By Vic Larcher and Joe Brierley.
Countries throughout the world are counting the health and socio-economic costs of the COVID-19 pandemic, including the strategies necessary to contain it. Profound consequences from social isolation are beginning to emerge, and there is an urgency about charting a path to recovery, albeit to a “new normal” that mitigates them.
Children have not suffered as much from the direct effects of COVID-19 infection as older adults. Still, there is mounting evidence that their health and welfare are being adversely affected. Closure of schools has been a critical component of social isolation but has a far broader impact than the diminution of educational opportunities, as important as these are. Reopening of schools is essential to recovery, with some countries already tentatively implementing it. Children’s interests are vital considerations in any recovery plan, but the question remains as to how to address them within the context of how society views children; should they be regarded as pawns, pathfinders or partners in this enterprise?
Children as pawns
Traditional moral theories grant children limited moral status, broadly proportionate to their state of moral development; others have ethical and legal authority to make appropriate decisions on their behalf. Granting children rights confers some moral agency; the UN Convention on the Rights of the Child provides protection, welfare and education rights, irrespective of the child’s ability to claim them. It follows that children should receive adequate protection, e.g. by provision of appropriate public health facilities and social distancing. Any harms that might accompany a return to school should be minimised and balanced against those of remaining in lockdown
Nevertheless, contemporary thinking about childhood accords children more active roles and a voice in matters that concern them.
Children as pathfinders
A staged return to the “new normal” might cast children in a pathfinder role. In World War 2 pathfinders were elite troops who prepared the way for the main forces. In the case of children’s return to school, this might mean that older children, whose educational prospects and crucial examinations have been compromised, might lead the process, with appropriate safeguards e.g. technology such as track and trace apps. An additional reason for selecting older children is that they are more likely to have the capacity to give valid consent to the use of technology and testing e.g. swabs/blood and are more likely to comply with hand hygiene & social distancing
If the efficacy and safety of this approach are validated, it would signpost the method of return to schooling and ‘adult’ functions more widely, as well as encouraging the more active involvement of children as participants with social utility.
Children as partners
It might seem to strain credulity to regard children as partners in lockdown easing; as they often lack the ability to define and claim the liberty rights of adults, but they will equally inhabit the socio-economic “new normal.” In support of this concept of partnership and participation, article 12 of the UNRC requires children to be informed and consulted over matters that concern them, with their views given due weight in accordance with age and maturity. In recent years, children have become actively involved in health care and research planning, and as activists for prevention of climate change. Some show capacity for self-directed acts of kindness and altruism, in keeping with a level of moral development some adults never achieve: their evolving moral agency throughout childhood is unquestionable.
Because of the uncertainties surrounding the easing of lockdown, such a second wave of infection, easing can be considered an experimental procedure, meaning children, as others, are de facto research subjects. Since children are increasingly active participants in identification of research topics, and the design and implementation of trials, it seems logical to include them as active participants and architects of this ‘project.’ Children at the least need clear explanations of the risks and benefits of leaving lockdown in terms that they can understand. If future societies (including today’s children) are to retain trust in Government, it is essential that those in power “show their working out”; the principles of ethical decision-making require transparency, accountability and reasonableness.
Society has a clear duty to protect children from the harms of the pandemic, but children should be more than passive recipients of our concern, they are future citizens with a right to an open future. Post COVID-19 a “new normal” must be built, hopefully a society that is a kinder, more inclusive and equal, in which today’s children are active members.
Children should be involved in the process rather than considered as mere pawns in a societal game of chess. Although, we would do well to remember that “[pawns] are the soul of chess…….on their good or bad arrangements depends the gain or loss of the party, “ (Philidor FAD, 1749 cited in Euwe M, Hooper D. A Guide to Chess endings. New York Dover Publications 1976) – maybe not such an inappropriate metaphor after all?
Author: Vic Larcher (i) and Joe Brierley (ii)
(i) Emeritus Consultant in Paediatrics and Bioethics, Great Ormond St Children’s Hospital, London
(ii) Consultant Intensivist & Bioethics, Paediatric Bioethics Centre, Great Ormond St Children’s Hospital, London
Competing interests: None declared
Social media accounts of post authors: JB @brierl_jb