issues, there are also several ethical questions that arise at the interpersonal level. This essay focuses on several of these issues. In particular, I argue that, despite the insistence in public health messaging that avoiding infecting others constitutes ‘saving lives’, virus transmission that results in death constitutes an act (...) of killing. Whether this killing is wrongful depends on several factors. I consider one intuitively plausible view—namely, that in many cases, killing via unintentional transmission is not wrongful, because the parties in question have implicitly waived their rights against this harm, often via reciprocal risk imposition. I argue that this view is mistaken, but that its central insight can be better captured by identifying the appropriate standards of blame that we ought to apply during a pandemic. I conclude by showing how these conclusions can be fruitfully applied to certain institutional questions, such as helping to justify restricting government mandates. (shrink)

The COVID-19 pandemic has coincided with the proliferation of ethical guidance documents to assist public health authorities, health care providers, practitioners and staff with responding to ethical challenges posed by the pandemic. Like ethical guidelines relating to infectious disease that have preceded them, what unites many COVID-19 guidance documents is their dependency on an under-developed approach to bioethical principlism, a normative framework that attempts to guide actions based on a list of prima facie, unranked ethical principles. By situating (...) them in relation to the key philosophical debates concerning bioethical principlism, we aim to explore the limits and limitations of pandemic ethical guidance documents as, specifically, ethics documents – documents that fulfil the functions of ethics as a fundamentally normative discipline. This means not only determining whether such ethical guidance documents can, in principle, provide adequate action guidance and action justification, but also, more importantly where pandemics are concerned, determining whether they support consistent decision making and transparent processes of justification. Having highlighted the problems with merely furnishing ethical guidelines with substantive ethical content in terms of principles and values, we argue that organizations that develop these documents should, instead, focus on the procedural dimensions of action guidance and action justification, which extend to questions regarding the make-up of the committees, panels and groups that develop such guidelines, the public transparency of justifications for specific pandemic-related advice or interventions and the development of explicit procedures for transparent and consistent decision making. (shrink)

In this review, we present some ethical imperatives observed in this pandemic from a data ethics perspective. Our exposition connects recurrent ethical problems in the discipline, such as, privacy, surveillance, transparency, accountability, and trust, to broader societal concerns about equality, discrimination, and justice. We acknowledge data ethics role as significant to develop technological, inclusive, and pluralist societies. - - - Resumen: En esta revisión, exponemos algunos de los imperativos éticos observados desde la ética de datos en esta (...) pandemia. Nuestra exposición busca conectar problemas éticos típicos dentro de esta disciplina, a saber, privacidad, vigilancia, transparencia, responsabilidad y confianza, con preocupaciones a nivel social relacionadas con la igualdad, discrimi nación y justicia. Consideramos que la ética de datos tiene un rol significativo para desarrollar sociedades tecnificadas, inclusivas y pluralistas. (shrink)

In this article, we discuss the ethics of research suspensions in animal research facilities and the consequent (mis)treatment of laboratory animals during emergencies. Through a case study from Switzerland during the COVID-19 pandemic, we articulate ethical principles and moral considerations that ought to guide the treatment and care of laboratory animals within animal research facilities during emergencies. They include a principle of preparedness, the importance of recognizing animal laboratory personnel as essential workers and conducting a Harm-Benefit Analysis in (...) the case of an emergency, assigning responsibilities in a clear way, and providing psychological support in the aftermath of an emergency. More generally, we suggest that the pandemic should be taken as a learning opportunity for critically re-evaluating and improving emergency planning within animal research institutions worldwide, in view of mitigating risks to both human and animal well-being in future emergencies. (shrink)

This paper considers the obligation higher income countries have to lower and middle income countries during a global pandemic. Further considers which reforms are needed to the global supply-chain of medical resources. The short-comings in distribution and medical infrastructure have exacerbated the health crisis in developing countries. Global justice demands radical redistribution of medical resources in order to prevent mass casualties. This is argued first by highlighting that the COVID-19 pandemic should be acknowledged as an issue of global (...) justice, secondly, higher income countries ought to account for distribution inequity as a matter of rectifying past injustices, and thirdly argue for reform in distribution while considering the vaccine rollout as a prime example. We aim to show how the differences from country to country in response capabilities are a result of the economic foundation colonialism established and a direct result of cyclical poverty, which wealthy countries perpetuate to this day. (shrink)

The pandemic significantly raised the stakes for the translation of bioethics insights into policy. The novelty, range and sheer quantity of the ethical problems that needed to be addressed urgently within public policy were unprecedented and required high‐bandwidth two‐way transfer of insights between academic bioethics and policy. Countries such as the United Kingdom, which do not have a National Ethics Committee, faced particular challenges in how to facilitate this. This paper takes as a case study the brief career (...) of the Ethics Advisory Board (EAB) for the NHS Covid‐19 App, which shows both the difficulty and the political complexity of policy‐relevant bioethics in a pandemic and how this was exacerbated by the transience and informality of the structures through which ethics advice was delivered. It analyses how and why, after EAB's demise, the Westminster government increasingly sought to either take its ethics advice in private or to evade ethical scrutiny of its policies altogether. In reflecting on EAB, and these later ethics advice contexts, the article provides a novel framework for analysing ethics advice within democracies, defining four idealised stances: the pure ethicist, the advocate, the ethics arbiter and the critical friend. (shrink)

This paper explores the role of speculative anticipation in ethics during the COVID-19 pandemic and provides a structure to think about ethical decision-making in times of extreme uncertainty. We identify three different but interwoven domains within which speculative anticipation can be found: global, local, and projective anticipation. Our analysis aims to open possibilities of seeing the situatedness of others both locally and globally in order to address larger social issues that have been laid bare by the presence of (...) SARS-CoV-2. Our account of speculative anticipation builds on the analyses of the gendered impact of anticipation in technoscience by Vincanne Adams, Michelle Murphy and Adele Clarke; studies in cultural anthropology by Ann Laura Stoler; and the recent research on speculative fiction by Esther Jones. Like theirs, ours is intended to be useful. We offer it as a tool to recast questions and revisit assumptions in the context of the COVID-19 pandemic. It is hoped that by using the frame of the ethics of speculative anticipation, one might be able to consider how to avoid those futures that reproduce inequity, and instead actively and responsibly envision those futures that are informed by equity and sustainability. (shrink)

The largest medical institutions and various ethicists advocate a utilitarian approach in times of public health crises, to maximize benefits for society, in direct conflict with our usual (Kantian) view of respect for people as individuals. A central problem with utilitarianism is that there is no clear way to evaluate moral choices, including in medical decisions. In general, in medicine is respected the Kantian medical ethics. But in a pandemic, when resources are poor, deep choices of life and (...) death must be made. In these situations, the principles of utilitarianism offer the best answer, moving from a patient-centered thinking model to a society-centered thinking model. DOI: 10.13140/RG.2.2.36811.82728. (shrink)

In response to the COVID‐19 pandemic philosophers and governments have proposed scarce resource allocation guidelines. Their purpose is to advise healthcare professionals on how to ethically allocate scarce medical resources. One challenging feature of the pandemic has been the large numbers of patients needing mechanical ventilatory support. Guidelines have paradigmatically focused on the question of what doctors should do if they have fewer ventilators than patients who need respiratory support: which patient should get the ventilator? There is, however, (...) an important higher level allocation problem. Namely, how are we to ethically distribute newly obtained ventilators across hospitals: which hospital should get the ventilator(s)? In this paper, we identify a set of principles for allocating newly obtained ventilators across hospitals. We focus particularly on low and middle income countries, who frequently have limited pre‐existing intensive care capacity, and have needed to source additional ventilators. We first provide some background. Second, we argue that the main population healthcare aim during the COVID‐19 pandemic should be to save the most lives. Next, we assess a series of potential heuristics or principles that could be used to guide allocation: allocation to the most densely populated cities, random allocation, allocation based on the ratio of patients to ICU personnel, prioritisation in terms of intrahospital mortality, prioritisation of younger populations, and prioritisation in terms of population mortality. We conclude by providing a plausible ranking of the principles, while noting a number of epistemological challenges, in terms of how they best further the aim of increasing the probability of saving the most lives. (shrink)

The main aim of this article is to reflect on the impact of biases related to artificial intelligence (AI) systems developed to tackle issues arising from the COVID-19 pandemic, with special focus on those developed for triage and risk prediction. A secondary aim is to review assessment tools that have been developed to prevent biases in AI systems. In addition, we provide a conceptual clarification for some terms related to biases in this particular context. We focus mainly on nonracial (...) biases that may be less considered when addressing biases in AI systems in the existing literature. In the manuscript, we found that the existence of bias in AI systems used for COVID-19 can result in algorithmic justice and that the legal frameworks and strategies developed to prevent the apparition of bias have failed to adequately consider social determinants of health. Finally, we make some recommendations on how to include more diverse professional profiles in order to develop AI systems that increase the epistemic diversity needed to tackle AI biases during the COVID-19 pandemic and beyond. (shrink)

In times of crises, public health leaders may claim that trials of public health interventions are unethical. One reason for this claim can be that equipoise—i.e. a situation of uncertainty and/or disagreement among experts about the evidence regarding an intervention—has been disturbed by a change of collective expert views. Some might claim that equipoise is disturbed if the majority of experts believe that emergency public health interventions are likely to be more beneficial than harmful. However, such beliefs are not always (...) justified: where high quality research has not been conducted, there is often considerable residual uncertainty about whether interventions offer net benefits. In this essay we argue that high-quality research, namely by means of well-designed randomized trials, is ethically obligatory before, during, and after implementing policies in public health emergencies (PHEs). We contend that this standard applies to both pharmaceutical and non-pharmaceutical interventions, and we elaborate an account of equipoise that captures key features of debates in the recent pandemic. We build our case by analyzing research strategies employed during the COVID-19 pandemic regarding drugs, vaccines, and non-pharmaceutical interventions; and by providing responses to possible objections. Finally, we propose a public health policy reform: whenever a policy implemented during a PHE is not grounded in high-quality evidence that expected benefits outweigh harms, there should be a planned approach to generate high-quality evidence, with review of emerging data at preset time points. These preset timepoints guarantee that policymakers pause to review emerging evidence and consider ceasing ineffective or even harmful policies, thereby improving transparency and accountability, as well as permitting the redirection of resources to more effective or beneficial interventions. (shrink)

This chapter provides a high-level overview of key ethical issues raised by the use of surveillance technologies, such as digital contact tracing, disease surveillance, and vaccine passports, to combat the COVID-19 pandemic. To some extent, these issues are entirely familiar. I argue that they raise old questions in new form and with new urgency, at the intersection of information ethics, research ethics, and public health. Whenever we deal with data-driven technologies, we have to ask how they fare (...) in relation to important values like privacy, fairness, transparency, and accountability—values emphasized by information ethics scholars. Likewise, when such technologies put individuals at risk in order to drive scientific research and knowledge construction, we have to ask how they implicate values such as autonomy, beneficence and non-maleficence, and justice—values central to research ethics. And as researchers focusing on health information have long argued, when the data collected by these technologies pertain to individuals and public health, these ethical issues take on a special cast. -/- It is also true, however, that the pandemic has placed these questions in a new and revealing light. I highlight three insights from information ethics and research ethics that can help us navigate this difficult terrain. First, the value of privacy is instrumental, not absolute—there is nothing wrong with asking how to balance privacy against other important values. Second, privacy has both individual and social importance. Weighing privacy, on one hand, and public health, on the other, is not, therefore, a contest between individual and collective interests. Rather, it is an attempt to balance disparate public goods. Third, we ought to put these kinds of ethical decisions in the hands of third parties, rather than leaving them up to those who directly stand to benefit from them. In the case of pandemic surveillance technologies, this should mean more public, democratic oversight. (shrink)

The background paper provides an introduction to the concept of pandemics and to the ethical and political issues related with pandemic preparedness.

The article seeks to reclaim a type of fear lost in silent omission in education, yet central to the development of an ethical subject. It distinguishes the fear described by Martin Heidegger through the concept of befindlichkeit and fear for the other as an essential moment for ethics articulated by Emmanuel Levinas. It argues that the latter conception of fear has inverted the traditional assumption of the ideal ethical subject as fearless. It then examines how Levinas’s interpretation of fear (...) might contribute to the discussion on fear and responsibility in the context of the COVID-19 pandemic. It concludes that fear for the other reveals our tremendous capacity to suffer for the other, which is an aspect of the emotional life that has not been identified in the general educational discourse. This inattention manifests itself as a categorical omission in which the existence of fear for the other is not recognized and impedes the ability of educators to address ethics as it is deeply lived. (shrink)

The current global COVID-19 pandemic has led to a deep and multidimensional crisis across all sectors of society. As countries contemplate their mobility and social-distancing policy restrictions, we have a unique opportunity to re-imagine the deliberative frameworks and value priorities in our food systems. Pre-pandemic food systems at global, national, regional and local scales already needed revision to chart a common vision for sustainable and ethical food futures. Re-orientation is also needed by the relevant sciences, traditionally siloed in (...) their disciplines and without adequate attention paid to how the food system problem is variously framed by diverse stakeholders according to their values. From the transdisciplinary perspective of food ethics, we argue that a post-pandemic scheme focused on bottom-up, regional, cross-sectoral and non-partisan deliberation may provide the re-orientation and benchmarks needed for not only more sustainable, but also more ethical food futures. (shrink)

This essay illustrates ethical decisions that the policy makers, healthcare providers, and non-government organizations can use as guide in their day to day activities and engagements. The paper does not attempt to provide a definitive menu on how to act on certain situation, but it discusses principles that are congruent with our treasured Filipino values. Likewise, the essay neither imposes nor provides universal solutions to dilemmas but rather it encourages deep practical reasoning to arrive at culturally sensitive decisions.

The study investigated ethical considerations and science diplomacy on coronavirus disease (Covid-19) pandemic in Nigeria. The outbreak of the coronavirus disease (Covid-19) in Nigeria has spread quickly to about 34 states out of the 36 states and over 5000 persons have tested positive as at the time of this research after the first index case of an Italian and there is a projection that in coming days and weeks the number of infected persons and states will increase. The study (...) was guided by two objectives and also adopted the normative ethical theory. The study employed the methods of exposition and critical analysis to explain better the ethical issues and science diplomacy of Covid-19 pandemic in Nigeria. Data was sourced from secondary sources such as journal articles, newspaper, books and internet sources. The findings of the study showed that the citizens have some obligations that will aid the containment of the virus and as well as the government. The study also found out that science diplomacy was used, which has led to Nigeria collaborating with China to get medical aids to effectively fight the pandemic. Consequently, the study recommended amongst others that the Ministry of Health and the Nigeria Center for Disease Control (NCDC) should adopt and enforce the World Health Organization (WHO) Guidance for Managing Ethical Issues in Infectious Disease Outbreak as a working document in crisis like the Covid-19 pandemic that has ravaged Nigeria and the government should involve more in science diplomacy with other countries so that it will help in the fight against Covid-19 and other diseases that may occur in the future. (shrink)

The increasingly prominent role of digital technologies during the coronavirus pandemic has been accompanied by concerning trends in privacy and digital ethics. But more robust protection of our rights in the digital realm is possible in the future. -/- After surveying some of the challenges we face, I argue for the importance of diplomacy. Democratic countries must try to come together and reach agreements on minimum standards and rules regarding cybersecurity, privacy and the governance of AI.

The COVID-19 pandemic revealed numerous weaknesses in pandemic preparedness and response, including underfunding, inadequate surveillance, and inequitable distribution of countermeasures. To overcome these weaknesses for future pandemics, WHO released a zero draft of a pandemic treaty in February, 2023, and subsequently a revised bureau's text in May, 2023. COVID-19 made clear that pandemic prevention, preparedness, and response reflect choices and value judgements. These decisions are therefore not a purely scientific or technical exercise, but are fundamentally grounded (...) in ethics. The latest treaty draft reflects these ethical considerations by including a section entitled Guiding Principles and Approaches. Most of these principles are ethical—they establish core values that undergird the treaty. Unfortunately, the treaty draft's set of principles are numerous, overlapping, and show inadequate coherence and consistency. We propose two improvements to this section of the draft pandemic treaty. First, key guiding ethical principles should be clearer and more precise than they currently are. Second, the link between ethical principles and policy implementation should be clearly established and define boundaries on acceptable interpretation, ensuring that signatories abide by these principles. (shrink)

Gender-Based violence (GBV) is a disturbing phenomenon prevalent in all regions of the world. GBV is seen as any harmful act that is carried out against a person’s consent and that it is as a result of socially ascribed (gender) dissimilarities between males and females. The study exposes that the fight against GBV have been unsuccessful because of several factors which includes the acceptance of such actions by some traditions and cultures therefore bringing to the fore conventional ethical relativism, in (...) other words, cultural relativism. The study concluded that the rate of GBV in Nigeria is soaring high and the neglect to tackle it has made it turnout to be a shadow pandemic ravaging Nigeria. Consequently, the study amongst others recommends that the Nigerian National Assembly should enact new laws against GBV because its eradication can only be possible using the law as an instrument of social change. (shrink)

Control measures, such as “lockdowns”, have been widely used to suppress the COVID-19 pandemic. Under some conditions, they prevent illness and save lives. But they also exact an economic toll. How should we balance the impact of such policies on individual lives and livelihoods (and other dimensions of concern) to determine which is best? A widely used method of policy evaluation, benefit–cost analysis (BCA), answers these questions by converting all the effects of a policy into monetary equivalents and then (...) summing them up. A different method, social welfare analysis, proceeds by determining the effects of a policy on individual wellbeing and then applying an aggregation formula to them to evaluate the overall effects of a policy. In this chapter, we survey these methods and argue that social welfare analysis has important advantages. One crucial advantage is that it enables ethical considerations relating to the impact of policies on individual wellbeing and its distribution to be incorporated into policy assessments in a transparent way. We illustrate this with a simple numerical model for evaluating pandemic policies that vary in terms of the stringency of the controls that they impose on individual behaviour, showing how the evaluation depends on the ethical significance accorded to their impact on the wellbeing of different age and income groups. (shrink)

Would compulsory treatment or vaccination for Covid-19 be justified? In England, there would be significant legal barriers to it. However, we offer a conditional ethical argument in favour of allowing compulsory treatment and vaccination, drawing on an ethical comparison with external constraints—such as quarantine, isolation and ‘lockdown’—that have already been authorised to control the pandemic. We argue that, if the permissive English approach to external constraints for Covid-19 has been justified, then there is a case for a similarly permissive (...) approach to compulsory medical interventions. (shrink)

This paper uses virtue ethics to discuss the COVID-19 outbreak, Hollywood science-fiction/pandemic films, and the environmental crisis. We outline the ideas of hubris and nemesis and argue that responding to the COVID-19 pandemic requires that we develop virtues. We will explore these ethical issues through an eco-reading (Hiltner 2018) of two popular films cinematic representation of pandemics, The Andromeda Strain (1971) and Contagion (2011). Fictional narratives are particularly adept at celebrating the moral and intellectual virtues of individuals (...) (as is standard in Hollywood cinema) and dramatizing the tensions inherent in human scientific and technological civilisation. Using examples from our texts and with reference to COVID-19, we begin with a discussion of virtues and vices, both individual and collective, we then explore the concept of flourishing and apply this framework to collective action problems such as climate change and COVID-19. Thus, science fiction can provoke new forms of environmental philosophising and ethical engagement, while addressing the most important challenges facing humanity at present. (shrink)

A comprehensive understanding of the ethics of the COVID-19 pandemic priorities must be sensitive to the influence of social inequality. We distinguish between ex-ante and ex-post relevance of social inequality for COVID-19 disadvantage. Ex-ante relevance refers to the distribution of risks of exposure. Ex-post relevance refers to the effect of inequality on how patients respond to infection. In the case of COVID-19, both ex-ante and ex-post effects suggest a distribution which is sensitive to the prevalence social inequality. On (...) this basis, we provide a generic fairness argument for the claim that welfare states ought to favour a healthcare priority scheme that gives particular weight to protecting the socially disadvantaged. (shrink)

We explore the ethics of deliberately exposing consenting adults to SARS-CoV-2 to induce immunity to the virus (“DEI” for short). We explain what a responsible DEI program might look like. We explore a consequentialist argument for DEI according to which DEI is a viable harm-reduction strategy. Then we consider a non-consequentialist argument for DEI that draws on the moral significance of consent. Additionally, we consider arguments for the view that DEI is unethical on the grounds that, given that large-scale (...) DEI would be highly likely to result in some severe illnesses and deaths, DEI amounts to a form of killing. Our thesis is that incorporating a DEI program alongside the status-quo “calibrate-the-curve” responses could have significant advantages at the early stages of pandemics. These potential advantages mean that, at a minimum, research into DEI would have been justified early in the COVID-19 pandemic, and that DEI programs should be explored as potential additions to our overall approach to emerging pandemics in the future. (shrink)

This paper aims to analyze the ethical challenges in experimental drug use during the early stage of the COVID-19 pandemic, using Germany as a case study. In Germany uniform ethical guidelines were available early on nationwide, which was considered as desirable by other states to reduce uncertainties and convey a message of unity. The purpose of this ethical analysis is to assist the preparation of future guidelines on the use of medicines during public health emergencies. The use of hydroxychloroquine, (...) remdesivir and COVID-19 convalescent plasma in clinical settings was analyzed from the perspective of the ethical principles of beneficence, non-maleficence, justice and autonomy. We observed that drug safety and drug distribution during the pandemic affects all four ethical principles. We therefore recommend to establish ethical guidelines (i) to discuss experimental treatment options with patients from all population groups who are in urgent need, (ii) to facilitate the recording of patient reactions to drugs in off-label use, (iii) to expand inclusion criteria for clinical studies to avoid missing potentially negative effects on excluded groups, and (iv) to maintain sufficient access to repurposed drugs for patients with prior conditions. (shrink)

This Open Access book shows how value sensitive design (VSD), responsible innovation, and comprehensive engineering can guide the rapid development of technological responses to the COVID-19 crisis. Responding to the ethical challenges of data-driven technologies and other tools requires thinking about values in the context of a pandemic as well as in a post-COVID world. Instilling values must be prioritized from the beginning, not only in the emergency response to the pandemic, but in how to proceed with new (...) societal precedents materializing, new norms of health surveillance, and new public health requirements. -/- The contributors with expertise in VSD bridge the gap between ethical acceptability and social acceptance. By addressing ethical acceptability and societal acceptance together, VSD guides COVID-technologies in a way that strengthens their ability to fight the virus, and outlines pathways for the resolution of moral dilemmas. This volume provides diachronic reflections on the crisis response to address long-term moral consequences in light of the post-pandemic future. Both contact-tracing apps and immunity passports must work in a multi-system environment, and will be required to succeed alongside institutions, incentive structures, regulatory bodies, and current legislation. This text appeals to students, researchers and importantly, professionals in the field. (shrink)

In this essay, we advocate that the issue of health data ethics should no longer be considered on the level of individual scientists or research labs, but rather as a problem involving all stakeholders, from publishers, funders, ethical committees to governments, for the sake of research integrity.

Aim: The aim of this study is to reveal the convergence of public health ethics, institutional, collective, and individual ethics obligation during the COVID-19 pandemic and give some explanations with online media reports. Method: The study method is qualitative content analysis; this method was chosen as it would suit best the purpose of the study. The Turkish Medical Association, Turkish Public Health Association, and online newspaper articles and videos have been scanned using keywords. After that, related online (...) reports and interviews have been classified and analyzed according to the context in between May 22, 2020 and November 16, 2020. No official ethical permission was obtained as the study was conducted through open access internet news sites. Results: The COVID-19 scientific committee and the Ministry of Health has suggested a new way of normal life called controlled social life for all places in Turkey. In the frame of these recommendations, with the Google research engine, many articles of online media including some announcements of medical and legal associations, interviews, and calls made by the authorities were selected and analyzed. These articles and interviews containing each problem and pieces of information provided for the common understandings of the society were selected and evaluated at three topics individual, collective and state and institutional responsibility and obligations. Conclusion: Although the warnings of associations, health authorities, and scientists are mostly about personal-civil responsibility, some occurring practices have caused violations. In addition, the level of education, perception capacity, and habits that include existing social-cultural and religious rituals have prevented people from adapting to this new style of life, in other words, controlled social life. Therefore, besides the original national culture and customs, universal ethical responsibilities and obligations should teach starting from primary school and should consist of whole life understanding as a higher perspective. (shrink)

This study was conducted by an academic research team at PRINCESS NOURAH BINT ABDULRAHMAN UNIVERSITY with the purpose of promoting the levels of healthy, value and ethical awareness among the students to limit the effects of covid-19. The study applied the descriptive, analytic survey approach to document the conceptions 0f the public education instructors throughout KSA concerning their role in raising the cognitive aspects and healthy and ethical skills for encountering coronavirus pandemic (COVID-19). The study population included all the (...) instructors of public education (male & female) in all the Kingdom governorates with its both public and private sectors amounting (525,610) instructors as per the MINISTRY OF EDUCAYION statistics for the school year (1441 H ) . The sample contained 357 instructors (male& female). For this purpose, the researchers designed a questionnaire. The study concluded that there is a high level of conceptions of the instructors about their cognitive skills, healthy and ethical responsibility for providing awareness about coronavirus pandemic (COVID-19) . The study proposes some supporting and effective strategies to achieve such online learning under this pandemic. (shrink)

When central authority fails in socially crucial tasks, mutual aid, solidarity, and grassroots organization frequently arise as people take up slack on the basis of informal networks and civil society organizations. We can learn something important about the possibility of horizontal organization by studying such experiments. In this paper we focus on the rationality, care, and effectiveness of grassroots measures to respond to the pandemic and show how they illustrate core elements of anarchist thought. We do not argue for (...) the correctness of any version of anarchist politics, nor claim that the bulk of this grassroots work was done with anarchist ideas explicitly in mind. Nonetheless, the current pandemic, like many social crises before it, serves as a sort experiment in political implementation. -/- Two things have been striking in the US response to the COVID-19 pandemic: the chaos, incompetence, irrationality, and often cruel misguidedness of the centralized government response; and the rationality, care, and effectiveness of grassroots measures in many parts of the country. In this paper we focus on the latter—especially the case of Washington, DC—to illustrate core features of anarchist politics. We do not argue for the correctness of any version of anarchist politics here, but merely illustrate guiding ideas that have been a part of anarchist theory and practice for well over a century. We also do not claim that the bulk of this grassroots work was done with anarchist ideas in mind, or explicitly out of a commitment to anarchist politics. Some was, and some arises out of related ideological commitments, but most simply functions out of no more than a desire to support one another. -/- The current pandemic, like many social crises before it, rather than providing a stand-alone argument or functioning as an implementation of any political theory, serves as a sort of laboratory experiment. When central authority fails in socially crucial tasks, mutual aid, solidarity, and grassroots organization frequently arise as people take up slack on the basis of informal networks and civil society organizations. We can learn something important about the possibility of horizontal organization by studying such experiments, including how it arises through spontaneous action. If political thought is best illustrated through its implementation in practice, the functioning of grassroots individuals and organizations in a time of crisis is one way to understand the political mechanisms core to anarchist thought. (shrink)

Technologies to rapidly alert people when they have been in contact with someone carrying the coronavirus SARS-CoV-2 are part of a strategy to bring the pandemic under control. Currently, at least 47 contact-tracing apps are available globally. They are already in use in Australia, South Korea and Singapore, for instance. And many other governments are testing or considering them. Here we set out 16 questions to assess whether — and to what extent — a contact-tracing app is ethically justifiable.

The costs of the COVID-19 pandemic are yet to be calculated, but they include the loss of millions of lives and the destruction of countless livelihoods. What is certain is that the SARS-CoV-2 virus has changed the way we live for the foreseeable future. It has forced many to live in ways they would have previously thought impossible. As well as challenging scientists and medical professionals to address urgent value conflicts in the short term, COVID-19 has raised slower-burning value (...) questions for corporations, public institutions, governments, and policymakers. In simple terms, the pandemic has brought what we care about into sharp relief, both collectively and individually. Whether this revaluation of our values will last beyond the current pandemic is unknown. Once COVID-19 has been tamed, will the desire to return to our previous lives be irresistible? Or will living under pandemic conditions have taught us something that will be incorporated into how we design our future lives and technologies? These are hard questions for the ethics of technology, which this volume aims to explore and address. (shrink)

This paper reflects on the current Covid-19 crisis and the emotional stress that it leads to from the Jaina perspective. It demonstrates that any pandemic like situation is concomitant with a pandemic of emotions as well; fear and stress being prominent of them. The problem of fear is grave and must be dealt with equal measures. The concept of fear is thus analysed from various perspectives as gleaned from the diverse range of Jaina texts. The paper attempts to (...) make the philosophical texts come alive into the current situation and shows how a samyagdṛṣṭi remains unaffected (though, not absolutely) and mithyādṛṣṭi goes through constant turmoil despite facing the same circumstances. This can be further seen as a case of applied philosophy and ethics. (shrink)

BackgroundViral pandemics present a range of ethical challenges for policy makers, not the least among which are difficult decisions about how to allocate scarce healthcare resources. One important question is whether healthcare workers should receive priority access to a vaccine in the event that an effective vaccine becomes available. This question is especially relevant in the coronavirus pandemic with governments and health authorities currently facing questions of distribution of COVID-19 vaccines.Main textIn this article, we critically evaluate the most common (...) ethical arguments for granting healthcare workers priority access to a vaccine. We review the existing literature on this topic, and analyse both deontological and utilitarian arguments in favour of HCW prioritisation. For illustrative purposes, we focus in particular on the distribution of a COVID-19 vaccine. We also explore some practical complexities attendant on arguments in favour of HCW prioritisation.ConclusionsWe argue that there are deontological and utilitarian cases for prioritising HCWs. Indeed, the widely held view that we should prioritise HCWs represents an example of ethical convergence. Complexities arise, however, when considering who should be included in the category of HCW, and who else should receive priority in addition to HCWs. (shrink)

Bioethics experts played a key role in ensuring a coherent ethical response to the COVID-19 pandemic in the fields of healthcare, public health, and scientific research in Canada. In the province of Quebec, a group of academic and practicing bioethicists met periodically in the early months of the pandemic to discuss approaches and solutions to ethical dilemmas encountered during the crisis. These meetings created the opportunity for a national survey of bioethics practitioners from different fields. The survey, in (...) which forty-five Canadian bioethics practitioners (clinical ethicists, ethicist members of REBs and government health policy ethicists, or any bioethicist practicing outside of academia) participated, explored their concerns, challenges and opportunities during the first wave of the pandemic, with the objective of informing bioethics research about the difficulties experienced by bioethicists “in the field”. Participants reported increased stress levels, increased workloads, and a greater proportion of their work being devoted to public health ethics. Most of their concerns focused on groups other than themselves, such as health professionals, patients, research participants, and people in vulnerable socio-economic situations. An optimism about the future of bioethics was noted due to an increased awareness of the importance of bioethics by the public and by health and research institutions. (shrink)

Given the unprecedented novel nature and scale of coronavirus and the global nature of this public health crisis, which upended many public/environmental research norms almost overnight. However, with further waves of the virus expected and more pandemics anticipated. The COVID-19 pandemic of 2020 opened our eyes to the ever-changing conditions and uncertainty that exists in our world today, particularly with regards to environmental and public health practices disruption. This paper explores environmental and public health evidence-based practices toward responding to (...) Covid-19. A literature review tried to do a deep dive through the use of various search engines such as Mendeley, Research Gate, CAB Abstract, Google Scholar, Summon, PubMed, Scopus, Hinari, Dimension, OARE Abstract, SSRN, Academia search strategy toward retrieving research publications, “gray literature” as well as reports from expert working groups. To achieve enhanced population health, it is recommended to adopt widespread evidence-based strategies, particularly in this uncertain time. As only together can evidence-informed decision-making (EIDM) can become a reality which include effective policies and practices, transparency and accountability of decisions, and equity outcomes; these are all more relevant in resource-constrained contexts, such as Nigeria. Effective and ethical EIDM though requires the production as well as use of high-quality evidence that are timely, appropriate and structured. One way to do so is through co-production. Co-production (or co-creation or co-design) of environmental/public health evidence considered as a key tool for addressing complex global crises such as the high risk of severe COVID-19 in different nations. A significant evidence-based component of environmental/public health (EBEPH) consist of decisions making based on best accessible, evidence that is peer-reviewed; using data as well as systematic information systems; community engagement in policy-making; conducting sound evaluation; do a thorough program-planning frameworks; as well as disseminating what is being learned. As researchers, scientists, statisticians, journal editors, practitioners, as well as decision makers strive to improve population health, having a natural tendency toward scrutinizing the scientific literature aimed at novel research findings serving as the foundation for intervention as well as prevention programs. The main inspiration behind conducting research ought to be toward stimulating and collaborating appropriately on public/environmental health action. Hence, there is need for a “Plan B” of effective behavioral, environmental, social as well as systems interventions (BESSI) toward reducing transmission. (shrink)

Ebola is a deadly disease with no cure; there is no vaccine developed yet. Many died during the 2014 outbreak in West Africa, and many healthcare professionals went to the virus infected area to treat the patients while placing their lives in danger. Not every medical professional placed in the field is a fully trained specialist, and sometimes one or two under-trained doctors are in charge of the entire clinic with some nurses and operating technicians. When unexpected outbreaks of the (...) virus occur in the places, the doctor(s) would encounter medical and ethical dilemmas. Should they leave or stay? In fact, this dilemma is not confined to the Ebola pandemic but relevant to all similar cases. In this paper, three authors, a medical resident, a clinical bioethicist, and a theoretical bioethicist respond to the dilemma. (shrink)

In various responses to the COVID-19 pandemic, we can observe insufficient sensitivity towards the needs and circumstances of poorer citizens. Particularly in a context of high inequality, policy makers need to engage with the wider public in debates and consultations to gain better insights in the realities of the worst-off within their jurisdiction. When consultations involve members of traditionally underrepresented groups, these are not only more inclusive, which is in itself an ethical aim, but pool ideas and observations from (...) a much more diverse array of inhabitants. Inclusivity increases the odds to identify a larger range of weak spots for health security and to design health interventions that are less burdensome on those worst-off. (shrink)

This paper takes under consideration a piece by Roger Crisp in which he questions what the problem of moral luck can teach us about COVID-19 lockdown rule-breakers. Taking the position that although such rule-breakers might seem to be new examples of moral luck, Crisp ends up denying the existence of moral luck and argues that moral luck is an outdated notion in so far as it relies on other questionable aspects of morality, that is, retributivist punishment and blame. Although the (...) author agrees with Crisp that pandemic rule-breaker cases are putative examples of resultant moral luck, he proposes that Crisp has misconstrued what moral luck is and the paper examines in detail what he sees as the numerous problems with Crisp’s claims. The author concludes that Crisp’s analysis of pandemic rule-breaking does not shed any new light on the moral luck debate, and the difficult questions of luck, moral responsibility, and desert are not so easily resolved. -/- . (shrink)

Online therapy sessions and other forms of digital mental health services (DMH) have seen a sharp spike in new users since the start of the COVID-19 pandemic. Having little access to their social networks and support systems, people have had to turn to digital tools and spaces to cope with their experiences of anxiety and loss. With no clear end to the pandemic in sight, many of us are likely to remain reliant upon DMH for the foreseeable future. (...) As such, it is important to articulate some of the specific ways in which the pandemic is affecting our self and world-relation, such that we can identify how DMH services are best able to accommodate some of the newly emerging needs of their users. In this paper I will identify a specific type of loss brought about by the COVID-19 pandemic and present it as an important concept for DMH. I refer to this loss as loss of perceptual world-familiarity. Loss of perceptual world-familiarity entails a breakdown in the ongoing effortless responsiveness to our perceptual environment that characterizes much of our everyday lives. To cash this out I will turn to insights from the phenomenological tradition. Initially, my project is descriptive. I aim to bring out how loss of perceptual world-familiarity is a distinctive form of loss that is deeply pervasive yet easily overlooked-hence the relevance of explicating it for DMH purposes. But I will also venture into the space of the normative, offering some reasons for seeing perceptual world-familiarity as a component of well-being. I conclude the paper with a discussion of how loss of perceptual world-familiarity affects the therapeutic setting now that most if not all therapeutic interactions have transitioned to online spaces and I explore the potential to augment these spaces with social interaction technologies. Throughout, my discussion aims to do justice to the reality that perceptual world-familiarity is not an evenly distributed phenomenon, that factors like disability, gender and race affect its robustness, and that this ought to be reckoned with when seeking to incorporate the phenomenon into or mitigate it through DMH services. (shrink)

This dissertation explores the idea and ethics of vaccination for the sake of others. It conceptually distinguishes four different kinds of vaccination—self-protective, paternalistic, altruistic, and indirect—based on who receives the primary benefits of vaccination and who ultimately makes the vaccination decision. It describes the results of focus group studies that were conducted to investigate what people who might get vaccinated altruistically think of this idea. It also applies the different kinds of vaccination to ethical issues surrounding COVID-19, such as (...) lockdown measures, routine or mandatory vaccination of healthy children, and the ethical justification of restrictive measures for unvaccinated people. A more general philosophical account of vaccination ethics is ultimately developed, which is based not on moral duties, but on the moral reasons that people may have to get vaccinated for the sake of others. It is argued that such reasons may be stronger or weaker, depending on various factors related to the vaccines in question and the specific epidemiological circumstances. (shrink)

John Dewey proposed soon after the atomic bombings of Hiroshima and Nagasaki that citizens of techno-industrial nations suffer from "cultural lag" (LW 15:199-200; cf. LW 4:203-28). He had in mind a sort of moral jet lag, a condition in which most of the basic alternatives we have on hand to think and talk about moral and political life, from customary moralizing to sophisticated theorizing, were developed, canned, and pickled on a shelf so long ago that they now lag far behind (...) the multi-faceted problems that our values must speak to. The failure of many countries, most visibly the United States, to effectively navigate climate change and the Covid-19 global pandemic exemplifies our moral jet lag. Our collective responses to the new normal of global disruptions are, in William James’s words in Pragmatism, “out of plumb and out of key and out of ‘whack’” (1907, 37). The American philosophical tradition that includes James and Dewey has long sought to compensate for the excesses of America’s hyper-individualism and its anti-naturalistic distrust of experimental intelligence. In this brief analysis of our morally jet lagged response to the Covid-19 pandemic, we draw heavily on two highly articulated intellectual resources for America’s moral, political, and educational recovery: Jane Addams’s social ethics and Dewey’s deeply democratic theory of moral and political deliberation. (shrink)

The most prominent strand of moral thought in the African philosophical tradition is relational and cohesive, roughly demanding that we enter into community with each other. Familiar is the view that being a real person means sharing a way of life with others, perhaps even in their fate. What does such a communal ethic prescribe for the coronavirus pandemic? Might it forbid one from social distancing, at least away from intimates? Or would it entail that social distancing is wrong (...) to some degree, although morally permissible on balance? Or could it mean that social distancing is not wrong to any degree and could, under certain circumstances, be the right way to commune? In this article, I defend the latter view. I argue that, given an independently attractive understanding of how to value communal relationship, distancing oneself from others when necessary to protect them from serious incapacitation or harm can come at no cost to right action. However, I also discuss cases in which social distancing would evince a lack of good character, despite being the right thing to do. (shrink)

In this article, we propose the Fair Priority Model for COVID-19 vaccine distribution, and emphasize three fundamental values we believe should be considered when distributing a COVID-19 vaccine among countries: Benefiting people and limiting harm, prioritizing the disadvantaged, and equal moral concern for all individuals. The Priority Model addresses these values by focusing on mitigating three types of harms caused by COVID-19: death and permanent organ damage, indirect health consequences, such as health care system strain and stress, as well as (...) economic destruction. It proposes proceeding in three phases: the first addresses premature death, the second long-term health issues and economic harms, and the third aims to contain viral transmission fully and restore pre-pandemic activity. -/- To those who may deem an ethical framework irrelevant because of the belief that many countries will pursue "vaccine nationalism," we argue such a framework still has broad relevance. Reasonable national partiality would permit countries to focus on vaccine distribution within their borders up until the rate of transmission is below 1, at which point there would not be sufficient vaccine-preventable harm to justify retaining a vaccine. When a government reaches the limit of national partiality, it should release vaccines for other countries. -/- We also argue against two other recent proposals. Distributing a vaccine proportional to a country's population mistakenly assumes that equality requires treating differently situated countries identically. Prioritizing countries according to the number of front-line health care workers, the proportion of the population over 65, and the number of people with comorbidities within each country may exacerbate disadvantage and end up giving the vaccine in large part to wealthy nations. (shrink)