Pandemic Ethics

Pandemic Ethics: Is it right to cut corners in the search for a coronavirus cure?

By Julian Savulescu

Cross-posted from The Guardian

The race is on to find a treatment for coronavirus. This race is split between two approaches: the trialling of pre-existing drugs used for similar diseases, and the hunt for a vaccine. In both instances, important ethical decisions must be made. Is it OK to reassign a treatment that comes with side-effects? And with thousands dying from coronavirus every day, is it acceptable to cut corners in the search for a vaccine?

Read more: https://www.theguardian.com/commentisfree/2020/mar/25/search-coronavirus-cure-vaccine-pandemic

Pandemic Ethics: Covid-19 Shows Just How Much of Ethics Depends on (Good) Data

Written by Hazem Zohny

In times of crises, the archetypal ethicist sits in the proverbial armchair and hums and haws, testing out intuitions about an action or policy against a jumble of moral theories. Covid-19 shows why the archetypal ethicist is as useless as antibiotics are for viral infections.

This is because virtually all the difficult ethical questions this pandemic raises boil down to having access to the relevant data, rather than the relevant intuitions or theories.

Consider these questions, all sourced from recent blogs in this Pandemic Ethics Series:

But also: Should isolation have started earlier? How draconian is too draconian? Should we aim for herd immunity? What criteria should determine who gets the ventilator if they start to run out? Etc. Etc.

These all seem like meaty moral questions – and they are. But their meatiness does not really stem from the values or principles they call into question. Instead, it is the uncertainty of the empirical data surrounding all aspects of the pandemic that should incite all the humming and hawing.

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Pandemic Ethics: Who gets the ventilator in the coronavirus pandemic? These are the ethical approaches to allocating medical care

By Julian Savulescu and Dominic Wilkinson

Cross-posted from ABC Online

Imagine there are two patients with respiratory failure.

Joan is 40, normally employed with two children and no other health conditions or disabilities. Mary is 80, with severe dementia, in a nursing home.

In the Western world, doctors are gearing up for an explosion of cases of COVID-19 and with a massive shortage of medical resources, including life-saving ventilators, they are likely to be presented with dilemmas of exactly this kind.

It is undeniable that people should have an equal chance when there are sufficient resources.

But when there are limited resources, doctors do take various factors into account.

Read more: https://www.abc.net.au/news/2020-03-18/ethics-of-medical-care-ventilator-in-the-coronavirus-pandemic/12063536

Pandemic ethics: Never again – will we make Covid-19 a warning shot or a dud?

by Anders Sandberg

The Covid-19 pandemic is not the end of the world. But it certainly is a wake-up call. When we look back on the current situation in a year’s time, will we collectively learn the right lessons or instead quickly forget like we did with the 1918 flu? Or even think it was just hype, like Y2K?

There are certainly plenty of people saying this is the new normal, and that things will never be the same. But historically we have adapted to trauma rather well. Maybe too well – we have a moral reason to ensure that we do not forget the harsh lessons we are learning now.

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Coronavirus: Dark Clouds, But Some Silver Linings?

By Charles Foster

Cross posted from The Conversation

To be clear, and in the hope of heading off some trolls, two observations. First: of course I don’t welcome the epidemic. It will cause death, worry, inconvenience and great physical and economic suffering. Lives and livelihoods will be destroyed. The burden will fall disproportionately on the old, the weak and the poor.

And second: these suggestions are rather trite. They should be obvious to reasonably reflective people of average moral sensibility.

That said, here goes:

1. It will make us realise that national boundaries are artificial

The virus doesn’t carry a passport or recognise frontiers. The only way of stopping its spread would be to shut borders wholly, and not even the most rabid nationalists advocate that. It would mean declaring that nations were prisons, with no one coming in or out – or at least not coming back once they’d left. In a world where we too casually assume that frontiers are significant, it doesn’t do any harm to be reminded of the basic fact that humans occupy an indivisible world.

Cooperation between nations is essential to combating the epidemic. That cooperation is likely to undermine nationalist rhetoric.

2. It will make us realise that people are not islands

The atomistic billiard-ball model of the person – a model that dominates political and ethical thinking in the west – is biologically ludicrous and sociologically unsustainable. Our individual boundaries are porous. We bleed into one another and infect one another with both ills and joys. Infectious disease is a salutary reminder of our interconnectedness. It might help us to recover a sense of society.

3. It may encourage a proper sort of localism

Internationalism may be boosted. I hope so. But if we’re all locked up with one another in local quarantine, we might get to know the neighbours and the family members we’ve always ignored. We might distribute ourselves less widely, and so be more present to the people around us.

We might even find out that our local woods are more beautiful than foreign beaches, and that local farmers grow better and cheaper food than that which is shipped (with the associated harm to the climate) across the globe.

4. It may encourage altruism

Exigencies tend to bring out the best and the worst in us. An epidemic may engender and foster altruistic heroes.

5. It may remind us of some neglected constituencies

Mortality and serious illness are far higher among the old, the very young, and those suffering from other diseases. We tend to think about – and legislate for – the healthy and robust. The epidemic should remind us that they are not the only stakeholders.

6. It may make future epidemics less likely

The lessons learned from the coronavirus epidemic will pay dividends in the future. We will be more realistic about the dangers of viruses crossing the barriers between species. The whole notion of public health (a Cinderella speciality in medicine in most jurisdictions) has been rehabilitated. It is plain that private healthcare can’t be the whole answer. Much has been learned about the containment and mitigation of infectious disease. There are strenuous competitive and cooperative efforts afoot to develop a vaccine, and vaccines against future viral challenges are likely to be developed faster as a result.

7. It might make us more realistic about medicine

Medicine is not omnipotent. Recognising this might make us more aware of our vulnerabilities. The consequences of that are difficult to predict, but living in the world as it really is, rather than in an illusory world, is probably a good thing. And recognising our own vulnerability might make us more humble and less presumptuous.

8. Wildlife may benefit

China has announced a permanent ban on trade in and consumption of wildlife. That in itself is hugely significant from a conservation, an animal welfare, and a human health perspective. Hopefully other nations will follow suit.

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Pandemic Ethics: Infectious Pathogen Control Measures and Moral Philosophy

By Jonathan Pugh and Tom Douglas

Listen to Jonathan Pugh and Tom Douglas on Philosophical Disquisitions  discussing  Covid 19 and the Ethics of Infectious Disease Control, a podcast interview that was inspired by this blog.

Following the outbreak of the SARS-CoV-2 coronavirus, a number of jurisdictions have implemented restrictive measures to prevent the spread of this highly contagious pathogen. In January, Chinese authorities effectively quarantined the entire city of Wuhan, the epicentre of the outbreak, which has a population of around 11 million people. There has since been much discussion of various measures that might be implemented now or in the future to counter the spread, including various forms of social distancing, further mass quarantines and lockdowns, closed borders, mandatory testing and screening and even potentially forced treatment.

There are important questions about the lawfulness of infectious pathogen control (IPC) measures. Here, though, we focus on the moral justification of IPC. How can moral philosophy help us to think through when and whether different IPC measures ought to be employed?

To do so, we will briefly summarise our analysis of the different ways non-consensual medical interventions can be justified in infectious diseases control and criminal justice settings, which we originally published open access here.

 

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Pandemic Ethics: How Much Risk Should Social Care Workers and Their Families Be Expected to Take?

By Doug McConnell

Recently many of the staff at an aged-care home in Sydney, Australia called in sick the day after the report of a CoVid-19 outbreak at that facility.1 Upon investigation of these absences, one of the reasons the workers gave was that they were concerned about protecting their own families. They didn’t want to act as a vector transferring the disease from the aged care home to their own homes.  So how much risk should social care workers and their families be obliged to take when responding to infectious diseases like CoVid-19? Continue reading

Pandemic Ethics: the Unilateralist Curse and Covid-19, or Why You Should Stay Home

by Anders Sandberg

In Scientific American Zeynep Tufekci writes:

Preparing for the almost inevitable global spread of this virus, … , is one of the most pro-social, altruistic things you can do in response to potential disruptions of this kind.

We should prepare, not because we may feel personally at risk, but so that we can help lessen the risk for everyone.

…you should prepare because your neighbors need you to prepare—especially your elderly neighbors, your neighbors who work at hospitals, your neighbors with chronic illnesses, and your neighbors who may not have the means or the time to prepare because of lack of resources or time.

I think this is well put. As a healthy middle-aged academic my personal risk of dying from Covid-19 seems modest – maybe about 0.4% if I get it, which in turn might be below 10% depending on how widespread the virus becomes. But I could easily spread the disease to people who are far more vulnerable, either directly or indirectly. Even slowing the spread is valuable since it helps avoid overloading the medical system at the peak of the epidemic. Continue reading

Pandemic Ethics: Should Frontline Doctors and Nurses Get Preferential Treatment?

Dominic Wilkinson, University of Oxford

It is mid-March 2020. James is a 29-year-old junior doctor working in a London hospital. Last week, James cared for a man who had become sick after returning from abroad. The man had been treated in isolation and is now improving. However, James has since become unwell. He developed a cough and fever, but then rapidly became breathless.

James has been admitted to his own hospital with signs of severe acute respiratory distress syndrome. Despite intensive treatment, James’ lungs are full of fluid and his oxygen levels are critically low. His kidneys have shut down, and his blood pressure is unstable.

The medical team caring for James has referred him to the regional extracorporeal membrane oxygenation (ECMO) centre – a potentially life-saving treatment that is used for some patients with severe organ failure.

But the ECMO centre has received several referrals. While James is young and fit, he also has features that suggest he may die even with ECMO, and there are other patients who would have a higher chance of recovery.

Should James receive preferential treatment? Continue reading

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