{"id":246,"date":"2020-05-26T08:36:04","date_gmt":"2020-05-26T08:36:04","guid":{"rendered":"https:\/\/blogs.bmj.com\/covid-19\/?p=246"},"modified":"2020-05-26T08:36:04","modified_gmt":"2020-05-26T08:36:04","slug":"can-covid-19-re-invigorate-ethics","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/covid-19\/2020\/05\/26\/can-covid-19-re-invigorate-ethics\/","title":{"rendered":"Can COVID-19 re-invigorate ethics?"},"content":{"rendered":"

By Louise Campbell<\/p>\n

The COVID-19 pandemic has catapulted ethics into the spotlight.\u00a0 Questions previously deliberated about by small numbers of people interested in or affected by particular issues are now being posed with an unprecedented urgency right across the public domain.\u00a0 One of the interesting facets of this development is the way in which the questions we are asking now draw attention, not just to the importance of ethics in public life, but to the very nature of ethics as practice, <\/em>namely ethics as it is applied to specific societal and environmental concerns.<\/em><\/p>\n

Some of these questions which have captured the public imagination were originally debated specifically within healthcare circles and at the level of health policy: what measures must be taken to prevent hospitals from becoming overwhelmed if there is a surge in the number of people requiring hospitalisation?\u00a0 How will critical care resources such as ventilators be prioritised if need outstrips supply?\u00a0 In a crisis situation, will older people or people with disabilities have the same opportunities to access scarce resources, even though they may have less chance of survival than people without age-related conditions or disabilities?\u00a0 What level of risk should healthcare workers be expected to assume when treating patients in situations in which personal protective equipment may be inadequate or unavailable?\u00a0 \u00a0Have the rights of patients with chronic conditions been traded off against the need to prepare the health service to meet a demand which to date has not arisen?\u00a0 Will the response to COVID-19 based on current evidence compromise the capacity of the health system to provide routine outpatient and non-emergency care to patients in the near future?<\/p>\n

Other questions relate more broadly to the intersection between health and society: how do we calculate the harms of compelling entire populations to isolate themselves from loved ones and from their communities?\u00a0 How do we balance these harms against the risks of giving people more autonomy to act responsibly?\u00a0 What consideration is given to the fact that, in an unequal society, restrictions on liberty will affect certain social groups in disproportionate ways?\u00a0 What does the catastrophic impact of COVID-19 on residents of nursing homes say about our priorities as a society and to what extent is their plight our collective responsibility?\u00a0 What steps have been taken to protect marginalised communities who are at greater risk from an outbreak of infectious disease: for example, people who have no choice but to coexist in close proximity with one another in direct provision centres, in prison settings and on halting sites?<\/p>\n

The broadest set of questions flirts with the idea of a common societal good: what justification can be provided for such unprecedented interference with the liberty of individual citizens?\u00a0 How are the \u2018public interest\u2019 considerations which underlie decisions to restrict liberty defined, and how transparent are they?\u00a0 By what consensus are public health goals reached?\u00a0 What level of social cohesion is required to maximise the effectiveness of measures taken to address the crisis?\u00a0 How will the longitudinal effects of these restrictions on the well-being of the population be measured?\u00a0 How should governmental structures be redesigned to address the increased poverty, deepening social inequity, educational inequality and loss of opportunity which will be the spiralling consequences of our attempts to contain the pandemic?<\/p>\n

All of these questions are ethical<\/em> questions because of three features that they share: first, they invite an evaluative response.\u00a0 Their currency is the language of right <\/em>and wrong, better <\/em>and worse, should <\/em>and shouldn\u2019t.\u00a0 <\/em>As such, finding answers is not merely a matter of describing solutions to the particular problems raised. \u00a0Reflection on the adequacy of these solutions is required, and this entails a process of identifying the harms and benefits – defined broadly or narrowly – which are associated with specific courses of action.\u00a0 Weighing these harms and benefits against one another is necessary if what is being proposed as an ethically-appropriate solution to a problem which has a societal impact is to be justified.\u00a0 Justification is a second important feature of ethics and the robustness of the justification provided will depend on the quality of the process by which it is reached.\u00a0 Whereas justification in the field of theoretical ethics involves scrutinising the reasoning leading to a conclusion \u2013 conceptual coherence, freedom from contradiction \u2013 justification in the domain of applied ethics involves examining, not just the quality of the reasoning involved or the appropriateness of the principles applied, but also the impartiality, transparency, fairness and inclusivity of the process by which the conclusion is reached. \u00a0\u00a0This reliance on principles which are publicly defensible emphasises the time-bound and historically contingent nature of applied ethics, but it is also linked to a third defining feature of ethics as practice: the ineliminable role played by values[i]<\/a>. \u00a0Our value systems as individuals and as members of society are deeply implicated in the questions we ask, the ethical issues we identify, the way we frame these issues, how we define what count as harms and benefits, the solutions we construct.\u00a0 Ethics as practice involves examining these values and the influence they have on our decisions and actions. \u00a0In pluralist societies, it is implicitly accepted that individuals will disagree with one another about the merits or otherwise of certain states of affairs and that their private ethical values are a matter of personal choice.\u00a0 What is interesting is how \u2018deep disagreements\u2019 \u2013 inability to reach a consensus because of a clash between values which are fundamental but irreconcilable – play out in the public domain, where solutions must be found to complex problems which affect everyone in society.<\/p>\n

How we justify the measures we have employed to contain the spread of COVID-19, how we will emerge from our current situation, how we will reimagine society after the pandemic has ended, what kinds of changes need to be made to our existing way of life \u2013 all of these issues will give rise to deep disagreements.\u00a0\u00a0 But deep disagreements are a necessary prerequisite of reflection on how we might better integrate the values of liberty, solidarity, compassion, belonging, identity and well-being in future versions of our society.\u00a0\u00a0 Ethics has never been more relevant.<\/p>\n

[i]<\/a> Ethical theory does not escape this: ethical norms for Plato, Aristotle, Kant and Mill were deeply rooted in their own historically-conditioned value-systems and social biases.<\/p>\n

 <\/p>\n

Author:<\/strong> Louise Campbell<\/p>\n

Affiliation: <\/strong>School of Medicine, National University of Ireland, Galway<\/p>\n

Competing interests: <\/strong>The author has no competing interests.<\/p>\n","protected":false},"excerpt":{"rendered":"

By Louise Campbell The COVID-19 pandemic has catapulted ethics into the spotlight.\u00a0 Questions previously deliberated about by small numbers of people interested in or affected by particular issues are now being posed with an unprecedented urgency right across the public domain.\u00a0 One of the interesting facets of this development is the way in which the […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":383,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[96,94,95],"tags":[],"class_list":["post-246","post","type-post","status-publish","format-standard","hentry","category-journal-of-medical-ethics","category-medical-ethics","category-pandemic"],"yoast_head":"\nCan COVID-19 re-invigorate ethics? - Coronavirus (COVID-19) Blog Posts Collection - BMJ Journals<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2020\/05\/26\/can-covid-re-invigorate-ethics\/\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Can COVID-19 re-invigorate ethics? - Coronavirus (COVID-19) Blog Posts Collection - BMJ Journals\" \/>\n<meta property=\"og:description\" content=\"By Louise Campbell The COVID-19 pandemic has catapulted ethics into the spotlight.\u00a0 Questions previously deliberated about by small numbers of people interested in or affected by particular issues are now being posed with an unprecedented urgency right across the public domain.\u00a0 One of the interesting facets of this development is the way in which the [...]Read More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/medical-ethics\/2020\/05\/26\/can-covid-re-invigorate-ethics\/\" \/>\n<meta property=\"og:site_name\" content=\"Coronavirus (COVID-19) Blog Posts Collection - BMJ Journals\" \/>\n<meta property=\"article:published_time\" content=\"2020-05-26T08:36:04+00:00\" \/>\n<meta name=\"author\" content=\"caitlinalder\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"caitlinalder\" \/>\n\t<meta name=\"twitter:label2\" content=\"Estimated reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"5 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2020\\\/05\\\/26\\\/can-covid-re-invigorate-ethics\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/covid-19\\\/2020\\\/05\\\/26\\\/can-covid-19-re-invigorate-ethics\\\/\"},\"author\":{\"name\":\"caitlinalder\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/covid-19\\\/#\\\/schema\\\/person\\\/6a90f3ceca251b386830821ec8125be0\"},\"headline\":\"Can COVID-19 re-invigorate ethics?\",\"datePublished\":\"2020-05-26T08:36:04+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/covid-19\\\/2020\\\/05\\\/26\\\/can-covid-19-re-invigorate-ethics\\\/\"},\"wordCount\":1072,\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/covid-19\\\/#organization\"},\"articleSection\":[\"Journal of Medical Ethics\",\"Medical ethics\",\"Pandemic\"],\"inLanguage\":\"en-GB\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/covid-19\\\/2020\\\/05\\\/26\\\/can-covid-19-re-invigorate-ethics\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2020\\\/05\\\/26\\\/can-covid-re-invigorate-ethics\\\/\",\"name\":\"Can COVID-19 re-invigorate ethics? - Coronavirus (COVID-19) Blog Posts Collection - BMJ Journals\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/covid-19\\\/#website\"},\"datePublished\":\"2020-05-26T08:36:04+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2020\\\/05\\\/26\\\/can-covid-re-invigorate-ethics\\\/#breadcrumb\"},\"inLanguage\":\"en-GB\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2020\\\/05\\\/26\\\/can-covid-re-invigorate-ethics\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2020\\\/05\\\/26\\\/can-covid-re-invigorate-ethics\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/blogs.bmj.com\\\/covid-19\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Can COVID-19 re-invigorate ethics?\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/covid-19\\\/#website\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/covid-19\\\/\",\"name\":\"Coronavirus (COVID-19) Blog Posts Collection - BMJ Journals\",\"description\":\"This centralised hub collects coronavirus (COVID-19) blog post and medical information from across the BMJ's journal blogs. 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