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)

A COVID-19 vaccine mandate is being introduced for health and social care workers in England, and those refusing to comply will either be redeployed or have their employment terminated. We argue th...

This article discusses the triage response to the COVID-19 delta variant surge of 2021. One issue that distinguishes the delta wave from earlier surges is that by the time it became the predominant strain in the USA in July 2021, safe and effective vaccines against COVID-19 had been available for all US adults for several months. We consider whether healthcare professionals and triage committees would have been justified in prioritising patients with COVID-19 who are vaccinated above those (...) who are unvaccinated in first-order or second-order triage. Given that lack of evidence for a correlation between short-term survival and vaccination, we argue that using vaccination status during first-order triage would be inconsistent with accepted triage standards. We then turn to notions of procedural fairness, equity and desert to argue that that there is also a lack of justification for using vaccination status in second-order triage. In planning for future surges, we recommend that medical institutions base their triage decisions on principles meant to save the most lives, minimise inequity and protect the public’s trust, which for the time being would not be served by the inclusion of vaccination status. (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)

The rare but severe cerebral venous thrombosis occurring in some AstraZeneca vaccine recipients has prompted some governments to suspend part of their COVID-19 vaccination programmes. Such suspensions have faced various challenges from both scientific and ethical angles. Most of the criticisms against such suspensions follow a consequentialist approach, arguing that the suspension will lead to more harm than benefits. In this paper, I propose a rights-based argument against the suspension of the vaccine rollouts amid this highly time-sensitive combat of (...) COVID-19. I argue that by suspending a vaccine rollout, a government infringes people's right to take the risks they deem worth taking for their health. I also consider four potential objections to my argument and explain why none of them undermines my argument. (shrink)

ABSTRACTThis article addresses the question of whether certain experiences that originate in causes other than bereavement are properly termed ‘grief’. To do so, we focus on widespread experiences of grief that have been reported during the Covid-19 pandemic. We consider two potential objections to a more permissive use of the term: grief is, by definition, a response to a death; grief is subject to certain norms that apply only to the case of bereavement. Having shown that these objections are (...) unconvincing, we sketch a positive case for a conception of grief that is not specific to bereavement, by noting some features that grief following bereavement shares with other experiences of loss. (shrink)

During the Covid-19 pandemic, public policy was not driven by findings from public health research, but by politicians’ desire to pursue their own interests. The media and politicians inflamed mass hysteria and then imposed ill-considered lockdowns to “solve” the problem. Lockdowns not only failed to protect those at risk from the virus, but also caused enormous collateral damage. Public choice theory helps explaining this decision-making. -/- .

The COVID-19 crisis opened up discussions on using online tools and platforms for academic work, e.g. for research (management) events that were originally designed as face-to-face interactions. As social scientists working in the domain of responsible research and innovation (RRI), we draft this paper to open up a dialogue on Responsible online Research and Innovation (RoRI), and deliberate particular socioethical opportunities and challenges of the onlineification in collaborative theoretical and empirical research. An RRI-inspired ‘going online’ approach would mean, we (...) suggest, trying to make academic events and research activities more inclusive, researchers’ attitude to their work more reflective and suggest processes that are more responsive to societal needs and ethical concerns. For such systematic reflection, we suggest using the RRI-heuristic provided by Owen et al., and applying the dimensions of ‘Anticipation, Inclusion, Reflection and Responsiveness’ (AIRR) in order to identify and reflect on the dilemmas involved in ‘going online’ in one’s research. (shrink)

Previous research has shown that women are disproportionately negatively affected by a variety of socio-economic hardships, many of which COVID-19 is making worse. In particular, because of gender roles, and because women’s jobs tend to be given lower priority than men’s (since they are more likely to be part-time, lower-income, and less secure), women assume the obligations of increased caregiving needs at a much higher rate. This unfairly renders women especially susceptible to short- and long-term economic insecurity and decreases (...) in wellbeing. Single-parent households, the majority of which are headed by single mothers, face even greater risks. These vulnerabilities are further compounded along the dimensions of race, ethnicity, class, and geography. Drawing upon the philosophical literature on political responsibility and structural injustice (specifically, the work of Iris Marion Young), I argue that while the state may not have had either foresight into, or control over, the disproportionate effect the pandemic would have on women, it can nonetheless be held responsible for mitigating these effects. In order to do so, it must first recognize the ways in which women have been affected by the outbreak. Specifically, policies must take into account the unpaid labor of care that falls on women. Moreover, given that this labor is particularly vital during a global health pandemic, the state ought to immediately prioritize the value of this work by providing financial stimuli directly to families, requiring employers to provide both sick leave and parental leave for at least as long as schools and daycares are inoperational, and providing subsidized emergency childcare. (shrink)

As governments around the world imposed lockdowns or stay-at-home measures, people began to feel the stress as time dragged on. There were already reports on some individuals committing suicide. How do governments respond to such a phenomenon? Our main focus is the Philippine government and how it responded to the COVID-19 pandemic. In this paper, we argue that the problem with COVID-19 went forth just dealing with physical health. First, people suffer not just from being infected but the (...) psychological stress of possibly getting the virus and the toll of the government lockdown or quarantine. Second, the Philippine Bayanihan ‘We Heal As One Act’ lacks focus on mental health issues while the government's response seemed to focus on security issues. Third, there are countries around the world that have acted effectively in protecting people’s mental health. Lastly, we propose appropriate measures to help address the people's mental health while still in the pandemic and for a future one. (shrink)

Bioethics, Volume 36, Issue 6, Page 687-698, July 2022.

La pandemia de la COVID-19 ha recordado la importancia de prevenir y planificarse ante eventos altamente desastrosos para la salud comunitaria. Varios fenómenos emergentes suponen amenazas prospectivas para la Salud Pública. Sin embargo, el carácter mayormente futuro de problemas como la resistencia antibiótica, el impacto del cambio climático en la salud o la bioingeniería de patógenos genera dificultades de análisis. ¿Cuáles son los desafíos éticos y epistemológicos que suscitan los problemas futuros para la Salud Pública? ¿Cómo deben abordarse los (...) problemas morales de escenarios futuros, potencialmente catastróficos? En este artículo se defiende la necesidad de adoptar enfoques éticos anticipativos desde la ética de la Salud Pública. En primer lugar, se argumentará que el abordaje de estos problemas futuros requiere reflexionar sobre el futuro como problema ético y epistémico. En segundo lugar, se analizarán las características de la incipiente ética anticipatoria en los ámbitos de la ética de la tecnología y la bioética. En tercer lugar, se defenderá la aplicación de metodologías de previsión y anticipación en debates sobre la ética de la Salud Pública. Finalmente, se ofrecerán algunas reflexiones para fortalecer los análisis normativos anticipativos a fin de prevenir y atajar de antemano los efectos adversos de las futuras crisis sanitarias. (shrink)

BackgroundAs the COVID-19 pandemic develops, healthcare professionals are looking for support with, and guidance to inform, the difficult decisions they face. In the absence of an authoritative national steer in England, professional bodies and local organisations have been developing and disseminating their own ethical guidance. Questions inevitably arise, some of which are particularly pressing during the pandemic, as events are unfolding quickly and the field is becoming crowded. My central question here is: which professional ethical guidance should the professional (...) follow?Main bodyAdopting a working definition of “professional ethical guidance”, I offer three domains for a healthcare professional to consider, and some associated questions to ask, when determining whether – in relation to any guidance document – they should “bin it or pin it”. First, the professional should consider the source of the guidance: is the issuing body authoritative or, if not, at least sufficiently influential that its guidance should be followed? Second, the professional should consider the applicability of the guidance, ascertaining whether the guidance is available and, if so, whether it is pertinent. Pertinence has various dimensions, including whether the guidance applies to this professional, this patient and/or this setting, whether it is up-to-date, and whether the guidance addresses the situation the professional is facing. Third, the professional should consider the methodology and methods by which the guidance was produced. Although the substantive quality of the guidance is important, so too are the methods by which it was produced. Here, the professional should ask whether the guidance is sufficiently inclusive – in terms of who has prepared it and who contributed to its development – and whether it was rigorously developed, and thus utilised appropriate processes, principles and evidence.ConclusionAsking and answering such questions may be challenging, particularly during a pandemic. Furthermore, guidance will not do all the work: professionals will still need to exercise their judgment in deciding what is best in the individual case, whether or not this concerns COVID-19. But such judgments can and should be informed by guidance, and hopefully these preliminary observations will provide some useful pointers for time-pressed professionals. (shrink)

Is there such a thing as corona solidarity? Does voluntary mutual aid solve the problems caused by COVID-19? I argue that the answer to the first question is “yes” and to the second “no.” Not that the answer to the second question could not, in an ideal world, be “yes,” too. It is just that in this world of global capitalism and everybody looking out for themselves, the kind of communal warmth celebrated by the media either does not actually (...) exist or is too weak to rule out the uglier manifestations of group togetherness, driven partly by the pandemic. I make my point by offering two approaches to understanding what solidarity is. According to the first, it is essentially partiality: “us” against “them.” According to the second, it can be many things, including the impartial promotion of the good of others. I show that the second reading would make it possible for mutual aid to solve the problems caused by COVID-19 and other crises. This would happen at the expense of conceptual clarity, but that is a minor concern. The major concern is that the more natural manifestations of group togetherness are incited by negative feelings. This is par for the course within the narrower reading of solidarity, but it means that the potentially positive ideas of identity, care, communal values, and special relations are displayed in violent confrontation instead of a calm recognition of the threats that most of us face together. (shrink)

The article entitled “Post-COVID-19: Education and Thai Society in Digital Era” has two objectives: 1) to study digital technology 2) to study the living life in Thailand in the digital era after COVID-19 pandemics. According to the study, it was found that the new digitized service is a service process on digital platforms such as ordering food, hailing a taxi, and online trading. It is a service called via smartphone. The information is used digitally. Public relations, digital marketing, (...) and living in cyberspace play an increasingly digital role. People have communication skills, use Line, Facebook, social media, have tools to search for knowledge, learn and improve themselves. People in the new era of life have a new way of life therefore there is social life in the cyber world. There should be ethics, attitudes, values, and click-on images that are linked to digital use. For a good time life, It is important to have digital intelligence (Digital Quotient) to live after post-COVID19, the digital era. (shrink)

This article aims to highlight the healthcare issues raised by COVID-19 in Pakistan’s scenario. Initially, Pakistan lacked “standard operating procedures,” and the government had to ship testing kits from China and Japan. Moreover, due to violations of the lockdown and standard operating procedures (SOPs), the rapidly increasing number of cases created a burden on the healthcare system. More and more, this pandemic and its impact have grown. As vaccine development has not been successful yet, “herd immunity” can only be (...) achieved if about three quarters of the population contract the virus—requiring immuno￾compromised citizens to be sacrificed for the sake of the country. Moreover, Pakistan has limited testing capacity, so most COVID-19 tests are missing their mark even as the virus spreads. The current scenario is also raising several concerns about the capacity of the government to tackle the prevailing healthcare crisis. In this regard, healthcare professionals suggest that the government must act responsibly to ensure better security provided to healthcare professionals. Identifying suspected cases, introducing personal protective equipment, and taking administrative measures to ensure that better security is provided to healthcare professionals are the needs of the hour to improve outcomes of COVID-19 patients. Testing, tracking, and lockdowns must be focused on areas where clusters are detected. The healthcare professionals must be given utmost protection before this pan￾demic could wreak havoc in terms of fatalities. Investing in the chronically underfunded healthcare system is needed, so that Pakistan can build capacity to fight the pandemic. (shrink)

COVID-19-related controversies concerning the allocation of scarce resources, travel restrictions, and physical distancing norms each raise a foundational question: How should authority, and thus responsibility, over healthcare and public health law and policy be allocated? Each controversy raises principles that support claims by traditional wielders of authority in “federal” countries, like federal and state governments, and less traditional entities, like cities and sub-state nations. No existing principle divides “healthcare and public law and policy” into units that can be allocated (...) in intuitively compelling ways. This leads to puzzles concerning (a) the principles for justifiably allocating “powers” in these domains and (b) whether and how they change during “emergencies.” This work motivates the puzzles, explains why resolving them should be part of long-term responses to COVID-19, and outlines some initial COVID-19-related findings that shed light on justifiable authority allocation, emergencies, emergency powers, and the relationships between them. (shrink)

Governmental reactions to crises like the COVID-19 pandemic can be seen as ethics communication. Governments can contain the disease and thereby mitigate the detrimental public health impact; allow the virus to spread to reach herd immunity; test, track, isolate, and treat; and suppress the disease regionally. An observation of Sweden and Finland showed a difference in feasible ways to communicate the chosen policy to the citizenry. Sweden assumed the herd immunity strategy and backed it up with health utilitarian arguments. (...) This was easy to communicate to the Swedish people, who appreciated the voluntary restrictions approach and trusted their decision makers. Finland chose the contain and mitigate strategy and was towards the end of the observation period apparently hesitating between suppression and the test, track, isolate, and treat approach. Both are difficult to communicate to the general public accurately, truthfully, and acceptably. Apart from health utilitarian argumentation, something like the republican political philosophy or selective truth telling are needed. The application of republicanism to the issue, however, is problematic, and hiding the truth seems to go against the basic tenets of liberal democracy. (shrink)

This article approaches the COVID-19 pandemic as an inherently antagonistic phenomenon. To do so, it carries forward the philosophical contentions that Žižek outlines in his Pandemic! COVID-19 Shakes the World, as well as his wider work. With reference to the parallax Real and McGowan’s Hegelian contradiction, it is demonstrated that Žižek’s philosophical premises hold a unique importance in politically confronting COVID-19. Indeed, by drawing specific attention to the various ways in which our confrontations with the Real expose (...) the limitations of our socio-ideological orders, it is argued that it is in these very limitations that the limits of the Real are transposed through the various “fictions” we employ to fight and perceive it. In outlining this confrontation, a focused discussion on the Real as “impossible” – a “characteristic” that affords an important political significance for the present context and its ongoing limitations – is provided. In conclusion, if the COVID-19 pandemic demands a new “commons”, and if our response to the crisis should be one where the desires of the nation-state are regulated and controlled, then, it may not simply be enough that we “demand the impossible”. Instead, it is today that the impossible demands a new “us”. (shrink)

COVID-19 continues to dominate 2020 and is likely to be a feature of our lives for some time to come. Given this, how should health systems respond ethically to the persistent challenges of responding to the ongoing impact of the pandemic? Relatedly, what ethical values should underpin the resetting of health services after the initial wave, knowing that local spikes and further waves now seem inevitable? In this editorial, we outline some of the ethical challenges confronting those running health (...) services as they try to resume non-COVID-related services, and the downstream ethical implications these have for healthcare professionals’ day-to-day decision making. This is a phase of recovery, resumption and renewal; a form of reset for health services.1 This reset phase will define the ‘new normal' for healthcare delivery, and it offers an opportunity to reimagine and change services for the better. There are difficulties, however, healthcare systems are already weakened by austerity and the first wave of COVID-19 and remain under stress as the pandemic continues. The reset period is operating alongside, rather than at the end, of the pandemic and this creates difficult ethical choices. ### Balancing the greater good with individual care Pandemics—and public health emergencies more generally—reinforce approaches to ethics that emphasise or derive from the interests of communities, rather than those grounded in the claims of the autonomous individual. The response has been to draw on more public health focused ethics, ‘if demand outstrips the ability to deliver to existing standards, more strictly utilitarian considerations will have to be applied, and decisions about how to meet the individual's need will give way to decisions about how to maximise overall benefit’.2 Alongside this, effective …. (shrink)

The modern ethical framework demands informed consent for research participation that includes disclosure of material information, as well as alternatives. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic (COVID-19) results in illness that often involves rapid deterioration. Despite the urgent need to find therapy, obtaining informed consent for COVID-19 research is needed. The current pandemic presents three types of challenges for investigators faced with obtaining informed consent for research participation: (1) uncertainty over key information to informed consent, (...) (2) time and pressure constraints, and (3) obligations regarding disclosure of new alternative therapies and re-consent. To mitigate consenting challenges, primary investigators need to work together to jointly promote urgent care and research into COVID-19. Actions they can take include (1) prior plan addressing ways to incorporate clinical research into clinical practice in emergency, (2) consider patients vulnerable with early deliberation on the consent process, (3) seek Legally Authorized Representatives (LARs), (4) create a collaborative research teams, (5) aim to consent once, despite evolving information during the pandemic, and (6) aim to match patients to a trial that will most benefit them. The COVID-19 pandemic both exacerbates existing challenges and raises unique obstacles for consent that require forethought and mindfulness to overcome. While research teams and clinician-investigators will need to be sensitive to their own contexts and adapt solutions accordingly, they can meet the challenge of obtaining genuinely informed consent during the current pandemic. (shrink)

The role of bioethicists amidst crises like the COVID-19 pandemic is not well defined. As professionals in the field, they should respond, but how? The observation of the early days of pandemic confinement in Finland showed that moral philosophers with limited experience in bioethics tended to apply their favorite theories to public decisions, with varying results. Medical ethicists were more likely to lend support to the public authorities by soothing or descriptive accounts of the solutions assumed. These are approaches (...) that Tuija Takala has called the firefighting and window dressing models of bioethics. Human rights lawyers drew attention to the flaws of the government’s regulative thinking. Critical bioethicists offered analyses of the arguments presented and the moral and political theories that could be used as the basis of good and acceptable decisions. (shrink)

In the ongoing pandemic, death statistics influence people’s feelings and government policy. But when does COVID-19 qualify as the cause of death? As philosophers of medicine interested in conceptual clarification, we address the question by analyzing the World Health Organization’s rules for the certification of death. We show that for COVID-19, WHO rules take into account both facts and values.

Resumen: La rápida proliferación de la pandemia del Covid-19 por todo el mundo, trajo consigo una suerte de despertar respecto de las producciones teóricas y/o científicas en el terreno de las Ciencias Sociales y Humanidades. Según el Coronavirus Resource Center de la John Hopkins University al día 04 de mayo se registran un total de 6.570.362 de casos confirmados de contagio y pérdidas humanas a nivel mundial de un total de 387.634. Ahora bien, desde temprana data en el contexto (...) pandémico emergieron una amplia gama de documentos desde los diferentes saberes y/o disciplinas, en muchos casos llegaban a ser incluso contradictorios entre sí. En este sentido, uno de los análisis que generó una gran ola de críticas y comentarios fue el libro “¡Pandemia!: El covid-19 sacude al mundo”. En el presente artículo nos introduciremos en el libro del filósofo esloveno Slavoj Žižek para extrapolar sus reflexiones, correspondientes a un prisma psicoanalítico-filosófico al contexto latinoamericano. Palabras Clave: Covid-19; Latinoamérica; Pandemia; Slavoj Žižek.: The rapid proliferation of the Covid-19 pandemic throughout the world brought with it a kind of awakening with respect to theoretical and / or scientific productions in the field of Social Sciences and Humanities. According to the Coronavirus Resource Center of John Hopkins University, as of May 4, a total of 6,570,362 confirmed cases of contagion and human loss have been registered worldwide, out of a total of 387,634. Now, from an early date in the pandemic context, a wide range of documents emerged from different knowledge and / or disciplines, in many cases even contradictory. In this sense, one of the analyzes that generated a great wave of criticism and comments was the book "Pandemic!: The covid-19 shakes the world." In this article we will introduce ourselves in the book of the Slovenian philosopher Slavoj Žižek to extrapolate his reflections, corresponding to a psychoanalytic-philosophical prism to the Latin American context. Key Words: Covid-19; Latin America; Pandemic; Slavoj Žižek. (shrink)

Trans healthcare and thus trans people have been severely affected by the COVID-19 pandemic. Trans people’s healthcare situations have turned out to be so vulnerable in this crisis because they have been precarious to begin with. There are multiple ways in which trans healthcare has been affected: Surgeries and other procedures have been cancelled or postponed, and mental health services have been paused or moved online. This raises ethical questions around discrimination against trans people in the healthcare system. This (...) article argues that cancelling trans surgeries and procedures in the COVID-19 crisis is made possible through an understanding of trans healthcare as non-essential. The article explores how trans healthcare in particular has been affected by the pandemic. (shrink)

COVID-19 pandemic has claimed thousands of lives around the world. Among the casualties are doctors, nurses, and other health care professionals. Those who defy the danger of death and continue to render their services have to deal with psychological and mental stress due to the lack of protective measures and equipment, the overwhelming number of patients, and the experience of discrimination. In fact, some left their job. In this paper, I will argue that the motivation of health care professionals (...) and the outcome of their sacrifices, as against assuring personal safety, can be explained by the principle of the common good. First, they are faithful to their oath as health care professionals since it is their commitment as part of an institution that assumes the responsibility of providing health care to people in need. Second, restoring the patients’ condition goes beyond health issues since the recovery of each COVID-19 patient diminishes the spread of the virus, which, if not for the care of HCPs, could worsen the situation with snowballing consequences to society as a whole. While it is expected for any health care professional as a frontliner in times of pandemic, their motivation to serve exemplifies the greater value for the common good. (shrink)

In general, existential threats are those that may potentially result in the extinction of the entire human species, if not significantly endanger its living population. Among the said threats include, but not limited to, pandemics and the impacts of a technological singularity. As regards pandemics, significant work has already been done on how to mitigate, if not prevent, the aftereffects of this type of disaster. For one, certain problem areas on how to properly manage pandemic responses have already been identified, (...) like the following: (a) not being able to learn from previous experiences, (b) the inability to act on warning signals, and (c) the failure to reach a global consensus on a problem (i.e., in a timely manner). In terms of a singularity, however, it may be said that further research is still needed, specifically on how to aptly respond to its projected negative outcomes. In this paper, by treating the three problem areas noted above as preliminary assessment measures of a country’s capacity to coordinate a national response to large-scale disasters, we examine the readiness of the Philippines in preparing for an intelligence explosion. By citing certain instances of how the said country, specifically its national government, faced the coronavirus disease 2019 pandemic, it puts forward the idea that the likely Philippine disaster response towards a singularity needs to be worked on, appealing for a more comprehensive assessment of such for a more informed response plan. (shrink)

The COVID-19 pandemic has demonstrated how different (even conflicting) interventions on nature can be scientifically justified: interventions can be deemed "effective" only in relation to specific target variables - in relation to variables the values of which we seek to control. Choosing the "right" target variables, in turn, depends on our values and pragmatic aims. This essay is based on a presentation given at the symposium "Multidisciplinary Perspectives on the COVID-19 Pandemic", organised at the Helsinki Collegium for Advanced (...) Studies on 16 June 2020. (shrink)

Mobile applications are increasingly regarded as important tools for an integrated strategy of infection containment in post-lockdown societies around the globe. This paper discusses a number of questions that should be addressed when assessing the ethical challenges of mobile applications for digital contact-tracing of COVID-19: Which safeguards should be designed in the technology? Who should access data? What is a legitimate role for “Big Tech” companies in the development and implementation of these systems? How should cultural and behavioural issues (...) be accounted for in the design of these apps? Should use of these apps be compulsory? What does transparency and ethical oversight mean in this context? We demonstrate that responses to these questions are complex and contingent and argue that if digital contract-tracing is used, then it should be clear that this is on a trial basis and its use should be subject to independent monitoring and evaluation. (shrink)

This critical essay evaluates the potential integration of distinct kinds of expertise in policymaking, especially during situations of critical emergencies, such as the COVID-19 pandemic. This article relies on two case studies: herd immunity and restricted access to ventilators for disabled people. These case studies are discussed as examples of experts’ recommendations that have not been widely accepted, though they were made within the boundaries of expert epistemic authority. While the fundamental contribution of biomedical experts in devising public health (...) policies during the COVID-19 pandemic is fully recognized, this paper intends to discuss potential issues and limitations that may arise when adopting a strict expert-based approach. By drawing attention to the interests of minorities, the paper also claims a broader notion of “relevant expertise.” This critical essay thus calls for the necessity of wider inclusiveness and representativeness in the process underlying public health policymaking. (shrink)

Nearly 400 million adults have been vaccinated against COVID-19. Children have been excluded from the vaccination programmes owing to their lower vulnerability to COVID-19 and to the special protections that apply to children’s exposure to new biological products. WHO guidelines and national laws focus on medical safety in the process of vaccine approval, and on national security in the process of emergency authorisation. Because children suffer much from social distancing, it is argued that the harms from containment measures (...) should be factored in a broader perspective on the good of the child. Considering the available knowledge on the disease, vaccine, and coping strategies, the decision about vaccine access to children is a public responsibility. The ultimate choice is a matter of paediatric informed consent. Moreover, jurisdictions that permit non-participation in established childhood vaccination programmes should also permit choice of vaccines outside of the approved programmes. Even if vaccine supply is too short to cover the paediatric population, the a priori exclusion of children is unjust. It may also exacerbate local and global inequalities. The second part of the paper delineates a prudent and ethical scheme for gradual incorporation of minors in vaccination programmes that includes a rigorous postvaccination monitoring. This is a theoretical paper in ethics that uses the Pfizer vaccine as a stock example, without discussing possible differences among existing vaccines. The key purpose is reflection on the good of the child in emergencies and vaccine policymaking. All data relevant to the study are included in the article and in its refernces. (shrink)

In many countries, the COVID-19 pandemic led to a period of lockdown that impacted individuals’ lifestyles, in both professional and personal spheres. New problems and challenges arose, as well as opportunities. Numerous studies have examined the negative effects of lockdown measures, but few have attempted to shine light on the potential positive effects that may come out of these measures. We focused on one particular positive outcome that might have emerged from lockdown: creativity. To this end, this paper compared (...) self-reported professional creativity and everyday creativity before and during lockdown, using a questionnaire-based study conducted on a French sample. We expected participants to be more creative during than prior to lockdown, in both professional and everyday spheres. Regarding Pro-C, we did not see any significant differences between the two comparison points, before and during lockdown. Regarding everyday creativity, we observed a significant increase during lockdown. Furthermore, our results suggest that participants with a lower baseline creativity benefited more from the situation than those with a higher initial baseline creativity. Our results provide new insights on the impact of lockdown and its positive outcomes. These measures may have inarguably negative consequences on the physical and mental health of many, but their positive impact exists as well. (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)

Home, digital technologies and data are intersecting in new ways as responses to the COVID-19 pandemic emerge. We consider the data practices associated with COVID-19 responses and their implications for housing and home through two overarching themes: the notion of home as a private space, and digital technology and surveillance in the home. We show that although home has never been private, the rapid adoption and acceptance of technologies in the home for quarantine, work and study, enabled by (...) the pandemic, is rescripting privacy. The acceleration of technology adoption and surveillance in the home has implications for privacy and potential discrimination, and should be approached with a critical lens. (shrink)

The pandemic caused by the SARS-CoV2 novel coronavirus is creating a global crisis. There is a global ambience of uncertainty and anxiety. In addition, nations have imposed strict and restrictive public health measures including lockdowns. In this heightened time of vulnerability, public cooperation to preventive measures depends on trust and confidence in the health system. Trust is the optimistic acceptance of the vulnerability in the belief that the health system has best intentions. On the other hand, confidence is assessed based (...) on previous experiences with the health system. Trust and confidence in the health system motivate people to accept the public health interventions and cooperate with them. Building trust and confidence therefore becomes an ethical imperative. This article analyses the COVID-19 pandemic in the south Indian state of Tamil Nadu and the state’s response to this pandemic. Further, it applies the Trust-Confidence-Cooperation framework of risk management to analyse the influence of public trust and confidence on the Tamil Nadu health system in the context of the preventive strategies adopted by the state. Finally, the article proposes a six-pronged strategy to build trust and confidence in health system functions to improve cooperation to pandemic containment measures. (shrink)

The novel coronavirus has not only brought along disruptions to daily socio-economic activities, but sickness and deaths due to its high contagion. With no widely acceptable pharmaceutical cure, the best form of prevention may be precautionary measures which will guide against infections and curb the spread of the disease. This study explored the relationship between COVID-19 knowledge, risk perception, and precautionary behavior among Nigerians. The study also sought to determine whether this relationship differed for men and women. A web-based (...) cross-sectional design approach was used to recruit 1,554 participants from all geopolitical zones in Nigeria, through social media platforms using a snowball sampling technique. Participants responded to web-based survey forms comprising demographic questions and adapted versions of the Ebola knowledge scale, SARS risk perception scale, and precautionary behavior scale. Moderated mediation analysis of the data showed that risk perception mediated the association between COVID-19 knowledge and precautionary behavior and this indirect effect was in turn moderated by gender. Results indicate that having adequate knowledge of COVID-19 was linked to higher involvement in precautionary behavior through risk perception for females but not for males. It was also noted that awareness campaigns and psychological intervention strategies on COVID-19 related activities may be particularly important for males more than females. Drawing from the health belief model, we recommend that COVID-19 awareness campaigns should target raising more awareness of the risks associated with the infection to make individuals engage more in precautionary behaviors. (shrink)

The Covid-19 pandemic has fuelled indignation. People have been indignant about the breaking of lockdown rules, about the mistakes and deficiencies of government pandemic policies, about enforced mask-wearing, about vaccination programmes (or lack thereof), about lack of care with regards vulnerable individuals, and more. Indeed, indignation seems to have been particularly prevalent on social media platforms such as Twitter and Facebook, where indignant remarks are often accompanied by variations on the hashtag #WTF?! In this paper, I explore indignation’s distinctive (...) character as a form of moral anger, in particular suggesting that what is characteristic of indignation is not only that it discloses moral injustices but betrays our disbelief at the very occurrence of the offence. Having outlined the character of indignation, I consider how the structure of indignation impacts how we do, respond to, and receive indignation. I explore indignation in action, so to speak, in the context of Covid-19, with a particular emphasis on how indignation occurs ‘on the internet’. (shrink)

The World Health Organization has declared a world pandemic due to COVID-19. In response, most affected countries have enacted measures involving compulsory confinement and restrictions on free movement, which likely influence citizens' lifestyles. This study investigates changes in health risk behaviors with duration of confinement. An online cross-sectional survey served to collect data about the Spanish adult population regarding health behaviors during the first 3 weeks of confinement. A large sample of participants from all Spanish regions completed the survey. (...) Binomial logistic regressions adjusted for socioeconomic characteristics, body mass index, previous HRBs, and confinement context were conducted to investigate associations between the number of weeks confined and a set of six HRBs. When adjusted, we observed significantly lower odds of experiencing a higher number of HRBs than before confinement overall in a time-dependent fashion: OR 0.63; 95% CI: 0.49–0.81 for the second and OR 0.47; 95% CI: 0.36–0.61 for the third week of confinement. These results were equally consistent in all age and gender subgroup analyses. The present study indicates that changes toward a higher number of HRBs than before confinement, as well as the prevalence of each HRB except screen exposure, decreased during the first 3 weeks of COVID-19 confinement, and thus the Spanish adult population may have adapted to the new situational context by gradually improving their health behaviors. (shrink)

John Rawls begins a Theory of Justice with the observation that 'Justice is the first virtue of social institutions, as truth is of systems of thought… Each person possesses an inviolability founded on justice that even the welfare of society as a whole cannot override'1. The COVID-19 pandemic has resulted in lock-downs, the restriction of liberties, debate about the right to refuse medical treatment and many other changes to the everyday behaviour of persons. The justice issues it raises are (...) diverse, profound and will demand our attention for some time. How we can respect the Rawlsian commitment to the inviolability of each person, when the welfare of societies as a whole is under threat goes to the heart of some of the difficult ethical issues we face and are discussed in this issue of the Journal of Medical Ethics. The debate about ICU triage and COVID-19 is quite well developed and this journal has published several articles that explore aspects of this issue and how different places approach it.2–5 Newdick et al add to the legal analysis of triage decisions and criticise the calls for respecting a narrow conception of a legal right to treatment and more detailed national guidelines for how triage decisions should be made.6 They consider scoring systems for clinical frailty, organ failure assessment, and raise some doubts about the fairness of their application to COVID-19 triage situations. Their argument seems to highlight instances of what is called the McNamara fallacy. US Secretary of Defense Robert McNamara used enemy body counts as a measure …. (shrink)

The COVID-19 pandemic has both highlighted and exacerbated global health inequities, leading for calls for responses to COVID to promote social justice and ensure that no one is left behind. One key lesson to be learnt from the pandemic is the critical importance of decolonizing global health and global health research so that African countries are better placed to address pandemic challenges in contextually relevant ways. This paper argues that to be successful, programmes of decolonization in complex global (...) health landscapes require a complex three-dimensional approach. Drawing on the broader discourse of political decolonization that has been going on in the African context for over a century, we present a model for unpacking the complex task of decolonization. Our approach suggests a three-dimensional approach which encompasses hegemomic; epistemic; and commitmental elements. (shrink)

Amid the current COVID-19 crisis, everyone has been called upon to offer assistance. What can historians contribute? One obvious approach is to draw on our knowledge of the history of epidemics and proclaim the lessons of history. But does history offer clear lessons? To make their expertise relevant, some historians assert that there are enduring patterns in how societies respond to all epidemics that can inform our experiences today. Others argue that there are informative analogies between specific past epidemics (...) and our present crisis, for instance between COVID-19 and prior outbreaks of SARS or influenza. Both strategies can be pursued, but each must be done with care. It is certainly possible to map COVID-19 onto the classic dramatic structure of an epidemic, but we cannot yet know how it will end, a failure of prognostication that constrains the advice we can offer. It is likewise possible to draw on the history of medical therapeutics and public health interventions to identify the risks we face of both underuse and overuse of our remedies, but we cannot yet judge whether our current commitment to heroic social distancing is warranted. While historians can offer insight, we must temper our contributions with humility. (shrink)

Many experts have warned that environmental degradation is increasing the likelihood of future pandemics like COVID-19, as habitat loss and poaching increase close contact between wildlife and people. This fact has been framed as a reason to increase wildlife conservation efforts. We have many good reasons to step up conservation efforts, but arguments for doing so on the basis of pandemic prevention are rhetorically, ethically, and empricially flawed.

COVID-19 presents many challenges, both clinical and philosophical. In this paper we discuss a major lacuna that COVID-19 revealed in our philosophy and understanding of medicine. Whereas we have some understanding of how physician-scientists interrogate the world to learn more about medicine, we do not understand the epistemological costs and benefits of the various ways clinicians acquire new knowledge in their fields. We will also identify reasons this topic is important both when the world is facing a pandemic (...) and when it is not. (shrink)

Vaccines, when available, will prove to be crucial in the fight against Covid-19. All societies will face acute dilemmas in allocating scarce lifesaving resources in the form of vaccines for Covid-19. The author proposes The Value of Lives Principle as a just and workable plan for equitable and efficient access. After describing what the principle entails, the author contrasts the advantage of this approach with other current proposals such as the Fair Priority Model.

The mobility restrictions related to COVID-19 pandemic have resulted in the biggest disruption to individual mobilities in modern times. The crisis is clearly spatial in nature, and examining the geographical aspect is important in understanding the broad implications of the pandemic. The avalanche of mobile Big Data makes it possible to study the spatial effects of the crisis with spatiotemporal detail at the national and global scales. However, the current crisis also highlights serious limitations in the readiness to take (...) the advantage of mobile Big Data for social good, both within and beyond the interests of health sector. We propose two strategical pathways for the future use of mobile Big Data for societal impact assessment, addressing access to both raw mobile Big Data as well as aggregated data products. Both pathways require careful considerations of privacy issues, harmonized and transparent methodologies, and attention to the representativeness, reliability and continuity of data. The goal is to be better prepared to use mobile Big Data in future crises. (shrink)

COVID-19 has truly affected most of the world over the past many months, perhaps more than any other event in recent history. In the wake of this pandemic are patients, family members, and various types of care providers, all of whom share different levels of moral distress. Moral conflict occurs in disputes when individuals or groups have differences over, or are unable to translate to each other, deeply held beliefs, knowledge, and values. Such conflicts can seriously affect healthcare providers (...) and cause distress during disastrous situations such as pandemics when medical and human resources are stretched to the point of exhaustion. In the current pandemic, most hospitals and healthcare institutions in the United States have not allowed visitors to come to the hospitals to see their family or loved ones, even when the patient is dying. The moral conflict and moral distress among care providers when they see their patients dying alone can be unbearable and lead to ongoing grief and sadness. This paper will explore the concepts of moral distress and conflict among hospital staff and how a system-wide provider wellness programme can make a difference in healing and health. (shrink)

COVID-19 is a very complex pandemic. It has affected individuals, different countries and regions of the world equally in some senses and differently in other senses. While sub-Saharan Africa has weathered a range of outbreaks of emerging and re-emerging infectious diseases, the manner in which the COVID-19 pandemic has evolved necessitates some observations, remarks and conclusions from our own situated observation point. Compared to previous epidemics/pandemics, many African countries have displayed a sense of solidarity in the face of (...) COVID-19 that convincingly demonstrates that an Ubuntu ethic is viable and globalizable. The African continent seems, at last, to have realized that ethics dumping must be avoided and has made strides in defining its COVID-19 research agenda and strengthening its epidemic response for both public health and health research. More needs to be done in terms of public engagement, funding and technical support for research on potential therapies/candidate vaccines that are a product of scientific studies on the continent. (shrink)

The COVID-19 challenge is unprecedented. It has caused enormous trauma, disrupted economies, social life, mass transportation, work and employment, supply chains, leisure, sport, international relations, academic programmes; literally everything. Churches and religious communities have not been spared; they have been severely affected and, in all likelihood, permanently transformed by the pandemic. The pre-COVID-19 world is gone, replaced by a ‘new normal’. The new landscape calls for both resilience and adaptation, embracing new ways of doing things and of being (...) church. Churches have to adapt; they have to ask themselves questions about the implications for being church in this ‘new normal’ context. This article aims to explore the impact of the coronavirus on the mission and theology of the church. (shrink)

Due to the novel coronavirus pandemic, the lockdown engendered has had a vicious impact on the global economy. This analysis’ prime intention is to evaluate the impact of the United States’ economic and health crisis as a result of COVID-19 on its financial stability. Additionally, the investigation analyzed the spillover impact of the worldwide economic slowdown experienced by COVID-19 on the United States’ financial volatility. The study applied an autoregressive distributed lag model and discovered that the economic and (...) health crises that occurred in the United States portentously upset the future expectations of its investors. Conspicuously, the health crisis in Spain and Italy were ominous spillovers of the United States’ financial instability in the short-run. Likewise, an economic crisis ensued in the United Kingdom because of COVID-19 causing spillover for the United States markets’ financial instability. The examination evaluated that Asian and African nations’ economic crises perilously affects the United States’ financial stability. The study determined that financial instability occurred in the United States due to its own economic and health crises persisted for a longer period than financial disequilibrium that occurred in other nations. The analysis suggested some strategies of smart lockdown that the government of the United States and other nations should follow to restart the economic cycle through tighter controls to minimize losses by following the steps of preparing a lockdown checklist, monitoring completion of lockdown tasks, and complete a close-down stock take or count. (shrink)