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Andrew Crowden is an experienced practical ethicist. Andrew has PhD and Master’s degrees from the Bioethics Centre at Monash University. He is Associate Professor in Philosophy at the University of Queensland’s School of Historical and Philosophical Inquiry, Honorary Associate Professor at the University of Melbourne and an Adjunct Professor at the University of the Sunshine Coast (USC) where he is Chairperson of the Human Research Ethics Committee (HREC) and Chairperson of the Animal Ethics Committee. He is also Deputy Chair of the AIATSIS Research Ethics Committee.
What is the biggest ethical or philosophical question that has arisen as a result of the coronavirus pandemic?
How to ensure fair implementation of non-pharmaceutical interventions (NPI) within a social justice framework during a time of pandemic is the big practical ethics challenge. Though, determining how common decency, kindness and ordinary virtue can inform our future lives on planet Earth may be the biggest philosophical question that has arisen as a result of this, or indeed any pandemic.
In pandemics ethics concerns are usually rightly directed toward practical matters. We know that certain matters need attention. Determining ethical priority related to access to resources, identifying and supporting healthcare workers as they determine their obligations to others when there is potential personal risk and getting the right balance between reducing disease spread and freedom of movement take priority. The emphasis on these matters and the associated ethics analysis varies as the response to a pandemic moves through various stages (usually identified as tier 1- 4, where the spread increases at each tier and capacity needs increase).
The best way to prevent and stop pandemic progress is the so-called nonpharmaceutical interventions (NPI) such as isolation and quarantine, school and business closures, social distancing measures and the like. Ideally mandatory NPI should be informed by evidence from science with effective coordination provision of accurate evidence -based information and inclusive participation. NPI should not be coercive and at the planning stages should consider reciprocity dimensions ensuring broad community representation including from first nations peoples. Determining how to do this and particularly when and how to implement mandatory isolation is arguably the biggest practical ethics challenge during all, but particularly the first three stages (tier 1-3) of a pandemic.
Why is it significant?
If NPI is not done, or not done well and the pandemic reaches later stages (particularly tier 4) health systems become overloaded. Things can become tricky. Difficult decisions about how best to triage the unwell and how to allocate resources have to be made quickly. Who gets the ventilator? Should your four year-old child get access? What about this 32-year-old infectious diseases physician? Why should you get the scarce resource? Who should? How do we decide? Effective NPI aims to prevent such end stage questions.
How can it be addressed?
The best way to ensure effective NPI is by the implementation of an inclusive universal public health ethics based on social justice that is aimed at lessening inequality and ensuring better health for all.
In doing so it is enlightening to reflect on what Albert Camus said in his 1947 novel The Plague. Camus describes experiences of a pandemic as being remarkably similar to those being experienced today. In Camus’s story, a failure of NPI leads to end stage (tier 4) experiences. Camus’ focus is on ‘hope’. The extraordinary virtues can be found within the ordinariness of human experiences; in the virtuous actions of kind ordinary people as they go about doing their best to look after each other well. Common decency provides the best way to respond to a pandemic. As we come out of this COVID-19 experience, that is what we need to think about. The biggest philosophical question that has arisen as a result of the coronavirus pandemic can only be: how can we ensure that common decency, kindness and ordinary virtue, evidenced by so many in response to this pandemic, informs our future lives on planet Earth?
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