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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.


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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: Why COVID passes are not discriminatory (in the way you think they are)

Alberto Giubilini

(This article is republished from The Conversation under a Creative Commons license. Read the original article)
The Conversation

UK health secretary Sajid Javid’s plans for vaccination requirements for frontline NHS workers has reignited the political and ethical debate over COVID passes.

The requirement constitutes a kind of vaccine pass; without proof of vaccination, healthcare workers are prevented from continuing working in the NHS in a frontline role. Other types of COVID passes have been introduced elsewhere, such as the so-called “green pass” used in many European countries.

COVID passes are certificates intended to limit the access to certain spaces – including, in some cases, the workplace – to people who are vaccinated, or who are thought to have immunity from previous COVID infections, or who have had a recent negative COVID test, or some combination thereof (depending on the type of pass). The aim is to minimise the risk that people in those spaces can infect others.

A common objection to COVID passes is that they are discriminatory because they would create a two-tier society with vaccinated people enjoying more freedom than the unvaccinated.

Read More »Cross post: Why COVID passes are not discriminatory (in the way you think they are)

How we got into this mess, and the way out

By Charles Foster

This week I went to the launch of the latest book by Iain McGilchrist, currently best known for his account of the cultural effects of brain lateralisation, The Master and His Emissary: The Divided Brain and the Making of the Western WorldThe new book, The Matter with Things: Our brains, our delusions, and the unmaking of the world is, whatever, you think of the argument, an extraordinary phenomenon. It is enormously long – over 600,000 words packed into two substantial volumes. To publish such a thing denotes colossal confidence: to write it denotes great ambition.

It was commissioned by mainstream publishers who took fright when they saw its size. There is eloquent irony in the rejection on the ground of its length and depth of a book whose main thesis is that reductionism is killing us. It was picked up by Perspectiva press. That was brave. But I’m predicting that Perspectiva’s nerve will be vindicated. It was suggested at the launch that the book might rival or outshine Kant or Hegel. That sounds hysterical. It is a huge claim, but this is a huge book, and the claim might just be right.

Nobody can doubt that we’re in a terrible mess. The planet is on fire; we’re racked with neuroses and governed by charlatans, and we have no idea what sort of creatures we are. We tend to intuit that we are significant animals, but have no language in which to articulate that significance, and the main output of the Academy is to scoff at the intuition.Read More »How we got into this mess, and the way out

NHS and Care Home Mandates Should Take Account of Natural Immunity to COVID

by Dominic Wilkinson, Jonathan Pugh, Julian Savulescu

 

Yesterday, the health secretary, Sajid Javid announced that COVID vaccines would become mandatory for frontline NHS staff from April.

Meanwhile, from tomorrow care home workers in the UK will not be able to work if they don’t have a vaccine certificate and are not medically exempt. This vaccine mandate has been controversial, with providers raising concerns that as many 70’000 employees could leave the sector putting beds and care at risk. However, its advocates have argued that it is a proportionate public health measure due to the need to protect vulnerable care home residents.

Proportionality is one key ethical criterion in public health ethics; public health interventions are only permissible if their benefits outweigh their costs. However, another key ethical criterion is necessity; public health interventions are only permissible if they are necessary for achieving a certain benefit.

One striking feature of the current UK care home and NHS staff mandate is that it does not allow an exemption for those who have proof of natural immunity.

Read More »NHS and Care Home Mandates Should Take Account of Natural Immunity to COVID

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?

Who Cares?

By Stephen Rainey & Yasemin J. Erden

How much of a role should the state play in taking care of us, as opposed to, say, our family members? According to some, care should “start at home” and should, moreover, be selfless. Statements like “Parents and other caregivers look after their children with little thought of return” from a recent New Statesman article sound nice, and elicit nods of approval – of course no returns are sought!

But are they true?Read More »Who Cares?

Paying for the Flu Vaccine

By Ben Davies

As I do every winter, I recently booked an appointment for a flu vaccine. I get it for free in the UK. If I didn’t have asthma, I’d still get vaccinated, but it would cost me between £9 and £14.99. That is both an ethical error on the part of the government, and may be a pragmatic one too.

Read More »Paying for the Flu Vaccine