Skip to main content Accessibility help
×
Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-27T01:00:12.706Z Has data issue: false hasContentIssue false

Chapter 52 - Public Ethics in Emergencies: Learning from the COVID-19 Pandemic

from Section 6 - Designing, Leading, and Managing Responses to Emergencies and Pandemics

Published online by Cambridge University Press:  11 January 2024

Richard Williams
Affiliation:
University of South Wales
Verity Kemp
Affiliation:
Independent Health Emergency Planning Consultant
Keith Porter
Affiliation:
University of Birmingham
Tim Healing
Affiliation:
Worshipful Society of Apothecaries of London
John Drury
Affiliation:
University of Sussex
Get access

Summary

This chapter explores the lessons that can be drawn from the ways in which bioethical governance operated during the COVID-19 pandemic. It examines the way in which our thinking is framed as this may substantially determine the policy choices that we make, it explores the contemporary context of public reasoning, and finally it examines the governance of ethical concerns. It proposes that there must be openness and transparency about the ethical issues and approaches that are being applied. It recognises that people do not necessarily need to agree with government decisions, but they do need to accept that they are reasonable and responsible. These principles can be brought together by using the techniques of deliberative democracy to review the ethical frameworks that have been developed during the pandemic for revision as necessary. Lessons can be drawn to help people prepare better for the governance of bioethical deliberations in future emergencies.

Type
Chapter
Information
Major Incidents, Pandemics and Mental Health
The Psychosocial Aspects of Health Emergencies, Incidents, Disasters and Disease Outbreaks
, pp. 394 - 402
Publisher: Cambridge University Press
Print publication year: 2024

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Coggon, J, Syrett, K, Viens, AM. Public Health Law: Ethics, Governance and Regulation. Routledge, 2017.Google Scholar
Montgomery, J, Williams, R. Public health values and evidence-based practice. In Social Scaffolding: Applying the Lessons of Contemporary Social Science to Health and Healthcare (eds Williams, R, Kemp, V, Haslam, A, Haslam, C, Bhui, K, Bailey, S): 227–43. Cambridge University Press, 2019.Google Scholar
White, DB, Lo, B. A framework for rationing ventilators and critical care beds during the COVID-19 pandemic. JAMA 2020; 323: 1773–4.CrossRefGoogle ScholarPubMed
Arie, S. COVID-19: can France’s ethical support units help doctors make challenging decisions? BMJ 2020; 369: m1291.CrossRefGoogle ScholarPubMed
Emanuel, E, Persad, G, Upshur, R, Thome, B, Parker, M, Glickman, A, et al. Fair location of scarce medical resources in the time of COVID-19. N Engl J Med 2020; 382: 2049–55.CrossRefGoogle Scholar
UK Faculty of Public Health. Tackling the Social, Professional, and Political Challenges of COVID-19: The Crucial Role of Public Health Ethics. UK Faculty of Public Health, 2020 (www.fph.org.uk/media/2922/fph-statement-of-public-health-ethics-and-covid-19.pdf).Google Scholar
Buccieri, K, Gaetz, S. Ethical vaccine distribution planning for pandemic influenza: prioritizing homeless and hard-to-reach populations. Public Health Ethics 2013; 6: 185–96.CrossRefGoogle Scholar
Kaposy, C, Bandrauk, N. Prioritizing vaccine access for vulnerable but stigmatized groups. Public Health Ethics 2012; 5: 283–95.Google Scholar
Lee, C, Rogers, WA, Braunack-Mayer, A. Social justice and pandemic influenza planning: the role of communication strategies. Public Health Ethics 2008; 1: 223–4.CrossRefGoogle Scholar
Montgomery, J, Stokes-Lampard, H, Griffiths, M, Gardiner, D, Harvey, D, Suntharalingam, G. Assessing whether COVID-19 patients will benefit from critical care, and an objective approach to capacity challenges during a pandemic: an Intensive Care Society clinical guideline. J Intensive Care Soc 2021; 22: 204–10.Google Scholar
Ortolani, C, Pastorello, EA. Hydroxychloroquine and dexamethasone in COVID-19: who won and who lost? Clin Mol Allergy 2020; 18: 17.Google Scholar
Schwartz, JL, Caplan, AL. Vaccination Ethics and Policy. The MIT Press, 2017.Google Scholar
Harmon, SHE, Faour, DE, MacDonald, NE, Graham, JE, Steffen, C, Henaff, L, et al. Immunization governance: mandatory immunization in 28 Global NITAG Network countries. Vaccine 2020; 38: 7258–67.Google Scholar
Cassimos, DC, Effraimidou, E, Medic, S, Konstantinidis, T, Theodoridou, M, Maltezou, HC. Vaccination programs for adults in Europe, 2019. Vaccines (Basel) 2020; 8: 34.CrossRefGoogle ScholarPubMed
Grill, K, Dawson, A. Ethical frameworks in public health decision-making: defending a value-based and pluralist approach. Health Care Anal 2017; 25: 291307.Google Scholar
Thompson, AK, Faith, K, Gibson, JL, Upshar, REG. Pandemic preparedness: an ethical framework to guide decision-making. BMC Med Ethics 2006; 7: 12.CrossRefGoogle ScholarPubMed
Daniels, N. Accountability for reasonableness. BMJ 2000; 321: 1300–301.Google Scholar
Daniels, N. Just Health: Meeting Health Needs Fairly. Cambridge University Press, 2008.Google Scholar
Faust, HS, Upshur, R. Public health ethics. In The Cambridge Textbook of Bioethics (eds Singer, P, Viens, AM): 274–80. Cambridge University Press, 2009.Google Scholar
Gostin, L. Public Health Law: Power, Duty, Restraint 2nd ed. University of California Press, 2008.Google Scholar
Kass, N. An ethics framework for public health. Am J Public Health 2001; 91: 1776–82.Google Scholar
Childres, J, Faden, R, Gaare, R, Gostin, L, Kahn, J, Richard, B, et al. Public health ethics: mapping the terrain. J Law Med Ethics 2002; 30: 169–77.CrossRefGoogle Scholar
Nuffield Council on Bioethics. Public Health Ethics. Nuffield Council on Bioethics, 2007.Google Scholar
Upshur, R. Principles for the justification of public health interventions. Can J Public Health 2002; 93: 101–3.Google Scholar
Coggon, J. What Makes Health Public? Cambridge University Press, 2012.CrossRefGoogle Scholar
Department of Health and Cabinet Office. Responding to Pandemic Influenza: The Ethical Framework for Policy and Planning. Department of Health, 2007.Google Scholar
Kaufman, KR, Petkova, E, Bhui, KS, Schulze, TG. A global needs assessment in times of a global crisis: world psychiatry response to the COVID-19 pandemic. BJPsych Open 2020; 6: e48.CrossRefGoogle ScholarPubMed
Public Health England. COVID-19: Review of Disparities in Risks and Outcomes. Public Health England, 2020 (www.gov.uk/government/publications/covid-19-review-of-disparities-in-risks-and-outcomes).Google Scholar
Office for National Statistics. Deaths Involving COVID-19 by Local Area and Socioeconomic Deprivation: Deaths Occurring between 1 March and 17 April 2020. Office for National Statistics, 2020 (www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsinvolvingcovid19bylocalareasanddeprivation/latest).Google Scholar
Bennet, B, Carney, T. Vulnerability: an issue for law and policy in pandemic planning? In Law and Global Health (eds Freeman, M, Hawkes, S, Bennett, B): 121–32. Oxford University Press, 2014.Google Scholar
Venkatapuram, S. Health Justice: An Argument from the Capabilities Approach. Polity Press, 2011.Google Scholar
Wolff, J. The Human Right to Health. WW Norton & Company, 2012.Google Scholar
Tasioualas, J. Minimum Core Obligations: Human Rights in the Here and Now. World Bank, 2017 (https://openknowledge.worldbank.org/handle/10986/29144).Google Scholar
European Group on Ethics in Science and New Technologies. Statement on European Solidarity and the Protection of Fundamental Rights in the COVID-19 Pandemic. European Group on Ethics in Science and New Technologies, 2020 (https://ec.europa.eu/info/sites/info/files/research_and_innovation/ege/ec_rtd_ege-statement-covid-19.pdf).Google Scholar
Wellcome Trust. Wellcome Global Monitor: How Does the World Feel About Science and Health? Wellcome Trust, 2019.Google Scholar
Newton, K. Government communications, political trust and compliant social behaviour: the politics of COVID‐19 in Britain. Polit Q 2020; 91: 502–13.Google Scholar
Lynas, M. COVID: Top 10 Current Conspiracy Theories. Alliance for Science, 2020 (https://allianceforscience.cornell.edu/blog/2020/04/covid-top-10-current-conspiracy-theories/).Google Scholar
Vosoughi, S, Roy, D, Aral, S. The spread of true and false news online. Science 2018; 359 : 1146–51.Google Scholar
Allington, D, Duffy, B, Wessely, S, Dhavan, N, Rubin, J. Health-protective behaviour, social media usage and conspiracy belief during the COVID-19 public health emergency. Psychol Med 2021; 51: 1763–9.Google Scholar
Freeman, D, Waite, F, Rosebrock, L, Petit, A, Causier, C, East, A, et al. Coronavirus conspiracy beliefs, mistrust, and compliance with government guidelines in England. Psychol Med 2022; 52: 251–63.CrossRefGoogle ScholarPubMed
Service, RF. Coronavirus antigen tests: quick and cheap, but too often wrong? Science 2020. Available at: https://doi.org/10.1126/science.abc9586.Google Scholar
US Food and Drug Administration. Coronavirus (COVID-19) Update: FDA Revokes Emergency Use Authorization for Chembio Antibody Test. US Food and Drug Administration, 2020 (www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-revokes-emergency-use-authorization-chembio-antibody-test.).Google Scholar
Deeks, JJ, Brookes, AJ, Pollock, AM. Operation Moonshot proposals are scientifically unsound. BMJ 2020; 370: m3699.Google Scholar
Liddell, K, Skopek, J, Palmer, S, Martin, S, Anderson, J, Sagar, A. Who gets the ventilator? Important legal rights in a pandemic. J Med Ethics 2020; 46: 421–6.CrossRefGoogle ScholarPubMed
Newdick, C, Sheehan, M, Dunn, M. Tragic choices in intensive care during the COVID-19 pandemic: on fairness, consistency and community. J Med Ethics 2020; 46: 646–51.Google Scholar
Age UK. Joint Statement on the Rights of Older People in the UK to Treatment During This Pandemic. Age UK, 2020 (www.ageuk.org.uk/latest-press/articles/2020/03/rights-of-older-people-during-pandemic/).Google Scholar
Popescu, D, Marcoci, A. Coronavirus: allocating ICU beds and ventilators based on age is discriminatory. The Conversation, 22 April 2020 (https://theconversation.com/coronavirus-allocating-icu-beds-and-ventilators-based-on-age-is-discriminatory-136459).Google Scholar
Luthi, S. Trump administration steps in as advocacy groups warn of Covid ‘death panels’. POLITICO, 10 August 2020 (www.politico.com/news/2020/08/10/coronavirus-treatment-death-panels-392463).Google Scholar
Wilkinson, D, Zohny, H, Kappes, A, Sinnot-Armstrong, W, Savalescu, J. Which factors should be included in triage? An online survey of the attitudes of the UK general public to pandemic triage dilemmas. BMJ Open 2020; 10: e045593.CrossRefGoogle ScholarPubMed
Lincoln, M. A special self-image is no defence against COVID-19. Nature 2020; 585: 325.CrossRefGoogle Scholar
Montgomery, J. Bioethics as a governance practice. Health Care Anal 2016; 24: 323.Google Scholar
Fidler, D. SARS, Governance and the Globalisation of Disease. Palgrave Macmillan, 2004.Google Scholar
World Health Organization. Report of the Ebola Interim Assessment Panel. World Health Organization, 2015 (www.who.int/csr/resources/publications/ebola/report-by-panel.pdf).Google Scholar
Onzivu, W. Reinforcing global health normative frameworks and legal obligations: can adaptive governance help? In Global Health and International Community: Ethical, Political and Regulatory Challenges (eds Coggon, J, Gola, S): 233–48. Bloomsbury, 2013.Google Scholar
World Health Organization. Ethics and COVID-19: Resource Allocation and Priority-Setting. World Health Organization, 2020 (www.who.int/ethics/publications/ethics-and-covid-19-resource-allocation-and-priority-setting/en/).Google Scholar
World Health Organization. Ethical Standards for Research During Public Health Emergencies: Distilling Existing Guidance to Support COVID-19 R&D. World Health Organization, 2020 (www.who.int/publications/i/item/WHO-RFH-20.1).Google Scholar
World Health Organization. Ethical Considerations to Guide the Use of Digital Proximity Tracking Technologies for COVID-19 Contact Tracing. World Health Organization, 2020 (www.who.int/publications/i/item/WHO-2019-nCoV-Ethics_Contact_tracing_apps-2020.1).Google Scholar
International Bioethics Committee and World Commission on the Ethics of Scientific Knowledge and Technology. Statement on COVID-19: Ethical Considerations from a Global Perspective. UNESCO, 2020 (https://unesdoc.unesco.org/ark:/48223/pf0000373115).Google Scholar
Comite Consultatif National d’Ethique. Ethical Issues in the Face of a Pandemic. Comite Consultatif National d’Ethique, 2020 (www.ccne-ethique.fr/en/publications/contribution-french-national-consultative-ethics-committee-covid-19-crisis-ethical).Google Scholar
Deutsher Ethikrat. Immunity Certificates During the COVID-19 Pandemic. Deutsher Ethikrat, 2020 (www.ethikrat.org/fileadmin/Publikationen/Stellungnahmen/englisch/opinion-immunity-certificates.pdf).Google Scholar
Comitato Nazionale per la Bioetica. COVID-19: Clinical Decision-Making in Conditions of Resource Shortage and the ‘Pandemic Emergency Triage’ Criterion. Comitato Nazionale per la Bioética, 2020 (http://bioetica.governo.it/en/opinions/opinions-responses/covid-19-clinical-decision-making-in-conditions-of-resource-shortage-and-the-pandemic-emergency-triage-criterion/).Google Scholar
Comitato Nazionale per la Bioética. COVID-19: Public Health, Individual Freedom, Social Solidarity. Comitato Nazionale per la Bioética, 2020 (http://bioetica.governo.it/en/opinions/opinions-responses/covid-19-public-health-individual-freedom-social-solidarity/).Google Scholar
Hine, D. The 2009 Influenza Pandemic: An Independent Review of the UK Response to the 2009 Influenza Pandemic. Cabinet Office, 2010.Google Scholar
Nuffield Council on Bioethics. Research in Global Health Emergencies. Nuffield Council on Bioethics, 2020.Google Scholar
Whittall, H. COVID, Transparency and Trust. Nuffield Council on Bioethics, 2020 (www.nuffieldbioethics.org/blog/covid-transparency-and-trust).Google Scholar
Gadd, E. Is the Government Using its Own Ethical Framework? Nuffield Council on Bioethics, 2020 (www.nuffieldbioethics.org/blog/is-the-government-using-its-own-ethical-framework).Google Scholar
Rutter, A, Bell, D, Cole, S. COVID-19 Guidance: Ethical Advice and Support Framework. Scottish Government, 2020 (www.gov.scot/publications/coronavirus-covid-19-ethical-advice-and-support-framework/).Google Scholar
Welsh Government. Coronavirus: Ethical Values and Principles for Healthcare Delivery Framework: Guidance for Healthcare Services When Making Decisions During the Coronavirus Outbreak. Welsh Government, 2020 (https://gov.wales/coronavirus-ethical-values-and-principles-healthcare-delivery-framework-html).Google Scholar
Hawker, L. Take that, Macron! French President’s ‘ludicrous’ Oxford vaccine claims brutally backfire. Daily Express, 3 February 2021 (www.express.co.uk/news/world/1392542/Emmanuel-macron-news-covid-Vaccine-oxford-AstraZeneca-jab-coronavirus-uk).Google Scholar
Bieniasz, P. Musings of an anonymous, pissed off virologist. Virology Blog, 5 January 2021 (https://twitter.com/PaulBieniasz/status/1345195420033691648).Google Scholar
Safi, M. Vaccine diplomacy: west falling behind in race for influence. The Guardian, 19 February 2021 (www.theguardian.com/world/2021/feb/19/coronavirus-vaccine-diplomacy-west-falling-behind-russia-china-race-influence).Google Scholar
Gostin, L. Global Health Security: A Blueprint for the Future. Harvard University Press, 2022 .Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×