Public Health

Pandemic Ethics: Saving Lives and Replaceability

Written by Roger Crisp

Imagine two worlds quite different from our own. In Non-intervention, if a person becomes ill with some life-threatening condition, though their pain may be alleviated, no attempt is made to save their lives. In Maximal-intervention, everything possible is done to save the lives of those with life-threatening conditions. Continue reading

PRESS RELEASE: Racial Justice Requires Ending Drug War, Say Leading Bioethicists

PRESS RELEASE: Free all non-violent criminals jailed on minor drug offences, say experts

Non-violent offenders serving time for drug use or possession should be freed immediately and their convictions erased, according to research published in the peer-reviewed The American Journal of Bioethics.

More than 60 international experts including world-leading bioethicists, psychologists and drug experts have joined forces to call for an end to the war on drugs which they argue feeds racism.

All drugs currently deemed illicit – even crack cocaine and heroin – should be decriminalized as a matter of urgency, according to this new alliance. Legalisation and regulation should then follow with restrictions on age, advertising and licensing, they say.

They have analysed evidence from over 150 studies and reports, concluding that prohibition unfairly affects Black and Hispanic people, damages communities, and violates the right to life as illustrated by the killing of medical worker Breonna Taylor in March last year.

“The ‘war on drugs’ has explicitly racist roots and continues to disproportionately target certain communities of color,” say lead study authors Brian D. Earp from Yale University and the University of Oxford and Jonathan Lewis from Dublin City University.

“Drug prohibition and criminalization have been costly and ineffective since their inception. It’s time for these failed policies to end.

“The first step is to decriminalize the personal use and possession of small amounts of all drugs currently deemed to be illicit, and to legalize and regulate cannabis. Policymakers should pursue these changes without further delay.”

Their research adds to growing calls for drug policy reform at a time of renewed focus on injustices faced by Black people, and cannabis legalisation for recreational use by a growing list of US states.

The study is based on evidence from existing research into how drug prohibition affects users, communities and human rights, and the impact of decriminalisation by governments.

The authors found that prohibition creates conditions for individuals to commit offences such as burglaries to fund their habit. This lowers life expectancy because people end up in prison, and triggers a ‘multitude’ of health-related costs from unsafe drug use.

Communities are damaged by illicit markets which undermine drug purity, with Black and Hispanic men more likely to end up in the criminal justice system. The war on drugs makes people more vulnerable to violations of their rights including what they choose to put in their bodies.

In contrast, the study highlights the liberal approach of countries such as Portugal where drug-related deaths have fallen and where users are encouraged to seek treatment.

An estimated £43.5bn ($58bn) could be generated in federal, state and local tax revenues through the legalization of drugs, according to the findings. This compares with an annual federal, state and local spend of more than £35bn ($47bn) on prohibition.

The authors stress that non-violent prisoners found with a small amount of illegal substances should be released.

Further Information

The study’s senior author Carl L. Hart was Columbia University’s first tenured African American professor of sciences. He is open about the fact he uses recreational drugs and his book Drug Use for Grown Ups is set for publication in January 2021.

For an interview, please contact:

Brian D. Earp (brian.earp@yale.edu), Jonathan Lewis (Jonathan.Lewis@dcu.ie), or Carl L. Hart (c.hart@columbia.edu)

For a copy of the paper, visit: https://newsroom.taylorandfrancisgroup.com/embargoed-releases/ 

For a copy of the journal article, please contact:
Simon Wesson, Press & Media Relations Executive
Email: newsroom@taylorandfrancis.com
Tel.: +44 (0)20 701 74468
Follow us on Twitter: @tandfnewsroom

The article will be freely available once the embargo has lifted via the following link: https://www.tandfonline.com/doi/full/10.1080/15265161.2020.1861364

This Machine Kills Viruses

Written by Stephen Rainey

If we had a machine that could eradicate coronavirus at the press of a button, there would likely be a queue to do the honours. Rather than having such a device, we have a science-policy interface, and a general context of democratic legitimacy. This isn’t a push-button, but a complex of socio-political liberties and privations. We can’t push the button, but we can learn how to use the technology we do have – by collectively following policies like staying inside, wearing masks outside, and keeping distance from others.

Because of the coronavirus pandemic a novel form of this scientific research, technological application, and influence or control of nature (including humans) is emerging. In this case, the application is public policy, as based on multitudes of scientific advice. That over which control is sought is twofold: the virus, and people. Control of the virus is not really possible without some control over the people. Likewise, control of the people becomes harder where the virus is not controlled. Public trust in tough policies wanes if there is no end in sight, or no clear rationale in place. Continue reading

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

Dementia, Pagal, or Neurocognitive Disorder: What Is In a Name?

By Doug McConnell

 

A recent BBC news story has drawn attention to the fact that there isn’t a word for “dementia” in many South Asian languages and some South Asian people living in the UK still use the stigmatising Punjabi word “pagal”, meaning “crazy” or “mad”. The news story implicitly assumes that the word “dementia” is non-stigmatising but this is disputed. If the word “dementia” is itself stigmatizing, are anglophones really in a position to criticize other languages? Can we adopt a non-stigmatising word for dementia? Continue reading

Could vaccine requirements for entering pubs be wrong, while closing pubs altogether is OK?

By Tom Douglas

Suppose that, before you could enter a pub, you had to produce a ‘vaccine passport’ showing that you had been vaccinated against the new coronavirus. 

Vaccine requirements like this are controversial. In the UK, the government has been keen to deny that it is even considering their use. This is in some ways puzzling, for closing pubs altogether has not been that controversial, and preventing people from entering pubs without exception seems, at first sight, to be a greater imposition on liberty than preventing people from entering pubs without first being vaccinated. As my colleagues Julian Savulescu and Alberto Giubilini recently noted, it seems better, in terms of liberty, to have some choice than none. 

This raises the question, could a vaccination requirement for entering pubs be wrong, while closing pubs altogether is not?

Continue reading

Cross post: Pandemic Ethics: Should COVID-19 Vaccines Be mandatory? Two Experts Discuss

Written by Alberto Giubilini (Oxford Uehiro Centre for Practical Ethics and WEH, University of Oxford )

Vageesh Jaini (University College London)

(Cross posted with the Conversation)

 

To be properly protective, COVID-19 vaccines need to be given to most people worldwide. Only through widespread vaccination will we reach herd immunity – where enough people are immune to stop the disease from spreading freely. To achieve this, some have suggested vaccines should be made compulsory, though the UK government has ruled this out. But with high rates of COVID-19 vaccine hesitancy in the UK and elsewhere, is this the right call? Here, two experts to make the case for and against mandatory COVID-19 vaccines.

 

Alberto Giubilini, Senior Research Fellow, Oxford Uehiro Centre for Practical Ethics, University of Oxford

COVID-19 vaccination should be mandatory – at least for certain groups. This means there would be penalties for failure to vaccinate, such as fines or limitations on freedom of movement.

The less burdensome it is for an individual to do something that prevents harm to others, and the greater the harm prevented, the stronger the ethical reason for mandating it.
Continue reading

Cross Post: Pandemic Ethics: Vaccine Distribution Ethics: Monotheism or Polytheism?

Written by Alberto Giubilini, Julian Savulescu, Dominic Wilkinson

(Oxford Uehiro Centre for Practical Ethics)

(Cross-posted with the Journal of Medical Ethics blog)

Pfizer has reported preliminary results that their mRNA COVID vaccine is 90% effective during phase III trials. The hope is to have the first doses available for distribution by the end of the year. Discussion has quickly moved to how the vaccine should be distributed in the first months, given very limited initial availability. This is, in large part, an ethical question and one in which ethical issues and values are either hidden or presented as medical decisions. The language adopted in this discussion often assumes and takes for granted ethical values that would need to be made explicit and interrogated. For example, the UK Government’s JCVI report for priority groups for COVID-19 vaccination reads: “Mathematical modelling indicates that as long as an available vaccine is both safe and effective in older adults, they should be a high priority for vaccination”. This is ethical language disguised as scientific. Whether older adults ‘should’ be high priority depends on what we want to achieve through a vaccination policy. And that involves value choices. Distribution of COVID-19 vaccines will need to maximize the public health benefits of the limited availability, or reduce the burden on the NHS, or save as many lives as possible from COVID-19. These are not necessarily the same thing and a choice among them is an ethical choice. Continue reading

The Duty To Ignore Covid-19

By Charles Foster

This is a plea for a self-denying ordinance on the part of philosophers. Ignore Covid-19. It was important that you said what you have said about it, but the job is done. There is nothing more to say. And there are great dangers in continuing to comment. It gives the impression that there is only one issue in the world. But there are many others, and they need your attention. Just as cancer patients were left untreated because Covid closed hospitals, so important philosophical problems are left unaddressed, or viewed only through the distorting lens of Covid. Continue reading

Pandemic Ethics: Should Santa Claus Deliver Christmas Presents This Year? Preparing For Our First COVID-19 Christmas

Written by: Alberto Giubilini; Oxford Uehiro Centre for Practical Ethics, &

Wellcome Centre for Ethics and Humanities, University of Oxford

It’s that time of the year again, when Christmas decorations start to appear way too early in shopping malls. It’s beginning to look a bit too much like Christmas. Except that, being it 2020, of course this year “it will be different”.

Pubs are very optimistically accepting bookings for Christmas dinners, but many Christmas markets are (un)fortunately being cancelled. You might still see your distant relatives on Christmas day, but (un)fortunately no more than 6 of them at any one time.

Amidst the inevitable confusion, one obvious question is whether Santa Claus should deliver presents this year.

There are various factors to consider when deciding what Santa – but indeed everyone else – should be allowed to do over Christmas. The most relevant are probably the following:

  1. COVID-19 infection rate over Christmas.
  2. Risks and benefits for others of Santa’s job.
  3. Risks and benefits for Santa

Continue reading

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