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Cross Post: Omicron: Better To Be Safe (And Quick) Than Sorry

Written by: Dominic Wilkinson, and Jonathan Pugh

People Image Studio/Shutterstock
On discovering the omicron variant, many countries moved quickly to impose travel restrictions and other public health measures, such as compulsory mask wearing. But, given the lack of data, is this the best course of action?

These measures have tangible costs, and some have argued that they are an over-reaction. Critics of the travel ban claim that new measures will not significantly prevent the spread of the variant. Indeed, World Health Organization (WHO) officials have urged countries not to hastily impose travel curbs, instead advocating a risk analysis and science-based approach.Read More »Cross Post: Omicron: Better To Be Safe (And Quick) Than Sorry

Event Summary: Vaccine Policies and Challenge Trials: The Ethics of Relative Risk in Public Health

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St Cross Special Ethics Seminar, Presented by Dr Sarah Chan, 18 November 2021

In this St Cross Special Ethics Seminar, Dr Sarah Chan explores three key areas of risk in ‘challenge trials’ – the deliberate infection of human participants to infectious agents as a tool for vaccine development and improving our knowledge of disease biology.  Dr Chan explores a) whether some forms of challenge trials cannot be ethically justified; b) why stratifying populations for vaccine allocation by risk profile can result in unjust risk distribution; and c) how comparing these cases and the evaluation of relative risk reveals flaws in approach to pandemic public health.


Read More »Event Summary: Vaccine Policies and Challenge Trials: The Ethics of Relative Risk in Public Health

Cross Post: Selective lockdowns can be ethically justifiable – here’s why

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Written by: Jonathan Pugh, Dominic Wilkinson, and Julian Savulescu

 

Spitzi-Foto/Shutterstock
COVID is surging in some European countries. In response, Austria and Russia are planning to reimpose lockdowns, but only for the unvaccinated. Is this ethical?

Some countries already have vaccine passport schemes to travel or enter certain public spaces. The passports treat those who have had vaccines – or have evidence of recent infection – differently from those who have not had a vaccine. But the proposed selective lockdowns would radically increase the scope of restrictions for the unvaccinated.

Lockdowns can be ethically justified where they are necessary and proportionate to achieve an important public health benefit, even though they restrict individual freedoms. Whether selective lockdowns are justified, though, depends on what they are intended to achieve.Read More »Cross Post: Selective lockdowns can be ethically justifiable – here’s why

Cross Post: Should You Stop Wearing A Mask Just Because the Law Gives You Permission To Do So?

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Written by Maximilian Kiener

On December 1 1955, in Alabama, Rosa Parks broke the law. But Parks was no ordinary criminal trying to take advantage of others. She merely refused to give up her seat on a bus to a white person and was arrested for this reason alone. Parks is a hero because she stood up, or rather sat down, for the rights of black people.

Among other things, Parks taught us that we shouldn’t take the law too seriously, since a legal prohibition does not always imply a moral prohibition. In fact, there can be cases where we should actually do what the law forbids.

But we can extend Parks’ lesson and add another scenario where we shouldn’t take the law too seriously. Just as legal prohibitions (such as not to occupy seats reserved for white people) do not always determine what we should do, legal permissions, or rights, cannot determine what we should morally do either.

Consider the UK government, which now permits its citizens to visit public places without wearing masks, despite surging COVID infection rates. Does that permission mean that people in England now have good reasons to abandon their masks?Read More »Cross Post: Should You Stop Wearing A Mask Just Because the Law Gives You Permission To Do So?

Responsibility and Victim-Blaming

Written by Dr Rebecca Brown

The recent sentencing of Wayne Couzens for the murder of Sarah Everard, along with the murder of Sabina Nessa last month, has prompted discussion in the UK of the prevalence of violence against women and the shortcomings of the criminal justice system. Prime Minister Boris Johnson has himself criticised the police for failing to take cases of violence against women sufficiently seriously. In particular, there has been outrage at comments made by some regarding steps women can take to ‘keep themselves safe’.Read More »Responsibility and Victim-Blaming

Mandatory Vaccination for Care Workers: Pro and Con

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By Dominic Wilkinson and Julian Savulescu
An edited version of this was published in The  Conversation 

The UK government is set to announce that COVID-19 vaccination will become mandatory for staff in older adult care homes. Staff will be given 16 weeks to undergo vaccination; if they do not, they will face redeployment from frontline services or the loss of their job. The government may also extend the scheme to other healthcare workers.

It is crucial to achieve a high vaccine uptake amongst older adult care home staff due to the high mortality risk faced by residents. ONS Data suggest that there has been a 19.5% increase in excess deaths in care homes since the beginning of the pandemic, with COVID-19 accounting for 24.3% of all care home resident deaths.

According to SAGE, 80% of staff working in care homes with older adult residents (and 90% of the residents themselves) need to be vaccinated in order to confer a minimum level of protection to this vulnerable population. In mid-April, only 53% of older adult care homes in England were meeting these thresholds, whilst, as of the 10th June, 17% of adult care home workers in England have not had a single dose of the COVID-19 vaccine.

Mandating vaccination would increase vaccine uptake in care home workers, but would be a significant intrusion into individual freedom. Is it ethically justifiable?

Read More »Mandatory Vaccination for Care Workers: Pro and Con

Guest Post: Frances Kamm- Harms, Wrongs, and Meaning in a Pandemic

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Written by F M Kamm
This post originally appeared in The Philosophers’ Magazine

When the number of people who have died of COVID-19 in the U.S. reached 500,000 special notice was taken of this great tragedy. As a way of helping people appreciate how enormous an event this was, some commentators thought it would help to compare it to other events that involved a comparable number of people losing their lives. For example, it was compared to all the U.S lives lost on the battlefield in World Wars 1 and II and the Vietnam War (or World War II, the Korean War, and Vietnam). Such comparisons raise questions, concerning dimensions of comparison, some of which are about degrees of harm, wrong, and meaningfulness which are considered in this essay. (Since the focus in the comparison was on the number of soldiers who died rather the number of other people affected by their deaths, this discussion will also focus on the people who die in a pandemic rather than those affected by their deaths.)

Read More »Guest Post: Frances Kamm- Harms, Wrongs, and Meaning in a Pandemic

Special St Cross Seminar summary of Maureen Kelley’s: Fighting Diseases of Poverty Through Research: Deadly dilemmas, moral distress and misplaced responsibilities

Written By Tess Johnson

You can find the video recording of Maureen Kelley’s seminar here, and the podcast here.

Lately, we have heard much in the media about disease transmission in conditions of poverty, given the crisis-point COVID-19 spread and mortality that India is experiencing. Yet, much of the conversation is centred on the ‘proximal’—or more direct—causes of morbidity and mortality, rather than the ‘structural determinants’—or underlying, systemic conditions that lead to disease vulnerability in a population. As a result, much global health research is focussed on infectious disease treatment and prevention, rather than responses to the complex political, economic and social needs that underly disease in vulnerable communities. This can result not only in less efficient and effective research, but also moral distress for researchers, and a disconnect between research goals and the responsibility that researchers feel for addressing a community’s immediate needs.

In her Special St Cross Seminar last week, Maureen Kelley introduced her audience to these problems in global health research. Professor Kelley outlined, first, empirical findings evidencing this problem, a result of research she recently performed with the Ethox Centre’s REACH team, in collaboration with global health research teams around the world. Second, she linked this empirical work to theory on moral distress and researchers’ and institutions’ responsibilities toward participating communities in low and middle-income countries (LMICs).Read More »Special St Cross Seminar summary of Maureen Kelley’s: Fighting Diseases of Poverty Through Research: Deadly dilemmas, moral distress and misplaced responsibilities

Cross Post: Vaccine passports: why they are good for society

Written by Barbara Jacquelyn Sahakian, University of Cambridge; Christelle Langley, University of Cambridge,

and Julian Savulescu, University of Oxford

person holding a mobile phone displaying a Covid-19 vaccinated message
Prostock-studio/Shutterstock
 

As more and more people get vaccinated, some governments are relying on “vaccine passports” as a way of reopening society. These passports are essentially certificates that show the holder has been immunised against COVID-19, which restaurants, pubs, bars, sports venues and others can use to grant them entry.

Israel currently operates a “green pass” system, which allows vaccinated people access to theatres, concert halls, indoor restaurants and bars. The UK government, had to roll back plans to trial vaccine passports after some of the venues involved experienced significant backlash against the proposals.

This is perhaps not surprising – vaccine passport schemes are controversial, with some arguing that they will reinforce inequalities. But there is an ethical case for using some form of certification of COVID status, as long as it is designed properly and as long as everyone has access to vaccines.

Let’s look at the ethics of vaccination and certification.Read More »Cross Post: Vaccine passports: why they are good for society

Cross Post: End-of-Life Care: People Should Have the Option of General Anaesthesia as They Die

Written by Dominic Wilkinson and Julian Savulescu

KieferPix/Shutterstock
Dying patients who are in pain are usually given an analgesic, such as morphine, to ease their final hours and days. And if an analgesic isn’t enough, they can be given a sedative – something to make them more relaxed and less distressed at the end of life. We have recently written about a third approach: using a general anaesthetic to ensure that the dying patient is completely unconscious. This has been described previously, but largely overlooked.

There are two situations when a general anaesthetic might be used in dying patients. The first is when other drugs have not worked and the patient is still distressed or in pain. The second is when a patient has only a short time to live and expresses a clear wish to be unconscious. Some dying patients just want to sleep.Read More »Cross Post: End-of-Life Care: People Should Have the Option of General Anaesthesia as They Die