Ethical Considerations For The Second Phase Of Vaccine Prioritisation
By Jonathan Pugh and Julian Savulescu
As the first phase of vaccine distribution continues to proceed, a heated debate has begun about the second phase of vaccine prioritisation, particularly with respect to the question of whether certain occupations, such as teachers and police officers amongst others, should be prioritised in the second phase. Indeed, the health secretary has stated that the government will look “very carefully” at prioritising shop workers – as well as teachers and police officers – for COVID vaccines. In this article, we will discuss moral and scientific reasons for and against different prioritisation strategies.
The first phase of the UK’s Joint Committee on Vaccination and Immunisation (JCVI)’s guidance on vaccine prioritisation outlined 9 priority groups. Together, these groups accommodated all individuals over the age of 50, frontline health and social care workers, care home residents and carers, clinically extremely vulnerable individuals, and individuals with pre-existing health conditions that put them at higher risk of disease and mortality. These individuals represent 99% of preventable mortality from COVID-19. Prioritising these groups for vaccination will mean that the distribution of vaccines in a period of scarcity will save the greatest number of lives possible.
In their initial guidance, the JCVI also suggested that a key focus for the second phase of vaccination could be on further preventing hospitalisation, and that this may require prioritising those in certain occupations. However, they also note that the occupations that should be prioritised for vaccination are considered an issue of policy, rather than an issue that the JCVI should advise on.
We shall suggest that the input of the JCVI is absolutely crucial to making an informed and balanced policy decision on this matter. But what policy should be pursued? Here, we outline some of the ethical considerations that bear on this policy decision.
Even Though Mass Testing For COVID Isn’t Always Accurate, It Could Still Be Useful – Here’s Why
By Jonathan Pugh
This article was originally published here by the Conversation, on 22nd Dec 2020
The mass testing of asymptomatic people for COVID-19 in the UK was thrown into question by a recent study. In a pilot in Liverpool, over half the cases weren’t picked up, leading some to question whether using tests that perform poorly is the best use of resources.
The tests involved in this study were antigen tests. These see whether someone is infected with SARS-CoV-2 by identifying structures on the outside of the virus, known as antigens, using antibodies. If the coronavirus is present in a sample, the antibodies in the test bind with the virus’s antigens and highlight an infection.
Antigen tests are cheap and provide results quickly. However, they are not always accurate. But what do we mean when we say that a test is inaccurate? And is it really the case that “an unreliable test is worse than no test”? Continue reading
Pandemic Ethics: Infectious Pathogen Control Measures and Moral Philosophy
By Jonathan Pugh and Tom Douglas
Listen to Jonathan Pugh and Tom Douglas on Philosophical Disquisitions discussing Covid 19 and the Ethics of Infectious Disease Control, a podcast interview that was inspired by this blog.
Following the outbreak of the SARS-CoV-2 coronavirus, a number of jurisdictions have implemented restrictive measures to prevent the spread of this highly contagious pathogen. In January, Chinese authorities effectively quarantined the entire city of Wuhan, the epicentre of the outbreak, which has a population of around 11 million people. There has since been much discussion of various measures that might be implemented now or in the future to counter the spread, including various forms of social distancing, further mass quarantines and lockdowns, closed borders, mandatory testing and screening and even potentially forced treatment.
There are important questions about the lawfulness of infectious pathogen control (IPC) measures. Here, though, we focus on the moral justification of IPC. How can moral philosophy help us to think through when and whether different IPC measures ought to be employed?
To do so, we will briefly summarise our analysis of the different ways non-consensual medical interventions can be justified in infectious diseases control and criminal justice settings, which we originally published open access here.
Dr Neil Armstrong – Why is Mental Healthcare so Ethically Confusing
Co-authored with Daniel D’Hotman de Villiers
In the first St. Cross seminar of the term, Dr. Neil Armstrong talked about ethical challenges raised by mounting bureaucratic processes in the institutional provision of mental healthcare. Drawing on vignettes from his ethnographic fieldwork, Dr. Armstrong argued that the bureaucratization of mental healthcare has led to a situation in which the provision of care involves conflicts of the sort that make it irretrievably morally confusing. The podcast will follow shortly here.
Elizabeth Anderson’s Uehiro Lectures: Lecture 3 – Communicating Moral Concern Beyond Blaming and Shaming
In Elizabeth Anderson’s final Uehiro lecture, she tackles what she takes to be the hardest problem facing our current political discourse – How can we overcome obstacles to communicating moral concerns in order to orient policy to important values (such as public health and justice)? This is a particularly difficult and intractable problem because it concerns our moral values; in overcoming this obstacle, there is thus a considerable degree of scope for disagreement, and judgments of the moral character of others based on their moral opinions. Over the course of the lecture, Anderson refines the diagnosis of this problem, and once again expresses optimism about overcoming the obstacles she highlights. This time she outlines how we might disarm the fear, resentment, pride, and contempt that is currently derailing our political discourse, and the virtues that we must develop to do so. You can find a recording of the lecture here.
Prof. Elizabeth Anderson’s Uehiro Lectures: Lecture 2 Summary – “Improving Political Discourse (1): Re-learning how to talk about facts across group identities”
Prof. Elizabeth Anderson’s second Uehiro lecture focuses on how we can overcome obstacles to fact-based political discourse. In particular, the lecture concerns how we might prevent identity-expressive discourse (a term introduced in the first lecture; see summary of lecture 1 below) from displacing the discussion of facts and evidence in public discourse, and how we might overcome the shameless lying and disinformation campaigns of populist populations. Over the course of the lecture, Anderson illustrates her analysis with illuminating cases studies, and finishes by providing her own solutions to the problem at hand, drawing on Cultural Cognition theory, John Dewey’s cultural conception of democracy, and emerging data from deliberative polling studies. You can find a recording of the lecture here
Elizabeth Anderson’s Uehiro Lecture Summary: “Can We Talk – Communicating Moral Concern In An Era of Polarized Politics” – Lecture 1: What Has Gone Wrong?
It is something of an understatement to suggest that we are living through turbulent times. Society today is characterised not just by deep divisions about how to address key social challenges of our time, but also on the emphasis that should be placed on evidence-based discussion of these issues, and the moral values that should guide national policies.
In this context, Elizabeth Anderson’s Uehiro lecture series, entitled ““Can We Talk – Communicating Moral Concern In An Era of Polarized Politics” could not be more timely. In the first of this three lecture series, Anderson offers a diagnosis of the problems that currently bedevil political discourse across the world. This first lecture sets the stage for the following two lectures in which she shall offer her own proposed solutions to the problems that she so vividly describes and analyses in this fascinating initial lecture. The remainder of this post shall briefly summarise the key points of the lecture – You can find a recording of the lecture here
Reversibility, Colds, and Neurosurgery
By Jonny Pugh
This blog was originally published on the Journal of Medical Ethics Blog
Happy new year to readers of the blog!
I always approach the new year with some trepidation. This is not just due to the terrible weather, or even my resolution to take more exercise (unfortunately in the aforementioned terrible weather). Instead, I approach January with a sense of dread because it is always when I seem to come down with the common cold.
In my recent research, I have been interested in the nature and moral significance of reversibility, and the common cold is an interesting case study of this concept. In this blog, I will use this example to very briefly preview a couple of points that I make in a forthcoming open access article about reversibility in the context of psychiatric neurosurgery. You can read the open access paper here.
Gene-Editing Mosquitoes at The European Youth Event 2018
By Jonathan Pugh
The below is a slightly extended version of my two 5min presentations at the European Youth Event 2018, at the European Parliament in Strasbourg. I was asked to present on the following questions:
- What are the ethical issues surrounding gene-editing, particularly with respect to eradicating mosquitoes?
- Should the EU legislate on gene-editing mosquitoes?
Illness and Attitude – Richard Holton’s 3rd Uehiro Lecture
By Jonathan Pugh
In the final lecture of the 2018 Uehiro lecture series, Richard Holton concluded his reflections on the theme of ‘illness and the social self’ by turning to questions about how attitudes can play a role in the onset of medical disorders, with a particular focus on psycho-somatic disorders.
You can find a recording of the lecture here
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