UK Ethics Accelerator: Coordinating and Mobilising Ethics Research Excellence to Inform Key Challenges in a Pandemic Crisis

Prof Ilina Singh
Professor Julian Savulescu in his office

PI: Ilina Singh

Co-Investigator: Julian Savulescu

UKRI/AHRC (Covid scheme)  for 18 month project

UK Ethics Accelerator: Coordinating and Mobilising Ethics Research Excellence to Inform Key Challenges in a Pandemic Crisis

The COVID-19 crisis demands that policy-makers, researchers, health and social care workers, and members of the public address unprecedented ethical dilemmas on a daily basis. Resolving these is hard, and it is risky. The complexity and speed of ethical challenges are leading to harms—some inevitable, some avoidable—on a significant scale. The main aim of the Ethics Accelerator (EA) is to harness and mobilise existing UK ethics research expertise to bear on these multiple, ongoing ethical challenges. The EA will rapidly provide evidence, guidance and critical analysis to decision-makers, helping to improve decision-making over the evolving pandemic response. A second aim is to enable systematic public deliberation around key ethical challenges. A third aim is to identify strategies to embed ethics at the core of future epidemic preparedness. The EA will leverage and promote a broad network of UK and international researchers to create flexible Taskforces that deliver rapid guidance and responsive advice to leadership in government, science, medicine, and public health. It will establish virtual fora for public discussion, deliberation and information about arising ethical challenges. In coordinating and focusing existing national investments in ethics research, the EA adds significant value and scales up the potential impacts of ethics research in science, medicine, policy and society. Primary outputs will be rapid research reviews; policy guidance; commissioned research; a broad peer review body; and stakeholder engagements. Main outcomes will be decision-making that is informed by ethics expertise, and is more transparent and accountable, thereby improving public trust.

OUC Researchers: Dominic Wilkinson and Jonathan Pugh

Below is a list of OUC outputs on this project.  For more information on the project and it's team members, visit the project's website.

Resources

Dao, B., Savulescu, J., Suen, J., Fraser, J. and Wilkinson, D., (2021), 'Ethical factors determining ECMO allocation during the COVID-19 pandemic', BMC Medical Ethics, Vol: 22(1): 70 [PMC8169422]

Levy, N. and Savulescu, J., (2021), 'After the Pandemic: New Responsibilities', Public Health Ethics, Vol: 14(2): Pages 120–133 [PMC7989173]

Palacios‐González, C., Pugh, J., Wilkinson, D. and Savulescu, J., (forthcoming 2021), 'Ethical heuristics for pandemic allocation of ventilators across hospitals', Developing World Bioethics, (online first)

Pugh, J., Wilkinson, D., Palacios Gonzalez, C. and Savulescu, J., (2021), 'Beyond Individual Triage: Regional Allocation of Life-Saving Resources such as Ventilators in Public Health Emergencies'Health Care Analysis, Vol: 29, pp. 263–282 [PMC7867404]

Pugh, J., Wilkinson, D. and Savulescu, J., (forthcoming 2021), 'Sense and sensitivity: can an inaccurate test be better than no test at all?', Journal of Medical Ethics, (online first)

Savulescu, J., Giubilini, A. and Danchin, M., (2021), 'Global Ethical Considerations Regarding Mandatory Vaccination in Children', The Journal of Pediatrics, Vol: 231(April): 10-16 [PMC7817402]; and

Authors' reply: Reply to Sprengholz and Betsch, The Journal of Pediatrics, online (17 August 2021)

Simon Thomas, E., Peiris, B., Di Stefano, L., Rowland, M. J. and Wilkinson, D., (2021), 'Evaluation of a hypothetical decision-support tool for intensive care triage of patients with COVID-19', Wellcome Open Research, 6-183 [Open Access]

Wilkinson, D., Finlay, I., Pollard, A., Forsberg, L. and Skelton, A., (2021), 'Should we delay covid-19 vaccination in children?', BMJ, Vol: 374:n1687 [PMC TO FOLLOW].  Paper cited in EurekAlert! | Mirage 

 

UK Government

Members of OUC have submitted evidence to Parliamentary committees on COVID-19: 

Written evidence from Dr Jonathan Pugh, Dr Lisa Forsberg, and Dr Thomas Douglas (COV0255)
'Restrictions of Liberty in Public Health, Medical Treatment, and Human Rights in The COVID-19 Pandemic'
Link to report: https://committees.parliament.uk/writtenevidence/9404/pdf

Written evidence from Dr Lisa Forsberg, Dr Isra Black, Dr Thomas Douglas, Dr Jonathan Pugh (COV0220)
'Compulsory vaccination for Covid-19 and human rights law'
Link to report: https://committees.parliament.uk/writtenevidence/9253/pdf/

Written evidence from the Wellcome Centre for Ethics and Humanities (COV0156)
On maintaining public health whilst upholding human rights 
Contributors from OUC include Dr Jonathan Pugh, Dr Stephen Rainey and Joseph Nguyen
Link to report: https://committees.parliament.uk/writtenevidence/8681/html/

Other

Exit Statement 'COVID-19: Ethical guidelines for the Exit Strategy'Alberto Giubilini and Julian Savulescu (1 October 2020).
"The UK “Exit Strategy”, which aims at safely easing the restrictions introduced in March 2020 to contain the COVID19 epidemics in the UK, needs to balance different values and priorities, beyond protecting the population from the virus. The task will be made even more difficult by the fact that Exit Strategy will have to be responsive to likely new spikes of COVID-19 cases, if not by an actual second wave of the virus."
Link to Exit Statement PDF.

World Health Organization Report 'Key criteria for the ethical acceptability of COVID-19 human challenge studies' cites papers by Julian Savulescu, Tom Douglas, Hannah Maslen and Alberto Giubilini (6 May 2020)
Controlled human challenge studies involves the deliberate infection of healthy volunteers.  They are particularly useful for testing multiple vaccine candidates quickly and efficiently, as well as providing data on the processes of transmission, infection and immunity. Aimed at scientists, policy-makers and regulators, the report outlines the criteria that would need to be met for human challenge studies on COVID-19 to be ethically acceptable.
Link to report: https://apps.who.int/iris/bitstream/handle/10665/331976/WHO-2019-nCoV-Ethics_criteria-2020.1-eng.pdf?ua=1

Cited papers

  1. Schaefer G, Tam CC, Savulescu J, Voo TC. Covid-19 vaccine development: time to consider Sars-Cov-2 challenge studies? SSRN Electronic Journal. January 2020. Link to paper on SSRN.com  - SSRN REGISTRATION REQUIRED (FREE)
  2. Bambery B, Douglas T, Selgelid MJ, Maslen H, Giubilini A, Pollard AJ et al. Influenza vaccination strategies should target children. Public Health Ethics. 2018;11(2):221–34. Link to paper on OUP website   - OPEN ACCESS
  3. Bambery B, Selgelid M, Weijer C, Savulescu J, Pollard AJ. Ethical criteria for human challenge studies in infectious diseases. Public Health Ethics. 2015;9(1):92–103. Link to paper on OUP website  - FREE

 

Practical Ethics in the News blogs

Published December 16, 2021 | By Julian Savulescu and Alberto Giubilini
Shaming unvaccinated people has to stop. We’ve turned into an angry mob and it’s getting ugly
[crosspost with The Conversation]

Published November 23, 2021 | By Alberto Giubilini and Julian Savulescu
Mandatory Vaccination Should Be Selective, Not General

Published November 16, 2021 | By Jonathan Pugh, Dominic Wilkinson, and Julian Savulescu
Selective lockdowns can be ethically justifiable – here’s why (republished from The Conversation, read the original article).

Published November 12, 2021 | By Alberto Giubilini
Why COVID passes are not discriminatory (in the way you think they are) (republished from The Conversation, read the original article).

Published November 10, 2021 | By Dominic Wilkinson, Jonathan Pugh, Julian Savulescu
NHS and Care Home Mandates Should Take Account of Natural Immunity to COVID

Published August 4, 2021 | By Alberto Giubilini and Erica Charters
The end of the COVID-19 pandemic

Published July 23, 2021 | By Dominic Wilkinson and Trish Greenhalgh
COVID: Media Must Rise Above Pitting Scientists Against Each other – Dealing With the Pandemic Requires Nuance [crosspost with The Conversation]

COVID: Why We Should Stop Testing in Schools [crosspost with The Conversation]
Published July 7, 2021 | By Dominic Wilkinson, Jonathan Pugh and Julian Savulescu 

​​​​Pfizer Jab Approved for Children, but First Other People need to be Vaccinated [crosspost with The Conversation] ​​​​​
Published June 4, 2021 | By Dominic Wilkinson, Jonathan Pugh and Julian Savulescu

Suspending The Astra-Zeneca Vaccine and The Ethics of Precaution
Published March 16, 2021 | By Jonathan Pugh, Dominic Wilkinson, and Julian Savulescu

Is it Irrational Not to Have a Plan? Should There Have Been National Guidance on Rationing in the NHS? [cross-posted in the Journal of Medical Ethics Blog]
Published March 2, 2021 | By Dominic Wilkinson and Jonathan Pugh

Self-experimentation with vaccines
Published February 24, 2021 | By Jonathan Pugh, Dominic Wilkinson and Julian Savulescu [cross-posted in the Journal of Medical Ethics Blog]

An Ethical Review of Hotel Quarantine Policies For International Arrivals
Published February 23, 2021 | By Jonathan Pugh, Dominic Wilkinson, Julian Savulescu

Cross-Post: Is It Ethical To Quarantine People In Hotel Rooms?
Published February 11, 2021 | By Jonathan Pugh and Dominic Wilkinson [originally published in The Conversation on 11 February 2021]

Cross-Post: Not Recommending AstraZeneca Vaccine For The Elderly Risks The Lives Of The Most Vulnerable
Published February 8, 2021 | By Jonathan Pugh and Julian Savulescu [cross-posted in The Conversation on 5 February 2021]

Ethical Considerations For The Second Phase Of Vaccine Prioritisation
Published January 22, 2021 | By Jonathan Pugh and Julian Savulescu

Even Though Mass Testing For COVID Isn’t Always Accurate, It Could Still Be Useful – Here’s Why
Published January 4, 2021 | By Jonathan Pugh [originally published in The Conversation on 22 December 2020]

Print and online media

The Conversation: Dominic Wilkinson, Alberto Giubilini, Julian Savulescu (4 February 2022)
Is this the end of the road for vaccine mandates in healthcare?
[crosspost with Practical Ethics in the News]

The Conversation: Dominic Wilkinson, Jonathan Pugh and Julian Savulescu (26 January 2022)
Vaccine mandates for healthcare workers should be scrapped – omicron has changed the game

The Conversation: Julian Savulescu, Dominic Wilkinson and Jonathan Pugh (6 December 2021)
Why the UK shouldn’t introduce mandatory COVID vaccination

The Conversation: Dominic Wilkinson and Jonathan Pugh (3 December 2021)
Omicron: better to be safe (and quick) than sorry

The Conversation: Dominic Wilkinson, Jonathan Pugh and Julian Savulescu (4 June 2021)
Pfizer jab approved for children, but first other people need to be vaccinated

The Week UK: Dominic Wilkinson, Jonathan Pugh and Julian Savulescu (7 June 2021)
The moral questions behind vaccinating children against Covid-19: Pfizer jab has been approved for use in adolescents - but experts caution against immediate rollout

Science Media Centre: Dominic Wilkinson (4 June 2021)
Expert reaction to MHRA extending the UK approval of the Pfizer-BioNTech COVID-19 vaccine to allows its use in 12- to 15-year-olds

Coverage arising from SMC article includes:

  • Huffington Post (quotes Adam Finn and Dominic Wilkinson) 
  • Independent (quotes Russell Viner and Dominic Wilkinson) 
  • BBC News (quotes Russell Viner and Dominic Wilkinson) 
  • The Guardian (quotes Adam Finn and Dominic Wilkinson) 
  • Mirror (quotes Adam Finn and Dominic Wilkinson 
  • Express (quotes Adam Finn and Dominic Wilkinson)

The Conversation: Jonathan Pugh, Dominic Wilkinson and Julian Savulescu (16 April 2021)
Learning to live with COVID – the tough choices ahead [cross-posted in Practical Ethics in the News]

LBC Radio: Dominic Wilkinson (17 April 2021)
Outrage over vaccine passports 'an overreaction,' claims medical expert 

The Conversation: Julian Savulescu, Dominic Wilkinson, Jonathan Pugh and Margie Danchin (25 March 2021)
There’s no need to pause vaccine rollouts when there’s a safety scare. Give the public the facts and let them decide

The Conversation: Jonathan Pugh and Dominic Wilkinson (11 March 2021)
COVID vaccines: is it wrong to jump the queue?