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Following the Science Without Forgetting Values

Written by Stephen Rainey

It is presently feared that ‘lockdown’ may be beginning to fray at the edges, as people tire of their restrictions. From the start of the emergency, discussion focussed upon the ability of the public to stay the course where restrictions were at stake. This neatly ignores the public’s being ahead of the government in acknowledging the severity of the situation before the 23rd March announcement to restrict social freedoms. At any rate, concerns over policy effectiveness were addressed through faith in behavioural science (via ‘Behavioural Insights’, née ‘The Nudge Unit’), and communications devices such as the repeated phrase, ‘following the science’.

‘Following the science’ raises reasonable questions including, which science and why? In what sense ‘follow’? To what degree? The idea of creating arguments ‘from science’ for any given policy is presumed sufficient as a motivation, or a reason for citizens to submit themselves to policy demands. However, given the expert basis for these arguments, it is not a safe bet that any given citizen will share the assumptions or knowledge base of the experts, let alone adopt them as straightforward reasons to alter their behaviour. Few people like to be told what to do without at least understanding what is being asked of them and why, so this can be a problem.

Read More »Following the Science Without Forgetting Values

Interview Series: Do Health and Social Care Workers Have a Moral Obligation to Keep Working if they Lack Protective Equipment?

    Philosopher Udo Schüklenk argues that it is morally permissible for doctors, nurses and other care workers to stop working if they lack PPE (personal protective equipment).  To listen to the interview, follow this link to the podcast: https://podcasts.apple.com/gb/podcast/is-it-morally-permissible-for-healthcare-workers-to/id1509190881?i=1000472576406  

Pandemic Ethics: Key Workers Have a Stronger Claim to Compensation and Hazard Pay for Working During The COVID-19 Pandemic Than The Armed Forces Do When on Deployment

By Doug McConnell and Dominic Wilkinson

Post originally appeared on the Journal of Medical Ethics Blog

 

While the general public enjoy the relative safety of social distancing, key workers are at a higher risk of both contracting COVID-19 and transmitting it to their families. This is especially the case for ‘frontline’ workers who are frequently exposed to the virus and may not have access to adequate personal protective equipment (PPE). Tragically, many key workers have died of COVID-19 around the world already, including over 100 in the UK.

Although it is relatively rare for key workers to die from COVID-19, the risk of death is obviously much greater than one would usually expect in these roles and key workers clearly have good reason to be anxious. For ‘frontline’ workers, the distress is compounded by working in harrowing conditions where so many are dying alone. Furthermore, frontline workers have to take on the burdens of ensuring they do not transmit infections to their families, by moving in with patients, living in hotels, or maintaining rigorous social distancing in their own homes.

These atypical costs, risks, and burdens suggest that key workers are owed compensation in addition to their usual pay and a few instances of nationally coordinated applause. Read More »Pandemic Ethics: Key Workers Have a Stronger Claim to Compensation and Hazard Pay for Working During The COVID-19 Pandemic Than The Armed Forces Do When on Deployment

Pandemic Ethics: Why Lock Down of the Elderly is Not Ageist and Why Levelling Down Equality is Wrong

By Julian Savulescu and James Cameron

Cross-posted with the Journal of Medical Ethics Blog

 

Countries all around the world struggle to develop policies on how to exit the COVID-19 lockdown to restore liberty and prevent economic collapse, while also protecting public health from a resurgence of the pandemic. Hopefully, an effective vaccine or treatment will emerge, but in the meantime the strategy involves continued containment and management of limited resources.

One strategy is a staged relaxation of lockdown. This post explores whether a selective continuation of lockdown on certain groups, in this case the aged, represents unjust discrimination. The arguments extend to any group (co-morbidities, immunosuppressed, etc.) who have significantly increased risk of death.

Read More »Pandemic Ethics: Why Lock Down of the Elderly is Not Ageist and Why Levelling Down Equality is Wrong

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

Maximising Ventilators: Some Ethical Complications

Written by Joshua Parker and Ben Davies

One of the impending tragedies of the COVID-19 pandemic is a grave mismatch between the supply of ventilators and the numbers needing them. This situation, as seen in Italy, is predicted to be mirrored here in the UK. Coronavirus can cause acute respiratory distress syndrome for which the management is mechanical ventilation on the ICU. This represents these patients’ only chance at survival. Part of the response to the incoming tsunami of patients requiring ventilation is to produce more ventilators. This is a reasonable way to try to lessen the mismatch between supply and demand. However, producing more ventilators cannot be the solution in isolation. As a complex piece of medical equipment, ventilators need trained staff to operate them and provide the additional care ventilated patients require. There has been a significant push to attempt to ensure enough ventilator trained staff as possible. Both staff and ventilator shortages present significant issues; yet it is shortages of ventilators that account for the bulk of ethical discussion so far. It is therefore worth exploring some of the ethical problems that might arise should there be plenty of ventilators, but not enough staff.

Read More »Maximising Ventilators: Some Ethical Complications

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

The Perfect Protocol? Ethics Guidelines in a Pandemic

Written by Joshua Parker and Ben Davies

One question occupying politicians and healthcare workers in the middle of this global pandemic is whether there will be enough ventilators when COVID-19 reaches its peak. As cases in the UK continue to increase, so too will demand for ventilators; Italy has reported overwhelming demand for the equipment and the need to ration access, and the UK will likely face similar dilemmas. Indeed, one UK consultant has predicted a scenario of having 8 patients for every one ventilator. Aside from anything else, this would be truly awful for the healthcare professionals having to make such decisions and live with the consequences.

Ethics is an inescapable part of medical practice, and healthcare professionals face numerous ethical decisions throughout their careers. But ethics is challenging, often involving great uncertainty and ambiguity. Medics often lack the time to sort through the morass that is ethics.  Many therefore prefer heuristics, toolboxes and a handful of principles to simplify, speed up and streamline their ethics.

Read More »The Perfect Protocol? Ethics Guidelines in a Pandemic

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

Why You Should Not (Be Allowed To) Have That Picnic in the Park, Even if it Does Not Make a Difference

Written by Alberto Giubilini

 

(a slightly longer version of this blogpost will appear in the journal Think. Link will be provided as soon as available)

It’s a sunny Sunday afternoon, early spring. The kind of afternoon that seems to be inviting you out for a stroll by the river. Maybe have a picnic on the green grass, in that spot over there, away from everyone. Why not?

The simple answer is: because there is a pandemic and the Government is enforcing a lockdown. You should stay home. End of the story.

And there isn’t a complex answer. The simple answer really is the end of the story.

But why? You probably understand the reasons for the lockdown. But that is a matter of policy, a general rule for the population. What difference does it make if I just go over there, where there is no one, keeping at distance from everyone? I am not going to harm anyone.

You are (probably) right: it (likely) does not make a difference, and you are (likely) not harming anyone. However, that is not the only relevant question to ask when we ask what we morally ought to do, or what a Government may permissibly require of us.

Let us consider the ethically relevant aspects of this situation.Read More »Why You Should Not (Be Allowed To) Have That Picnic in the Park, Even if it Does Not Make a Difference