The essays in this special issue of HEC Forum provide reflections that make explicit the implicit anthropology that our current pandemic has brought but which in the medical ethics literature around COVID-19 has to a great extent ignored. Three of the essays are clearly “journalistic” as a literary genre: one by a hospital chaplain, one by a medical student in her pre-clinical years, and one by a fourth-year medical student who reports her experience as she completed her undergraduate clerkships and (...) applied for positions in graduate medical education. Other essays explore the pandemic from historical, sociological, and economic perspectives, particularly how triage policies have been found to be largely blind to structural healthcare disparities, while simultaneously unable to appropriately address those disparities. Central issues that need to be addressed in triage are not just whether a utilitarian response is the most just response, but what exactly is the greatest good for the greatest number? Together, the essays in this special issue of HEC Forum create a call for a more anthropological approach to understanding health and healthcare. The narrow approach of viewing health as resulting primarily from healthcare will continue to hinder advances and perpetuate disparities. Health outcomes result from a complex interaction of various social, economic, cultural, historical, and political factors. Advancing healthcare requires contextualizing the health of populations amongst these factors. The COVID-19 pandemic has made us keenly aware of how interdependent our health as a society can be. (shrink)

Publics trust experts for personal and pro-social reasons. Scientists are among the experts publics trust most, and so, epistemic trust is routinely afforded to them. The call for epistemic trust to be more socially situated in order to account for the impact of science on society and public welfare is at the forefront of enhanced epistemic trust. I argue that the value-free ideal for science challenges establishing enhanced epistemic trust by preventing the inclusion of non-epistemic values throughout the evaluation of (...) evidence and communication of these values. By selectively silencing non-epistemic values, the ideal cannot take into account publics’ social and moral responses to inductive risk, which are instrumental for defining and determining public welfare. Furthermore, by emphasising epistemic values almost exclusively in science education and communication, the value-free ideal is presented to publics in such a way that it becomes a social indicator of trust. I show this through examination of the importance of values in decisions to trust, and conclude that values (and restrictions on them) can be used by lay publics to help decide which experts to trust. (shrink)

Vaccine hesitancy has been a major cause for concern throughout the COVID-19 pandemic. The World Health Organization have previously addressed vaccine hesitancy via the ‘3C model’ (Convenience, Complacency, and Confidence). Recent scholarship has added two more ‘Cs’ (Context and Communication) to formulate a ‘5C model’ that is more equipped to adapt to the uncertainties of the pandemic. This paper focuses on the four ‘Cs’ that explicitly concerns trust (Complacency, Confidence, Context, and Communication) and phenomenologically distinguishes confidence from trust. Experts view (...) vaccines in terms of confidence, where the prospect of an undesirable outcome is extremely rare. Hence, not vaccinating and compromising herd immunity is seen to be unreasonable. Hesitant individuals contest the expert perspective and view vaccines in terms of trust, where the prospect of disappointment is likely. From this perspective, to vaccinate is to take a risk, and it is within reason to have the freedom to choose otherwise. This paper focuses on the hesitant perspective to identify the two social indicators of trust in vaccines most prominently shown during the COVID-19 pandemic in the Global North: (i) the expert reaction to hesitant concerns and (ii) the loss of freedom in relation to vaccine requirements. (shrink)

Danielle Celermajer advocates for reconceptualizing responsibility in light of the climate crisis. I argue instead that we must understand current concepts of responsibility which are implicit in actual responsibility practices. I illustrate this by appeal to the practice of holding each other responsible for our beliefs-a practice in which we are constantly involved, but which is often obscured. It extends our responsibility to involuntary aspects of our own mind and involves socially distributed cognitive duties. Cognitive responsibility is part and parcel (...) of shared human conceptual frameworks that we should work to uncover and fully understand rather than revise. (shrink)