Ethical Exit Strategy (COVID-19)

Alberto Giubilini

PI:  Dr Alberto Giubilini

The ethical Exit Strategy: the path from relaxing measures to vaccination

  • Funded by UKRI

  • Duration: 10 months

  • Starting date: 1 June 2020

Overview

The current lockdown to contain the COVID-19 emergency, even as it is eased, implies a societal, economic, and psychological cost that is not sustainable for too long. The ‘exit strategy’ is and will be for quite a while the main focus of the public health and political debate, also in consideration of the not too remote possibility of a second wave of the virus in the coming months. But the exit strategy cannot be designed and implemented unless certain ethical decisions about trade-offs between values are made.

Although they might seem just technical decisions about epidemiology, economics, or psychology, many of the decisions in the exit strategy will actually be ethical decisions about how to weigh these different aspects against each other. This project addresses, in chronological order, three core steps of the exit strategies that require close ethical scrutiny:

  1. At what point, and through which steps, will it be acceptable to start the path back to some form of normality, and how should this path be affected in case of a second wave?
  2. What kind of contact-tracing technologies and procedures (e.g mobile app and human contact tracing) can be used during the transition, and how?
  3. When we have a vaccine, which vaccination policy should be adopted?

Relevance

From the way talk about exit strategy is currently framed, it might appear that it will be a matter of technical decisions or, as the Government put it, a matter ‘of taking the right steps at the right time, informed by the best science’. But this is only partly true. Policy makers will need to show commitment to ethical principles and be able to justify decisions to sacrifice certain values and principles for the sake of others, which will be unavoidable

For example, they might have to increase risk of illness or even death for certain individuals for the sake the psychological or financial interest of those who are being most heavily affected by the lockdown; to sacrifice to a certain degree privacy for the sake of public health in the use of contact-tracing technologies. This is not merely about “the best science”. These are ethical decisions.

It will not be possible to make these decisions without having a plausible story about which values will at some point have to be prioritized, and why.  This is not only because policy decisions need to be ethically acceptable (which is always a requirement), but also because without appealing to certain ethical values, that go beyond merely technical considerations, it will be difficult to gain people’s trust.

This research will result in a set of recommendations, in the form of policy papers addressed to the relevant Government departments as well as academic papers, about how to make these necessary trade-offs between values in a way that can inform both public health policy and public health communication strategy.

Investigator

Alberto Giubilini is a Senior Research Fellow at the Oxford Uehiro Centre for Practical Ethics and at the Wellcome Centre for Ethics and the Humanities, University of Oxford. He has a PhD in Philosophy from the University of Milan, and prior to joining the Uehiro Centre he worked in Australia at Monash University, University of Melbourne and Charles Sturt University. He has published on different topics in bioethics and philosophy, with a particular focus in recent years on public health ethics (including the ethics of vaccination, of antibiotic resistance, of challenge studies, and of coerciveness of public health measures more generally). He recently published the book The Ethics of Vaccination (Palgrave MacMillan 2019).

Resources

Project output: THIS Institute Report, expert group including Alberto Giubilini (21 July 2020)

Pandemic Ethics: Testing times: An ethical framework and practical recommendations for COVID-19 testing for NHS workers 

"The report sought to identify and characterise the ethical considerations likely to be important to the testing programme, while recognising the tension between different values and goals. The project was guided by an expert group and by an online consultation exercise held between 27 May and 8 June 2020 to characterise the range and diversity of views on this topic. The 93 participants in the consultation included NHS workers in clinical and non-clinical roles, NHS senior leaders, policy-makers, and relevant experts. The project report emphasises that getting the COVID-19 swab testing programme for NHS workers right is crucial to support staff and patient safety and broader public health. It also recognises that COVID-19 does not affect all population groups equally. People who are socio-economically disadvantaged or members of Black, Asian and Minority Ethnic (BAME) groups may face distinctive issues in relation to testing."

content to follow

    

Giubilini, A., (2019), 'Ethics of Vaccination', (Palgrave Macmillan) [Freely available open access content NBK538383].

Project output: Online debate article 'Should vaccinations be mandatory?' with Louise Gunning for Dutch magazine of Amnesty International (July 2020).