By Rhea Mittal.

One of the greatest assets of a nation is the health of its citizens, and this is inextricably linked with  governance. In a COVID-19 era, the impact and diversity of political strategy in relation to health outcomes has been demonstrated on a global level.

The 2019 Varsity Medical Ethics Debate was on the motion ‘This house believes authoritarian government is the route to good health outcomes’. In our paper we revisit this long-standing debate between democratic versus authoritarian governments and re-examine our selected cases from the perspective of their responses to the COVID-19 pandemic. After considering their potential for exploitation and disregard of fundamental principles of medical ethics, we argue that authoritarian regimes are not the route to good health outcomes.

Drawbacks of an authoritarian regime were evident at the beginning of the pandemic. The censorship and lack of transparency inherent to authoritarian nations may have concealed outbreaks and accelerated the spread of the disease. On the other hand, there has been effective containment of COVID-19 achieved by certain authoritarian regimes compared to their democratic counterparts.

The pandemic may have also blurred the divide between democratic and authoritarian rule, arguably pushing some democratic countries to a more authoritarian approach and providing ‘additional tools and justification for repressive tactics’ to existing autocratic regimes. Assessing the efficacy of one method over another is further hampered by the lack of comparable data available throughout the COVID-19 pandemic. Doubts cast over reported figures from autocratic nations alongside the presumed reliability of statistics from democratic countries renders it an impossible comparison.

Paper title: Varsity Medical Ethics Debate 2019: is authoritarian government the route to good health outcomes?

Authors: Azmaeen Zarif^1,2, Rhea Mittal^1,3, Ben Popham^1,4, Imogen C Vorley^5,6, Jessy Jindal^5,7, Emily C Morris^5,8

Affiliations:

¹ University of Cambridge School of Clinical Medicine, Cambridge, UK ² University of Cambridge Gonville and Caius College, Cambridge, UK ³ University of Cambridge Peterhouse, Cambridge, UK ⁴ University of Cambridge Robinson College, Cambridge, UK ⁵ Oxford Medical School, Oxford, UK ⁶ University of Oxford Saint Peter’s College, Oxford, UK ⁷ University of Oxford Merton College, Oxford, UK ⁸ University of Oxford Green Templeton College, Oxford, UK

Competing interests: None declared