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

Guest Post: Is it Wrong to Lower Your Chances of Doing What You Ought to Do?

Written by Farbod Akhlaghi (University of Oxford)

Suppose you have a moral obligation to take care of your ailing parent tomorrow. If you did something that would lower your chances of fulfilling that moral obligation – like going out partying all night tonight – would you thereby have done something morally wrong?

We do things that affect our chances of fulfilling our moral obligations all the time. They range from the most mundane, like taking a specific route from one place to another where you ought to be doing something at the latter place, to acts like smoking, abusing drugs, or severely neglecting one’s physical and mental well-being. Call actions that affect our chances of fulfilling our moral obligations in the future chance-affecting actions.

Whilst moral obligations are hotly debated in moral philosophy, there has been little to no direct discussion of the moral status of affecting the chances of fulfilling such obligations. This should surprise us. For they are a pervasive feature of our lives: many daily choices we make affect our chances of ultimately doing what we ought to do in the future. And the mere fact that it is, other things being equal, right to do what we are obligated to and wrong not to does not settle whether it is right or wrong to affect our chances of meeting our obligations. So, it seems morally urgent to ask: might we, for example, act wrongly when we make it less likely that we will fulfil an obligation in the future?

Read More »Guest Post: Is it Wrong to Lower Your Chances of Doing What You Ought to Do?

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… Read More »Pandemic Ethics: Moral Reasoning in a Pandemic [Guest Post]

Podcast and Event Summary: New St Cross Special Ethics Seminar: Medically Assisted Dying in Canada: from where we’ve come; to where we’re heading, presented by Professor Arthur Schafer (Centre for Professional and Applied Ethics, University of Manitoba)

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Written by: Dr Amna Whiston

In this seminar (available on podcast), Professor Arthur Schafer discussed the ethical challenges involved in the Canadian euthanasia debate at the New St Cross Special Ethics Seminar (online). Professor Schafer, who has written extensively over the last thirty years about a range of topics that includes professional and bio-medical ethics, having been a long-standing proponent of the view that allowing people to die with dignity enriches our rights as humans, critically addressed the question of whether Canada is currently heading in the right direction regarding the legalization of medical assistance in dying.

Autonomy, as Professor Schafer reminds us, is one of the core Canadian values, and this is reflected through the public battle against the prohibition of assisted suicide.  Back in 1993, (Rodriguez v. British Columbia [Attorney General]), the majority of the Supreme Court of Canada urged that at that time there was no public consensus among Canadians that the autonomy interest of people wishing to end their lives is paramount to the state interest in protecting the lives of its citizens. In recent years, Canadian public opinion has undergone a significant shift in favour of the autonomy interest of irredeemably suffering patients who, with no hope of recovery, wish to end their lives with dignity. In June 2016 the Canadian Parliament passed a legislation bill legalizing medical assistance in dying, which has now become legally permissible in several American states (Oregon, Washington State and Montana) and in a number of European nations (the Netherlands, Belgium, Switzerland, and Luxemburg). Today more than two-thirds of Canadians support the new legislation which makes it legally permissible for doctors to help the terminally ill to end their lives. This fact, nonetheless, leaves open a more general question (beyond the Canada context) of whether constitutional rights should be settled by opinion poll.

Read More »Podcast and Event Summary: New St Cross Special Ethics Seminar: Medically Assisted Dying in Canada: from where we’ve come; to where we’re heading, presented by Professor Arthur Schafer (Centre for Professional and Applied Ethics, University of Manitoba)

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.
Read More »Pandemic Ethics: Compulsory treatment or vaccination versus quarantine

Guest Post: Pandemic Ethics. Social Justice Demands Mass Surveillance: Social Distancing, Contact Tracing and COVID-19

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Written by: Bryce Goodman

The spread of COVID-19 presents a number of ethical dilemmas. Should ventilators only be used to treat those who are most likely to recover from infection? How should violators of quarantine be punished? What is the right balance between protecting individual privacy and reducing the virus’ spread?

Most of the mitigation strategies pursued today (including in the US and UK) rely primarily on lock-downs or “social distancing” and not enough on contact tracing — the use of location data to identify who an infected individual may have come into contact with and infected. This balance prioritizes individual privacy above public health. But contact tracing will not only protect our overall welfare. It can also help address the disproportionately negative impact social distancing is having on our least well off.
Contact tracing “can achieve epidemic control if used by enough people,” says a recent paper published in Science. “By targeting recommendations to only those at risk, epidemics could be contained without need for mass quarantines (‘lock-downs’) that are harmful to society.” Once someone has tested positive for a virus, we can use that person’s location history to deduce whom they may have “contacted” and infected. For example, we might find that 20 people were in close proximity and 15 have now tested positive for the virus. Contact tracing would allow us to identify and test the other 5 before they spread the virus further.
The success of contact tracing will largely depend on the accuracy and ubiquity of a widespread testing program. Evidence thus far suggests that countries with extensive testing and contact tracing are able to avoid or relax social distancing restrictions in favor of more targeted quarantines.

Read More »Guest Post: Pandemic Ethics. Social Justice Demands Mass Surveillance: Social Distancing, Contact Tracing and COVID-19

National Ethics Framework For Use in Acute Paediatric Settings During COVID-19 Pandemic

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Oxford Uehiro Centre’s Director of Medical Ethics, Professor Dominic Wilkinson, has led a UK ethical framework for treatment decisions in acute paediatric settings during the Covid-19 Pandemic. Professor Wilkinson produced the framework along with RCPCH Clinical Lead, Dr Mike Linney, Chair of RCPCH Ethics and Law Committee. This ethical framework is a modification of guidance… Read More »National Ethics Framework For Use in Acute Paediatric Settings During COVID-19 Pandemic

Guest Post: Pandemic Ethics-Earthquakes, Infections, and Consent

David Killoren
Dianoia Institute of Philosophy
Australian Catholic University, Melbourne

People often seem to be stubbornly resistant to change. Consider humanity’s collective failure to respond adequately to the climate emergency. Consider the lifelong smoker who won’t quit even after an emphysema diagnosis. Consider the meat-eater who watches Dominion, resolves to go vegan, and then falls off the wagon the next day. Even when we feel that we have excellent reasons to change our lives, we often drag our feet.

Yet when the coronavirus appeared in late 2019, our antipathy to change suddenly seemed to evaporate. Medical experts and politicians called for sweeping changes and huge numbers of people simply heeded the call. To be sure, there are dissenters. America’s deeply strange president is among them. But the degree of compliance with new restrictions and requirements that we’ve seen in recent weeks is extraordinary. Work, education, dating, dining, art, sport, even casual conversations with strangers—all of these facets of life have been dramatically altered, canceled, or paused for an indefinite period that may last two years or more, and there’s been little complaining from the people. If nothing else, the coronavirus crisis demonstrates this: When conditions are ripe, we are willing to upend our lives.

I’m not here to criticize or to defend the way we’re responding to the virus. But I want to raise some questions that I think aren’t receiving due attention.Read More »Guest Post: Pandemic Ethics-Earthquakes, Infections, and Consent

Cross Post: Boris Johnson Will Be Receiving The Same Special Treatment Other Patients Do In NHS Intensive Care

Written by Dominic Wilkinson, University of Oxford

This article originally appeared in The Conversation

In a world where the adjective “unprecedented” has become commonplace, the news of British Prime Minister Boris Johnson being admitted to the intensive care unit of St Thomas’ Hospital with COVID-19 seemed to take it to a new level.

There is little information in the public domain about Johnson’s medical condition, but this is clearly a very serious step. He will only have been transferred to intensive care because it is perceived that his condition is potentially life threatening and there is a possibility that he would need urgent medical attention, including the possible use of mechanical ventilation.

What would happen if that became necessary? Would Johnson’s treatment be any different from anyone else with the same condition? Would he receive special treatment because of his political position, because of his importance for the country? Would he be prioritised for a ventilator?Read More »Cross Post: Boris Johnson Will Be Receiving The Same Special Treatment Other Patients Do In NHS Intensive Care