Pandemic Ethics

Video Series: Are Coronavirus Contact Tracing Apps Safe?

Are contact tracing apps safe?  Dr Carissa Véliz (Oxford), author of ‘Privacy is Power’, explains why we should think twice about using such apps. They pose a serious risk to our privacy, and this matters, even if you think you have nothing to hide!

Pandemic Ethics: Good Reasons to Vaccinate: COVID19 Vaccine, Mandatory or Payment Model?

The best chance of bringing the Coronavirus pandemic to an end with the least loss of life and the greatest return  to normality seems to be the introduction of an effective vaccine. But how should such a vaccine be distributed?

To be effective, particularly in protecting the most vulnerable in the population, it would need to achieve herd immunity (the exact percentage of the population that would need to be immune for herd immunity to be reached depends on various factors, but current estimates range up to 82% of the population).

There are huge logistical issues around finding a vaccine, proving it to be safe, and then producing and administering it to the world’s population. Even if those issues are resolved, the pandemic has come at a time where there is another growing problem in public health: vaccine hesitancy.

Indeed, recent US polls  “suggest only 3 in 4 people would get vaccinated if a COVID-19 vaccine were available, and only 30% would want to receive the vaccine soon after it becomes available.”

If these results prove accurate then even if a safe and effective vaccine is produced, at best, herd immunity will be significantly delayed by vaccine hesitancy at a cost to both lives and to the resumption of normal life, and at worst, it may never be achieved.

Should it be made mandatory?

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Guest Post- Pandemic Ethics: Your Freedom Really Matters. So What?

Written by Farbod Akhlaghi (University of Oxford)

The coronavirus pandemic rages on. To the surprise of many, the enforcement of mask wearing, imposition of lockdowns, and other measures taken to try to halt the pandemic’s march have been met with some heavy and vocal resistance. Such resistance has materialised into protests in various countries against these measures taken by states, companies, and other organisations to prevent the spread of the novel coronavirus.

There are a range of reasons one might object to these measures. One reason that has repeatedly been voiced – sometimes shouted through angry un-masked mouths – is that these measures unjustly affect the freedom of those subject to them. The thought is that, for example, being forced to wear a mask, or denied entry into somewhere without a mask, is an unjust restriction of one’s freedom, presumably either to wear whatever they choose or to be free from the interference of others in going about one’s business.

Whatever good reasons there may be to object to these pandemic mitigating measures, I believe this one is simply a mistake. It is certainly true that our freedom, both to do things and from unjust interference, matter morally – they matter a lot too. But the moral significance of freedom, and the mere fact that measures like enforcing mask wearing, imposing lockdowns, and restricting movement do curtail such freedom, does not show that these measures unjustly restrict the freedom of those subject to them during this pandemic.

Failure to see this may be due to a failure to recognise the distinction, drawn by the moral philosopher Judith Jarvis Thomson, between the infringement and the violation of a right.

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Pandemic Ethics: Testing times: An ethical framework and practical recommendations for COVID-19 testing for NHS workers

Dr Alberto Giubilini, Senior Research Fellow at the Oxford Uehiro  Centre for Practical Ethics and Wellcome Centre for Ethics and Humanities was part of an independent rapid-response project to develop an ethical framework for COVID-19 swab testing for NHS workers. Following a stakeholder consultation, the expert group have published a report identifying ethical considerations and providing practical guidance and recommendations to identify good practice and support improvement.

The report is available online. 

Video Series: Why Parental Status Matters When Allocating Scarce Medical Resources

Which patients should we treat, if we can’t treat them all? The Covid-19 pandemic has brought questions about how to allocate scarce medical resources to the forefront. In this Thinking Out Loud interview with Katrien Devolder, Philosopher Moti Gorin (Colorado State University) argues that parents (or primary caregivers) of a dependent child should (sometimes) get priority. A controversial position that nevertheless has some intuitive appeal!

Pandemic Ethics: Moral Reasoning in a Pandemic [Guest Post]

Cross-Posted with The Boston Review

By Professor Frances Kamm, Harvard University

Policy discussions during the pandemic have raised concerns for me, as a moral philosopher, about how policy analysts and policy makers are thinking about deaths from COVID-19 and the right way to combat them. The policy discussions I have in mind have ranged from broad issues about how and when to open the economy to more focused concerns about how Intensive Care Units in hospitals should allocate scarce medical equipment (including ventilators). I will here consider three areas of concern about how people are reasoning about what is morally right in the pandemic.

Interpersonal Aggregation 
How should we weigh the economic costs of keeping the economy shut down versus the lives lost to COVID-19 from opening it up? Speaking on the PBS evening News Hour June 18, economist Nick Bloom calculated that the experience of being shut in and suffering economic trauma could result in the loss of a year of life for a person. I do not want to second guess his estimate, but to ask about the use it might be put to in reasoning about what to do.

Read  the full article

Video Series: (Un)fair Access to Covid-19 Treatment in Mexico?

Widespread corruption and racism in Mexico created extra hurdles for the development of Mexico’s recently published federal guidelines for deciding who gets to access scarce medical resources (e.g. ventilators in the case of Covid-19). Dr César Palacios-González (Oxford), who helped develop these guidelines,  talks about these challenges.

We’re All Vitalists Now

By Charles Foster

It has been a terrible few months for moral philosophers – and for utilitarians in particular. Their relevance to public discourse has never been greater, but never have their analyses been so humiliatingly sidelined by policy makers across the world. The world’s governments are all, it seems, ruled by a rather crude vitalism. Livelihoods and freedoms give way easily to a statistically small risk of individual death.

That might or might not be the morally right result. I’m not considering here the appropriateness of any government measures, and simply note that whatever one says about the UK Government’s response, it has been supremely successful in generating fear. Presumably that was its intention. The fear in the eyes above the masks is mainly an atavistic terror of personal extinction – a fear unmitigated by rational risk assessment. There is also a genuine fear for others (and the crisis has shown humans at their most splendidly altruistic and communitarian as well). But we really don’t have much ballast.

The fear is likely to endure long after the virus itself has receded. Even if we eventually pluck up the courage to hug our friends or go to the theatre, the fear has shown us what we’re really like, and the unflattering picture will be hard to forget.

I wonder what this new view of ourselves will mean for some of the big debates in ethics and law? The obvious examples are euthanasia and assisted suicide. Continue reading

Pandemic Ethics: Compulsory treatment or vaccination versus quarantine

By Thomas Douglas, Jonathan Pugh and Lisa Forsberg

Governments worldwide have responded to the Covid-19 pandemic with sweeping constraints on freedom of movement, including various forms of isolation, quarantine, and ‘lockdown’. Governments have also introduced new legal instruments to guarantee the lawfulness of their measures. In the UK, the Coronavirus Act 2020 gives the government new powers to detain individuals in order to prevent them from infecting others.

Interestingly, one measure that recent legislative changes in the UK leave off the table, at least for the time being, is the use of compulsory medical interventions—whether treatments or vaccinations. We surmise, however, that once treatments or vaccines for Covid-19 become available, there will be political interest in making them mandatory, since this may allow for the quickest and safest route out of the lockdown. In the case of vaccines, there will be a need to ensure that enough people are vaccinated to confer herd immunity. There may also be an argument for mandating vaccination of people who have contact with many others, such as teachers, retail staff and health care workers. In the case of treatments, we might hope that widespread use of anti-viral therapies will lighten the burden on the NHS by reducing the number of infected individuals who require intensive care. And there may be a need to ensure that people take the treatment even after their symptoms have resolved, to reduce their infectiousness.

From a legal point of view, there are clear barriers to compulsory treatments and vaccinations in the UK. The right of individuals with decision-making capacity to refuse any medical intervention that involves interference with their bodies is, for instance, robust and well-established in English law. This right persists even when the individual’s reasons for refusing the intervention are bizarre, irrational, or non-existent, and when the refusal would certainly lead to her death. The individual’s right to make her own medical decisions, and in particular to refuse interventions that interfere with her body, also enjoys robust protection in human rights law.
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Contact-tracing apps and the future COVID-19 vaccination should be compulsory. Social, technological, and pharmacological immunisation

Written by Alberto Giubilini

Wellcome Centre for Ethics and Humanities – Oxford Uehiro Centre for Practical Ethics

University of Oxford

 

 

Main point:

Lockdown measures to contain the spread of COVID-19 have so far been compulsory in most countries. In the same way, use of contact tracing apps should be compulsory once lockdown measures are relaxed. And in the same way, vaccination should be compulsory once the COVID-19 vaccine is available.

We can think of the lockdown as a form of ‘social immunization’, of contact tracing apps as a form of ‘technological immunization’, and of course of vaccination as pharmacological immunization. The same reasons that justify compulsory lockdown also justify compulsion in the other two cases.

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