Lockdowns were a morally and medically appropriate anti-contagion policy to stop the spread of Covid. However, lockdowns came with considerable costs. Specifically, lockdowns imposed harms and losses upon the young in order to benefit the elderly, who were at the highest risk of severe illness and death from Covid. This represented a shifting of the (epidemiological) burden of Covid for the elderly to a systemic burden of lockdown upon the young. This article argues that even if lockdowns were a (...) morally permissible response to Covid, the harms and losses they imposed on the young ground a claim of compensation. I defend an intergenerational compensation argument that defends a claim for an egalitarian intergenerational transfer to compensate the young for the harms of lockdown. (shrink)

In many countries and regions across the world, the initial response to the massive health risks posed by COVID-19 has been the institution of lockdown measures. Although they vary from place to place, these measures all involve trade-offs between ethical goods and imperatives, imposing significant restrictions on central human capabilities—including citizens’ ability to work, socialize, exercise democratic rights, and access education—in the name of protecting population health. As such, it seems imperative for philosophers to ask whether lockdown measures (...) are ethical.This is a difficult question. We are deeply uncertain about the possible effects of COVID-19 and of lockdown policies, raising questions about... (shrink)

Lockdowns and quarantines have been implemented widely in response to the COVID-19 pandemic. This has been accompanied by a rise in interest in the ethics of ‘passport’ systems that allow low-risk individuals greater freedoms during lockdowns and exemptions to quarantines. Immunity and vaccination passports have been suggested to facilitate the greater movement of those with acquired immunity and who have been vaccinated. Another group of individuals who pose a low risk to others during pandemics are those with genetically mediated (...) resistances to pathogens. In this paper, we introduce the concept of genomic passports, which so far have not been explored in the bioethics literature. Using COVID-19 as an illustrative example, we explore the ethical issues raised by genomic passports and highlight differences and similarities to immunity passports. We conclude that, although there remain significant practical and ethical challenges to the implementation of genomic passports, there will be ways to ethically use them in the future. (shrink)

Lockdowns were a morally and medically appropriate anti-contagion policy to stop the spread of Covid. However, lockdowns came with considerable costs. Specifically, lockdowns imposed harms and losses upon the young in order to benefit the elderly, who were at the highest risk of severe illness and death from Covid. This represented a shifting of the (epidemiological) burden of Covid for the elderly to a systemic burden of lockdown upon the young. This article argues that even if lockdowns were a (...) morally permissible response to Covid, the harms and losses they imposed on the young ground a claim of compensation. I defend an intergenerational compensation argument that defends a claim for an egalitarian intergenerational transfer to compensate the young for the harms of lockdown. (shrink)

Public health responses to the Covid‐19 pandemic included various measures to mitigate the spread of the virus. Among these, the most restrictive was a broad category referred to as “lockdowns.” We argue that the reasoning offered in favor of extended lockdowns—those lasting several months or longer—did not adequately account for a host of countervailing considerations, including the impact on mental illness, education, employment, and marginalized communities as well as health, educational, and economic inequities. Furthermore, justifications offered for extended lockdowns set (...) aside a basic tenet of public health ethics: restrictions on liberty and autonomy should be the least intrusive means of achieving the desired end. Since it is now clear that extended lockdowns cause severe harm to many vulnerable populations, the burden of proof is on those who would advocate for them, and there must be a much higher bar to implement an extended lockdown, with high‐quality evidence that the benefit would substantially exceed its harm. (shrink)

Over the past 6 months, coronavirus-induced disease has spread across 212 countries, affecting millions of people. As it has no known cure, social distancing is highly recommended for prevention of spread of the disease. Here, we have described the impact of the social distancing measures implemented by the Government of India on various sections of the society, especially the vulnerable sections. Furthermore, we have presented an analysis of these measures, according to the World Health Organization´s Guidance for Managing Ethical Issues (...) in Infectious Disease Outbreaks ; we have also applied principles, as applicable, from the Indian Council of Medical Research’s National Ethical Guidelines for Biomedical and Health Research Involving Human Participants. Finally, we have presented several measures that should have been adopted before and in addition to implementing the lockdown to improve its effectiveness. (shrink)

States all over the world have reacted to COVID-19 with quarantines of entire cities, provinces, and even nations. Previous studies and preliminary evidence from current lockdowns suggest that emergency measures protecting the public’s physical health by dislocating individuals, families, and social networks could well be causing a devastating public health crisis of mental ill-health in the months and years to come. This article is the first to take a public mental health ethics perspective in examining these lockdowns, the lodestar (...) of which is the right to mental health, rooted in the concept of human dignity. Even the strictest lockdowns are not necessarily unethical but are prone to damage mental health disproportionately, with vulnerable and disadvantaged populations being at particular risk. (shrink)

Lockdown measures in response to the COVID-19 pandemic involve placing huge burdens on some members of society for the sake of benefiting other members of society. How should we decide when these policies are permissible? Many writers propose we should address this question using cost-benefit analysis, a broadly consequentialist approach. We argue for an alternative non-consequentialist approach, grounded in contractualist moral theorising. The first section sets up key issues in the ethics of lockdown, and sketches the apparent (...) appeal of addressing these problems in a CBA frame. The second section argues that CBA fundamentally distorts the normative landscape in two ways: first, in principle, it allows very many morally trivial preferences—say, for a coffee—might outweigh morally weighty life-and-death concerns; second, it is insensitive to the core moral distinction between victims and vectors of disease. The third section sketches our non-consequentialist alternative, grounded in Thomas Scanlon’s contractualist moral theory. On this account, the ethics of self-defence implies a strong default presumption in favour of a highly restrictive, universal lockdown policy: we then ask whether there are alternatives to such a policy which are justifiable to all affected parties, paying particular attention to the complaints of those most burdened by policy. In the fourth section, we defend our contractualist approach against the charge that it is impractical or counterintuitive, noting that actual CBAs face similar, or worse, challenges. (shrink)

The lifting of lockdown is a typical case of the tragedy of the commons, and as such should be regulated by public authority, instead of being left to the ethics and responsibility of single individuals. I would therefore argue that we should think about an intermediate phase between the lockdown and the opening of shops (which in the Italian case is the transition from the red zone to the orange zone): diversified access to commercial activities, on an (...) hourly basis, for different population groups. This can be achieved either by creating different opening hours for different commercial activities and offices, or by opening them all at the same time but introducing free entrance hours based on age groups of clients. Both solutions would imply an extension of business and office hours, contrary to what has happened in most countries, where an attempt has been made to shorten the days and in some cases, such as in Italy, a curfew has even been introduced at a certain time of the day (in Italy, at 10 pm). (shrink)

Our aim in this brief essay is not to defend a particular policy or attitude toward lockdown measures in the United States or elsewhere, but to consider the scope and limits of different types of arguments that can be offered for them. Understanding the complexity of these issues will, we hope, go some way to helping us understand each other and our attitudes toward state responses to the pandemic.

Were governments justified in imposing lockdowns to contain the spread of the COVID-19 pandemic? We argue that a convincing answer to this question is to date wanting, by critically analyzing the factual basis of a recent paper, “How Government Leaders Violated Their Epistemic Duties During the SARS-CoV-2 Crisis” (Winsberg et al. 2020). In their paper, Winsberg et al. argue that government leaders did not, at the beginning of the pandemic, meet the epistemic requirements necessitated to impose lockdowns. We focus on (...) Winsberg et al.’s contentions that knowledge about COVID-19 resultant projections were inadequate; that epidemiologists were biased in their estimates of relevant figures; that there was insufficient evidence supporting the efficacy of lockdowns; and that lockdowns cause more harm than good. We argue that none of these claims are sufficiently supported by evidence, thus impairing their case against lockdowns, and leaving open the question of whether lockdowns were justified. (shrink)

Lockdowns in Australia have been strict and lengthy. Policy-makers appear to have given the preservation of quantity of lives strong priority over the preservation of quality of lives. But thought-experiments in population ethics suggest that this is not always the right priority. In this paper, I'll discuss both negative impacts on quantity of lives caused by the lockdowns themselves, including an increase in domestic violence, and negative impacts on quality of lives caused by lockdowns, in order to raise the (...) question of whether we each had reason to choose quantity over quality in our own lives in a way that would justify the lockdowns we had. (shrink)

[OPEN ACCESS] Commentaries on the ethics of Covid lockdowns nearly all focus on offering substantive guidance to policy‐makers. Lockdowns, however, raise many ethical questions that admit of a range of reasonable answers. In such cases, policy‐making in a liberal democracy ought to be sensitive to which reasonable views the public actually holds—a topic existing bioethical work on lockdowns has not explored in detail. In this essay, I identify several important questions connected to the kind of influence the public ought (...) to have on lockdown decision‐making, including how policy‐makers ought to handle misinformed or morally suspect viewpoints, and how policy‐makers ought to respond to minority viewpoints. I argue that questions like this, concerning the appropriate influence of the public on decision‐making, will be central to the field of bioethics as it increasingly focuses on policy and population‐level issues and therefore ought to be priorities for future work. (shrink)

In order to prevent the rapid spread of COVID-19, governments have placed significant restrictions on liberty, including preventing all non-essential travel. These restrictions were justified on the basis the health system may be overwhelmed by COVID-19 cases and in order to prevent deaths. Governments are now considering how they may de-escalate these restrictions. This article argues that an appropriate approach may be to lift the general lockdown but implement selective isolation of the elderly. While this discriminates against the elderly, (...) there is a morally relevant difference—the elderly are far more likely to require hospitalisation and die than the rest of the population. If the aim is to ensure the health system is not overwhelmed and to reduce the death rate, preventing the elderly from contracting the virus may be an effective means of achieving this. The alternative is to continue to keep everyone in lockdown. It is argued that this is levelling down equality and is unethical. It suggests that in order for the elderly to avoid contracting the virus, the whole population should have their liberty deprived, even though the same result could be achieved by only restricting the liberty of the elderly. Similar arguments may also be applied to all groups at increased risk of COVID-19, such as men and those with comorbidities, the obese and people from ethnic minorities or socially deprived groups. This utilitarian concern must be balanced against other considerations, such as equality and justice, and the benefits gained from discriminating in these ways must be proportionately greater than the negative consequences of doing so. Such selective discrimination will be most justified when the liberty restriction to a group promotes the well-being of that group (apart from its wider social benefits). (shrink)

Governments around the world have faced the challenge of how to respond to the recent outbreak of a novel coronavirus disease. Some have reacted by greatly restricting the freedom of citizens, while others have opted for less drastic policies. In this paper, I draw a parallel with vaccination ethics to conceptualize two distinct approaches to COVID-19 that I call altruistic and lockdown. Given that the individual measures necessary to limit the spread of the virus can in principle be (...) achieved voluntarily as well as through enforcement, the question arises of how much freedom governments ought to give citizens to adopt the required measures. I argue that an altruistic approach is preferable on moral grounds: it preserves important citizen freedoms, avoids a number of potential injustices, and gives people a much-needed sense of meaning in precarious times. (shrink)

At this stage of the COVID-19 pandemic, two policy aims are imperative: avoiding the need for a general lockdown of the population, with all its economic, social and health costs, and preventing the healthcare system from being overwhelmed by the unchecked spread of infection. Achieving these two aims requires the consideration of unpalatable measures. Julian Savulescu and James Cameron argue that mandatory isolation of the elderly is justified under these circumstances, as they are at increased risk of becoming severely (...) ill from COVID-19, and are thus likely to put disproportionate strain on limited healthcare resources. However, their arguments for this strategy are contingent on the lack of viable alternatives. We suggest that there is a possible alternative: a mandatory, centralised contact-tracing app. We argue that this strategy is ethically preferable to the selective isolation of the elderly, because it does not target members of a certain group, relying instead on the movements of each individual, and because it avoids the extended isolation of certain members of the society. Although this type of contact-tracing app has its drawbacks, we contend that this measure warrants serious consideration. (shrink)

Commentators believe that the COVID-19 pandemic reveals the inconveniences of capitalism and that the end of “neoliberalism” could be near. In this article we show that a capitalist ethics is capable to deal with the challenges of pandemics and comes with important advantages such as the prevention of overreactions. We apply both utilitarian and rights-based ethics to the case of epidemics in general and COVID-19 in particular. First a libertarian natural law ethics is used to assess the (...) government interventions in the Corona pandemic. We maintain that these interventions cannot be justified from a libertarian point of view despite of the possible objections that are discussed such as the “potential threat argument”. Moreover, the utilitarian argument in favor of government lockdowns is evaluated. The negative effects of lockdown on mental health, addictions, domestic violence, etc. have to be taken into account. The utilitarian argument in favor of lockdown is far from convincing, as economic calculation is not possible. (shrink)

In their recent article, ‘Why lockdown of the elderly is not ageist and why levelling down equality is wrong’, Savulescu and Cameron argue for selective isolation of the elderly as an alternative to general lockdown. An important part of their argument is the claim that the latter amounts to ‘levelling down equality’ and that this is ‘unethical’ or even ‘morally repugnant’. This response argues that they fail to justify either part of this claim: the claim that levelling down (...) is always morally wrong is subject to challenges that Savulescu and Cameron do not consider; and a policy of maintaining general lockdown does not constitute levelling down, as it provides absolute benefits to those who would be worse off under selective isolation. (shrink)

On 22nd September 2020 the UK Government announced new lockdown restrictions to supress the COVID-19 virus, with some areas of England having more restrictive lockdown guidance. Students in a number of cities have been confined to their halls of residences after outbreaks of COVID-19 and in Manchester security guards were preventing students leaving the buildings. The scientific community are, unsurprisingly, divided over the question of how far lockdowns should extend.1 Monday 21st September 2020 saw the publication of two (...) open letter to the UK government and Chief Medical Officers. One group, Sunetra Gupta et al,2 argued for a selective lockdown targeting the most vulnerable. The other, headed by Trisha Greenhalgh, arguing that attempts to suppress the virus should operate across the whole community.3 As we enter what appears to be a second wave of COVID-19 infections and accompanying lockdown measures, ethical debates over the appropriateness and extent of such measures are critical. Julian Savulescu and James Cameron4 in their article on lockdown of the elderly and why this is not ageist, put forward the case that, ‘an appropriate approach may be to lift the general lockdown but implement selective isolation of the elderly.’ Their central claim is that selective isolation of the elderly is to be preferred to imposing lockdown on all members of society. The aim of lockdown, restricting movement and key activities, is designed to reduce the number of deaths from COVID-19 and also to prevent the healthcare system from becoming overwhelmed. As the elderly are at significantly more risk of having severe cases of COVID-19 and therefore more likely to place demands on healthcare services, they are clearly prime candidates for lockdown measures, measures that will not only benefit them but the whole of society. This is not ageist as …. (shrink)

As many Western countries emerged from initial periods of lockdown in spring 2020, they had brought COVID-19 infection rates down significantly. This was followed, however, with more drastic second and third waves of viral spread, which many of these same countries are struggling to bring under control, even with the implementation of further periods of lockdown. Could this have been prevented by policymakers? We revisit two strategies that were focus of much discussion during the early stages of the (...) pandemic, and which were implemented in several Western countries, albeit in a weakened form. These strategies both proceed by targeting certain segments of the population, while allowing others to go about their lives unhindered. The first suggests selectively isolating those that would most likely suffer severe adverse effects if infected – in particular the elderly. The second involves identifying and quarantining those who are likely to be infected through a contact tracing app that would centrally store users’ information. We suggest that both strategies showed promise in preventing the need for further lockdowns, albeit in a significantly more stringent form than anything that was implemented in Western countries. We then proceed to an ethical evaluation of these more stringent policies. We contend that selective isolation strategies face severe ethical problems due to its discriminatory nature, while the ethical issues with a more aggressive contact tracing regime can be mitigated. This analysis has implications for how to respond effectively and ethically to future pandemics, and perhaps contains lessons on how to successfully emerge from our current predicament. (shrink)

A clear and provocative introduction to the ethics of COVID-19, suitable for university-level students, academics, and policymakers, as well as the general reader. It is also an original contribution to the emerging literature on this important topic. The author has made it available Open Access, so that it can be downloaded and read for free by all those who are interested in these issues. Key features include: -/- A neat organisation of the ethical issues raised by the pandemic. An (...) exploration of the many complex interconnections between these issues. A succinct case for a continued lockdown until we develop a vaccine. An original account of the Deep Moral Problem of the Pandemic, and a Revolutionary Argument for how we should change society post-pandemic. References to, and engagement with, many of the best writings on the pandemic so far (both in popular media and academic journals). -/- ISBN: 978-0-6489016-0-0. (shrink)

Global lockdowns during the COVID-19 pandemic have offered many people first-hand experience of how their daily online activities threaten their digital well-being. This article begins by critically evaluating the current approaches to digital well-being offered by ethicists of technology, NGOs, and social media corporations. My aim is to explain why digital well-being needs to be reimagined within a new conceptual paradigm. After this, I lay the foundations for such an alternative approach, one that shows how current digital well-being initiatives can (...) be designed in more insightful ways. This new conceptual framework aims to transform how philosophers of technology think about this topic, as well as offering social media corporations practical ways to design their technologies in ways that will improve the digital well-being of users. (shrink)

This paper conducts a cost–benefit analysis of Australia’s Covid-19 lockdown strategy relative to pursuit of a mitigation strategy in March 2020. The estimated additional deaths from a mitigation strategy are 11,500 to 40,000, implying a Cost per Quality Adjusted Life Year saved by locking down of at least 11 times the generally employed figure of $100,000 for health interventions in Australia. The lockdowns do not then seem to have been justified by reference to the standard benchmark. Consideration of the (...) information available to the Australian government in March 2020 yields a similar ratio and therefore the same conclusion that lockdown was not warranted. If Australia experiences a new outbreak, and cannot contain it without resort to a nationwide lockdown, the death toll from adopting a mitigation strategy at this point would be even less than had it done so in March 2020, due to the vaccination campaign, lessons learned since March 2020, and because the period over which the virus would then inflict casualties would now be much less than the period from March 2020. This would favour a mitigation policy even more strongly than in March 2020. This approach of assessing the savings in quality adjusted life years and comparing them to a standard benchmark figure ensures that all quality adjusted life years saved by various health interventions are treated equally, which accords with the ethical principle of equity across people. (shrink)

Recent outbreaks in Australia and the detection of more virulent SARS‐CoV‐2 strains suggest that Covid‐19 is not yet over. In July 2021, three states in Australia were in lockdown as a result of community transmission of the Delta variant. Despite being effective at mitigating outbreaks, lockdowns could have adverse effects on the elderly and people with dementia. This commentary reviews general lockdown and aged‐care lockdown policies in Victoria, New South Wales, and South Australia and highlights how these (...) could affect the well‐being of people with dementia and their caregivers. Drawing from literature on Covid‐19 and dementia, this commentary provides pragmatic recommendations on how to consider the well‐being of people with dementia and their care providers in Covid‐19 management policies. (shrink)

This dissertation explores the idea and ethics of vaccination for the sake of others. It conceptually distinguishes four different kinds of vaccination—self-protective, paternalistic, altruistic, and indirect—based on who receives the primary benefits of vaccination and who ultimately makes the vaccination decision. It describes the results of focus group studies that were conducted to investigate what people who might get vaccinated altruistically think of this idea. It also applies the different kinds of vaccination to ethical issues surrounding COVID-19, such as (...) lockdown measures, routine or mandatory vaccination of healthy children, and the ethical justification of restrictive measures for unvaccinated people. A more general philosophical account of vaccination ethics is ultimately developed, which is based not on moral duties, but on the moral reasons that people may have to get vaccinated for the sake of others. It is argued that such reasons may be stronger or weaker, depending on various factors related to the vaccines in question and the specific epidemiological circumstances. (shrink)

Faced with the serious threat of the deadly coronavirus, governments of different nations were swift to respond to the pandemic by declaring national lockdowns. Having confirmed fewer than ten cases of coronavirus that had tested positive, Zimbabwe called for a national lockdown which initially lasted three weeks before declaring it ‘indefinite’. Despite the fact that the lockdown declared in Zimbabwe was in the interest of public health, anecdotal evidence indicates that there has been an inextricable nexus between the (...) lockdown and increased corrupt tendencies. This paper, which is a product of qualitative research, utilised a narrative research approach and documentary analysis to explicate the relationship between Zimbabwe’s coronavirus lockdown and corruption. The paper looks at the different forms of corruption that occurred during the coronavirus lockdown in Zimbabwe and the implication of these on the well-being and welfare of economically vulnerable groups. In conclusion, the paper indicates the role that can be played by pro-human rights professionals such as social workers in the fight against corruption during emergency times to ensure transparency and accountability. (shrink)

In a recent article, ‘Why lockdown of the elderly is not ageist and why levelling down equality is wrong’, Savulescu and Cameron argue that a selective lockdown of older people is not ageist because it would treat people unequally based on morally relevant differences. This response argues that a selective lockdown of older people living in long-term care homes would be unjust because it would allow the expansive liberties of the general public to undermine the basic liberties (...) of older people, and because it would discriminate on the basis of extrinsic disadvantages. (shrink)

This first wave study of the Covid-19 pandemic investigates why the governments of different countries proceeded to lockdown at different speeds. We draw upon the literature on Corporate Governance Institutions (CGIs) to theorize that governments’ decision-making is undertaken in the light of prevailing beliefs, norms, and rules of the collectivity, as portrayed by the focal country’s CGIs, in their effort to maintain legitimacy. In addition, drawing on motivated cognition we posit that the government’s political ideology moderates this relationship because (...) decision-makers are biased when assessing the impact of lockdown on commerce. Running negative binomial regressions on a sample of 125 countries, we find that the more shareholder-oriented the CGIs, the slower the governmental response in shutting down the economy to protect from the pandemic. Moreover, the main relationship is stronger the more right-leaning the government’s ideology. Our study contributes to the research on corporate governance institutions and political ideology and illustrates how societal and ideological biases affect government decision-making, especially when important decisions about public welfare are taken with little information on hand. (shrink)

One consequence of the lockdowns that many countries have introduced in response to the COVID-19 pandemic is that people have become more vulnerable to loneliness. In this contribution, I argue that even if this does not render lockdowns unjustified, it is morally incumbent upon states to make reasonable efforts to protect their residents from loneliness for as long as their social confinement measures remain in place. Without attempting to provide an exhaustive list of ways in which this might be done, (...) I identify four broad measures that I believe many, if not most, states ought to take. These require states to (i) help ensure that people have affordable access to the internet, as well as opportunities for learning how to use this medium so as that they can digitally connect to others; (ii) help people to have harmonious and rewarding intimate relationships; and try to make (iii) non-human companionship as well as (iv) various non-social solutions to loneliness widely available. (shrink)

Before the pandemic, our life was often described as fast, since in globalised society speed has been generally understood as a marker of efficiency, productivity and diligence; and so many people...

Throughout the COVID-19 pandemic, the concept of solidarity has been invoked frequently. Much interest has centred around how citizens and communities support one another during times of uncertainty. Yet, empirical research which accounts and understands citizen’s views on pandemic solidarity, or their actual practices has remained limited. Drawing upon the analysis of data from 35 qualitative interviews, this article investigates how residents in England and Scotland enacted, understood, or criticised (the lack of) solidarity during the first national lockdown in (...) the United Kingdom in April 2020—at a time when media celebrated solidarity as being at an all-time high. It finds that although solidarity was practiced by some people, the perceived lack of solidarity was just as pronounced. We conclude that despite frequent mobilisations of solidarity by policy makers and other public actors, actual practices of solidarity are poorly understood—despite the importance of solidarity for public health and policy. (shrink)

We all now know that the novel coronavirus is anything but a common cold. The pandemic has created many new obligations for all of us, several of which come with serious costs to our quality of life. But in some cases, the guidance and the law are open to a degree of interpretation, leaving us to decide what is the ethical course of action. Because of the high cost of some of the obligations, a conflict of interest can arise between (...) what we want to do and what it is right to do. And so, some people choose to respect only the letter of the law, but not the spirit, or not to respect even the spirit of the guidelines. This paper identifies and describes the new obligations imposed on us all by the pandemic, considers their costs in terms of the good life, and provides an ethical analysis of two personal and two public cases in terms of the letter and spirit of the guidance and legislation. (shrink)

A virtual community is generally described as a group of people with shared interests, ideas, and goals in a particular digital group or virtual platform. Virtual communities have become ubiquitous in recent times, and almost everyone belongs to one or multiple virtual communities. The onset of the COVID-19 pandemic, with its associated national lockdowns, has made virtual communities more essential and a necessary part of our daily lives, whether for work and business, educational purposes or keeping in touch with friends (...) and family. Given these facts, how do we ensure that virtual communities become a true community qua community? We address this question by proposing and arguing for a ‘virtual communitarianism’—an online community that integrates essential features of traditional African communitarianism in its outlook and practice. The paper’s position is that virtual communitarianism can make for a strong ethical virtual community where members can demonstrate a strong sense of group solidarity, care and compassion towards each other. The inclusion of these virtues can bring members who often are farapart and help create a stronger community bond. This will ensure that the evolution of virtual communities does not happen without the integration of progressive African communitarian values. (shrink)

The South African government announced the much-discussed stay-at-home order between March 27 and April 30, 2020, during what was known as lockdown level 5, which meant that citizens were not allowed to leave their homes. The objective of this study is to assess the stay-at-home order against the global principles of the UDBHR. It is deducible that, in reference to the UDBHR, the government possessed the right to curtail individual liberty, thereby not infringing on Article 5 of the UDBHR (...) and therefore, in this context, passes the test of the UDBHR. However, it remains uncertain at present whether the limitation of freedom imposed by the South African stay-at-home order was successful in controlling the spread of COVID-19 and protecting individuals from harm. Initial investigations also indicate that individuals who are particularly vulnerable may not have received equitable treatment in accordance with the principle outlined in Article 10, therefore, it can be cautiously and modestly argued that the stay-at-home order does not withstand scrutiny when assessed against the UDBHR. Given the continued discussion about the efficacy of limiting freedom to control the spread of COVID-19, and the growing conviction that the advancement of justice is being called into question, the notion of least restriction ought to be considered seriously. Ten Have (2022) is correct in asserting that global bioethics should also seriously consider other principles beyond an almost exclusive focus on limiting individual freedom. The preliminary conclusion is that the potential implementation of the stay-at-home order in the future must be seriously reconsidered. (shrink)

A disaster is an occurrence disrupting a community’s normal functioning and existence. The disruption may render it impossible to comply with principles and to respect, protect, and fulfill rights as it happens in ordinary times; it may induce an overwhelming shortage of resources and make tragic decisions unavoidable. From its very beginning, the COVID-19 pandemic evoked the scenario of disaster medicine, where triage is likely to imply not simply postponing a treatment but letting someone die. However, it is not only (...) the health care system that faces disruption risks. Lockdown measures and other restrictions were imposed to curb the pandemic, impinging upon individual freedom as well as economic activities. The proposal of mandatory vaccination implied a suspension of the principle of autonomy, which is a fundamental pillar of modern medicine. Out of the ordinary balancing efforts may be required, and two questions arise. Do such exceptional circumstances suggest reconsidering the criteria to apply, especially when essential, life-saving treatments are at stake? Who should decide? Science offers the premises to build on, but the last word does not belong to science. It remains the province of ethics and politics. (shrink)

By its very nature ethnography is an emergent methodology. To be ethical the ethnographer needs to manage research ethics in-situ. This need to manage ethical dilemmas as they arise often comes into conflict with increased ethical regulation and procedures from ethics review boards that require the researcher to foresee ethical quandaries before data collection commences. These regulations can constrain the emerging purpose of the study, evolving means of data collection and multifaceted ways of interacting with participants that are (...) seen as being the strengths of undertaking an ethnographic approach. 0The chapters in this volume problematise this tension and highlight the importance of managing ethics in-situ by reflecting on recently completed and current projects drawing out ethical dilemmas relating to data ownership, dissemination, representation, social justice and managing ethnographic studies in the midst of a global pandemic and Covid-19 lockdowns. 0Reflecting on these experiences of doing educational ethnography with children and young people, drawing on a diverse range of studies conducted in England, Scotland, South America, India, and the Basque Country, this volume argues that administrative and conceptual change is needed to ensure that ethics does not become a tick box exercise but that ethnographers commit fully to conscientiously managing ethics in-situ. (shrink)

While a significant literature has appeared discussing theoretical ethical concerns regarding COVID-19, particularly regarding resource prioritization, as well as a number of personal reflections on providing patient care during the early stages of the pandemic, systematic analysis of the actual ethical issues involving patient care during this time is limited. This single-center retrospective cohort mixed methods study of ethics consultations during the first surge of the COVID 19 pandemic in Massachusetts between March 15, 2020 through June 15, 2020 aim (...) to fill this gap. Results indicate that there was no significant difference in the median number of monthly consultation cases during the first COVID-19 surge compared to the same period the year prior and that the characteristics of the ethics consults during the COVID-19 surge and same period the year prior were also similar. Through inductive analysis, we identified four themes related to ethics consults during the first COVID-19 surge including (1) prognostic difficulty for COVID-19 positive patients, (2) challenges related to visitor restrictions, (3) end of life scenarios, and (4) family members who were also positive for COVID-19. Cases were complex and often aligned with multiple themes. These patient case-related sources of ethical issues were managed against the backdrop of intense systemic ethical issues and a near lockdown of daily life. Healthcare ethics consultants can learn from this experience to enhance training to be ready for future disasters. (shrink)

This article describes how the COVID-19 pandemic has forced the higher education institutes in developing nations like India to relook at pedagogical approaches. Due to government imposing nationwide lockdown, higher educational institutes were quickly adopting to imbibe online learning medium. This research takes a qualitative thematic analytical approach to explore the facilitators and challenges to online learning from the perspectives of both learners and educators in higher education institutes. We have specifically explored the ethical and social concerns related to (...) online learning and the possible solution for the same. (shrink)

The infection rates of COVID-19 have been exponential in some countries despite the imposition of infectious disease control measures such as lockdowns and physical distancing, which form one of the basic principles of public health and infectious disease control. There have been significant problems with leaders and citizenry deliberately ignoring and not complying with such measures and which have directly resulted in sudden rises in infection numbers. Here, I show the nature and extent of the widespread problem and argue that (...) the problem is in large part due to our modern society characterised by liberal individualism. I apply the philosophy proposed by philosopher Alasdair MacIntrye to show that one key underlying cause of the non-compliant behaviour of citizenry is due to modern liberal individualism that has deprived the modern nation state of the opportunities and authority for it to teach or to dictate what is the common good of the society as a whole to individuals in its community. This is the first time MacIntyre’s philosophy has been applied to public health, and this paper demonstrates the need for ethics education to counter-balance liberal individualism in order to contain and to prevent another pandemic and public health crisis in modern society. (shrink)

The global spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or coronavirus disease 19 (COVID-19) has led to the imposition of severely restrictive measures by governments in the Western hemisphere. We feel a contrast between these measures and our freedom. This contrast, we argue, is a false perception. It only appears to us because we look at the issue through our contemporary moral philosophy of utilitarianism and an understanding of freedom as absence of constraints. Both these views can be (...) substituted with more sophisticated alternatives, namely an ethics of virtue and a notion of freedom of the will. These offer a fuller picture of morality and enable us to cooperate with the current restrictions by consciously choosing to adhere to them instead of perceiving them as draconian and immoral. We ask whether we should collaborate with the restrictions and argue that considerations of virtue will lead to an affirmative answer. More broadly, virtue ethics permits to deal with the practical concerns about how an individual should behave during this pandemic, given the current lockdown measures or lack thereof. -/- In section 1, we present how utilitarianism and a notion of freedom as negative liberty support the opposition to restrictive measures. In section 2, we outline an alternative based on an ethics of virtue and a more elaborated notion of free will. In the concluding section 3, we argue that considerations of virtue should guide the individual and public response to the emergency. (shrink)

The Covid-19 pandemic of 2020/21 has posed old ethical questions in a new and sharper form, as well as given rise to some new ethical issues. In this lecture, I look at the lessons we can learn from five of these issues: the allocation of scarce medical resources; experimenting on humans; setting priorities for vaccination; when lockdowns are justified; and preventing more pandemics.

The economic crash of 2008 demonstrated the fragility of financial systems throughout the world; COVID-19, as the first pandemic in over a century to wreak global havoc, has demonstrated the fragility of healthcare systems. At the time of writing, the virus has been with us for a little over a year, and concerted vaccination efforts have begun. At the same time, several variants (some significantly more infectious than others) of SARS-CoV2, the virus that causes COVID-19, have emerged in different countries, (...) sparking a new wave of border closures and local lockdowns, and a new wave of debates over the right way for governments and individuals alike to respond to the pandemic. The response of governments around the world has been far from synchronised over the last year, but almost without exception, they have made significant efforts to reduce the public health impact of the pandemic – overall, the preservation of life and health has been prioritised at the cost of material and financial goods and other widely used metrics of socio-political success. In this chapter, I suggest that a taking a care ethics perspective allows us to elucidate the important place of caring duties and caring relationships in ethical evaluation of pandemic management strategies. Government action and public attitudes alike demonstrate that care – concern for the wellbeing of others – has had significant normative force in motivating decision-making and shaping ethical responses to COVID-19. (shrink)

In the early months of 2020, the deadly Covid-19 disease spread rapidly around the world. In response, national and regional governments implemented a range of emergency lockdown measures, curtailing citizens’ movements and greatly limiting economic activity. More recently, as restrictions begin to be loosened or lifted entirely, the use of so-called contact tracing apps has figured prominently in many jurisdictions’ plans to reopen society. Critics have questioned the utility of such technologies on a number of fronts, both practical and (...) ethical. However, little has been said about the ways in which the normative design choices of app developers, and the products that result therefrom, might contribute to ethical reflection and wider political debate. Drawing from scholarship in critical design and human–computer interaction, this paper examines the development of a QR code-based tracking app called Zwaai (‘Wave’ in Dutch), where its designers explicitly positioned the app as an alternative to the predominant Bluetooth and GPS-based approaches. Through analyzing these designers’ choices, this paper argues that QR code infrastructures can work to surface a set ofethical–political seams, two of which are discussed here—responsibilizationandnetworked (im)permanence—that more ‘seamless’ protocols like Bluetooth actively aim to bypass, and which may go otherwise unnoticed by existing ethical frameworks. (shrink)

In the context of a public health emergency it is imperative to conduct research studies that will produce evidence rapidly while upholding ethical standards. The Ebola and Zika outbreaks highlighted the importance of devising agile processes for ethics review in emergencies, and international research ethics guidelines stress the duty to depart from standard processes for ethics review in emergency circumstances. However, before the COVID-19 pandemic it was not entirely clear what emergency procedures should look like. An additional (...) challenge is that while the same substantive ethical standards apply in emergency and non-emergency settings, deciding what these standards entail in the specific circumstances of a pandemic may be difficult. During the COVID-19 pandemic, challenges included identifying thresholds of social and scientific value, along with duties towards research participants, given the absence of therapeutic options; assessing continually changing risk–benefit profiles of studies, given rapidly emerging new evidence; developing appropriate informed consent processes, given lockdown scenarios; and even addressing the ethics of offering unproven interventions outside research settings. Additional issues raised during epidemics include devising feasible and meaningful community engagement strategies, mechanisms to ensure fairness in the distribution of the benefits that may result from research, and equitable and effective data-sharing plans that will inform pandemic response. Learning from these procedural and substantive challenges encountered in the ethics review of COVID-19 research is important for enhancing ethics preparedness for future emergencies. It can also potentially contribute to improving the ethics review of research in non-emergency circumstances. The seven cases in this chapter highlight ethical issues associated with ethics approval of multi-centre studies in pandemics, the need for careful consideration of the social and scientific value of research and challenges encountered when interventions are being transitioned from research to rollout, and issues that can arise when existing regulations and policies may limit capacities to appropriately adapt research to pandemic contexts. (shrink)

At the time of writing the COVID-19 pandemic was entering its ninth month, with nearly 800 000 recorded fatalities and 22 million infections in 188 countries and territories.1 In previous ethics briefings2 we raised concerns about the possibility that demand for life-sustaining treatment would overwhelm supply, with a consequent requirement for health professionals to make challenging triage decisions. Fortunately, to date, these have largely not been realised, although there is a possibility that countries in which containment measures have been (...) less-successful, such as South Africa, may still be required to triage.3 Despite the successful ‘flattening of the curve’ in many countries, there is a wide consensus that we remain firmly within the pandemic. Enormous practical challenges remain. It is unclear whether the pandemic will ultimately take the form of two or more successive waves, or whether the patchwork of global responses will lead to a sustained slow ‘burn’ with sporadic flare-ups.4 Areas of uncertainty include whether infection confers some immunity, how long any such immunity might last, whether effective vaccines can be developed and if seasonal temperature fluctuations alter the spread of the virus. The pandemic will also be fundamentally shaped by the decisions that governments make and the extent to which their diktats are complied with by citizens. With the – possibly temporary – retreat of urgent clinical ethics issues, such as triage, opportunities have arisen to reflect on some of the ethical questions that underlie and structure the demanding policy decisions that governments are wrestling with. One of the early questions was how to balance the complex constellation of costs and benefits associated with lockdown. Countries that …. (shrink)

The COVID-19 pandemic has undoubtedly become an era-defining challenge for the entire world. It has implications not only in the public health sector but also in the global economy and political landscape. The prevention strategy that has been followed in Sri Lanka is unique. Early action taken by the government and the ministry of health, being one of pre-emptive quarantining and isolation of suspected contacts even before they developed symptoms, was vital to contain the spread of the disease. During the (...) early phase, a nationwide lockdown in the form of a curfew was imposed which helped mitigate the spread of the virus. However, due to several lapses, there was a threat of community transmission; this was swiftly brought under control through ongoing government interventions. Thus, strict social/physical distancing measures enforced by the government, together with an increase in testing capacity, prevented widespread community transmission. Strictly containing the outbreaks as and when they were identified made it easier to bring the spread under control through contact tracing. In this article, we give an account of the strategy taken by Sri Lanka to mitigate the pandemic and comment on the lessons learned concerning the ethical responses to the COVID-19 crisis. (shrink)

COVID-19 vaccines are likely to be scarce for years to come. Many countries, from India to the U.K., have demonstrated vaccine nationalism. What are the ethical limits to this vaccine nationalism? Neither extreme nationalism nor extreme cosmopolitanism is ethically justifiable. Instead, we propose the fair priority for residents framework, in which governments can retain COVID-19 vaccine doses for their residents only to the extent that they are needed to maintain a noncrisis level of mortality while they are implementing reasonable public (...) health interventions. Practically, a noncrisis level of mortality is that experienced during a bad influenza season, which society considers an acceptable background risk. Governments take action to limit mortality from influenza, but there is no emergency that includes severe lockdowns. This “flu-risk standard” is a nonarbitrary and generally accepted heuristic. Mortality above the flu-risk standard justifies greater governmental interventions, including retaining vaccines for a country's own citizens over global need. The precise level of vaccination needed to meet the flu-risk standard will depend upon empirical factors related to the pandemic. This links the ethical principles to the scientific data emerging from the emergency. Thus, the FPR framework recognizes that governments should prioritize procuring vaccines for their country when doing so is necessary to reduce mortality to noncrisis flu-like levels. But after that, a government is obligated to do its part to share vaccines to reduce risks of mortality for people in other countries. We consider and reject objections to the FPR framework based on a country: having developed a vaccine, raising taxes to pay for vaccine research and purchase, wanting to eliminate economic and social burdens, and being ineffective in combating COVID-19 through public health interventions. (shrink)

That they are ‘following the science’ has become the watchword of many politicians during the present pandemic, especially when imposing or prolonging lockdowns or other liberty-restricting regulations. The scientists who advise politicians however are usually careful to add that the decision what to restrict and when is ultimately a political one. In science, as in medical practice, there is a delicate balance to be maintained between confidence in the best available information, and the necessary caveat that the assumptions and calculations (...) on which that information is based are subject to further scientific enquiry. For politicians and the public, moreover, as for patients, whether those informing them are judged to be trustworthy is a necessary consideration, a judgement determined by a variety of personal and political contingencies and circumstances. Ethics, by contrast, unable to appeal to scientific consensus or political authority, let alone a confidence-inspiring bedside manner, must rest the case for its essentially contestable assumptions and arguments being judged trustworthy, on its willingness to admit all reasoned voices to a conversation that is potentially unending, but in the process often highly enlightening. That conversation is contributed to in this issue of the Journal by several reasoned voices, mostly on ethical aspects of the COVID-19 pandemic. Relevant to issues on which politicians claim to be ‘following the science’, but also raising fundamental ethical questions, is this month’s feature article. In Ethics of Selective Restriction of Liberty in a Pandemic, 1 Cameron and colleagues consider ‘if and when it may be ethically acceptable to impose selective liberty-restricting measures in order to reduce the negative impacts of a pandemic by preventing particularly vulnerable groups [for example, the elderly in COVID-19] of the community from contracting the disease’ [and thereby, for example, increasing …. (shrink)