Ethical Public Health Policy Within Pandemics: Theory and Practice in Ethical Pandemic Administration (The International Library of Bioethics, 95)

This book contains original essays that look at contagious/infectious disease pandemics and the ethical public policy and administration these have entailed. In particular, the pandemics of the 1918 flu pandemic, HIV in the 1990s, SARS in 2003, Ebola from 2014–2016 and the novel COVID-19 in 2020 are highlighted. The contributions in this work offer the reader insights in these and several other recent pandemics that present differently—either via contagion or mortality rate—and how each should be addressed by countries of various sorts. This book is a must for the ongoing debate on how we should treat public health crises, such as the one we have all just encountered in the novel COVID-19 pandemic. 501392_1_En_OFC 1 501392_1_En_BookFrontmatter_OnlinePDF 2 Preface 7 Contents 8 Contributors 10 501392_1_En_1_PartFrontmatter_OnlinePDF 11 Part I Theoretical Background 11 501392_1_En_13_Chapter_OnlinePDF 12 1 Introduction 12 Bibliography 20 501392_1_En_1_Chapter_OnlinePDF 21 2 The Context and Foundations of Ethical Public Health Policy 21 2.1 Prologue 21 2.2 Introduction 22 2.2.1 How Do We Assess Infectious Diseases? 23 2.3 Part One 24 2.3.1 A Brief View from Select Pandemics 24 2.3.2 Conclusion of Part One 30 2.4 Part Two 30 2.4.1 Grounding Public Health Ethics 30 2.4.2 Prudential Grounds for Public Health 31 2.4.3 Moral Grounds for Public Health 34 2.4.4 Ethical Grounds for Pandemic Public Health 39 2.4.5 Conclusion for Part Two 41 Bibliography 47 501392_1_En_2_Chapter_OnlinePDF 51 3 The Common Good and Individual Rights in Pandemic Times: The Case of Sweden’s COVID-19 Strategy 51 3.1 Sweden’s Pandemic Strategy 51 3.2 Moral Conflicts in Pandemic Times: The Common Good vs. Individual Rights 53 3.3 A Utility-Based Conception of the Common Good 55 3.4 A Rights-Based Conception of the Common Good 57 3.5 Understanding the Swedish COVID-19 Strategy and Its Conception of the Common Good 60 3.6 Conclusions 64 Bibliography 67 501392_1_En_3_Chapter_OnlinePDF 70 4 Formal Epistemology Meets a Coronavirus: Rational Decision and the Response to Covid-19 70 4.1 Introduction 70 4.2 The Role of Science 72 4.3 Formal Epistemology and Decision Theory 75 4.4 A Note on Multi-Criteria Analysis (MCA) 78 4.5 Objectives Hierarchies 80 4.6 Final Remarks 83 References 86 501392_1_En_4_Chapter_OnlinePDF 88 5 Reevaluating Value in Public Health Policy: Values as Iterative Rational Inquiry 88 5.1 Introduction 89 5.2 Value in General 90 5.2.1 Value as Fixed 91 5.2.2 Axiology in the Making 92 5.3 Iterative Axiology and Rationality 94 5.4 Towards a Rational Public Health Policy During Pandemic 96 5.5 Conclusion 98 Works Cited 99 501392_1_En_5_Chapter_OnlinePDF 101 6 Pandemics and Race 101 6.1 Introduction 101 6.2 A Consensus Conception of Race 102 6.3 History, Public Health, and Modern Racialism 104 6.4 Racializing Pandemics 105 6.4.1 Pandemics, Ideology, and Explanation 105 6.4.2 Race, Epidemiology, and Risk 108 6.4.3 Racism, Oppression, and Causality 109 6.5 COVID-19 and Race 111 6.5.1 COVID-19 and Racial-Ideological Explanation 111 6.5.2 COVID-19 and Race as an Epidemiological Marker 112 6.5.3 COVID-19 and Racism as a Causal Factor 113 6.6 Conclusion 116 References 118 501392_1_En_2_PartFrontmatter_OnlinePDF 122 Part II Public Policy and Administration 122 501392_1_En_6_Chapter_OnlinePDF 123 7 Is There a Duty to Treat in a Pandemic? 123 7.1 Introduction 123 7.2 Oaths and Codes 126 7.3 Maybe There Is a Duty to Treat: The Pro Argument 128 7.4 On the Other Hand: The Con Argument 130 7.5 Conclusion 132 References 133 501392_1_En_7_Chapter_OnlinePDF 135 8 Principlist Pandemics: On Fraud, Ethical Guidelines, and the Importance of Procedural Transparency 135 8.1 Introduction 136 8.2 Philosophical Debates on Principlism 137 8.3 Principlist Pandemic Guidelines and the Functions of Ethics 139 8.4 Procedural Considerations for the Development of “Good” Ethical Guidance 144 8.5 Conclusion 148 References 150 501392_1_En_8_Chapter_OnlinePDF 153 9 Public Tasks During Contagious Disease Pandemics: A Rights-Based Perspective 153 9.1 Basic Assumptions of Rights-Based Ethics 154 9.2 The State as the Primary Bearer of Tasks in Contagious Disease Pandemics 159 9.3 The Unavoidable Ambivalence of Protective Measures and Its Normative Relevance 161 9.4 Dealing with the Impediments of Bureaucracy 163 9.5 The Importance and Limitations of the Protection of Life and Health 164 9.6 Instead of a Conclusion: The Importance of Prevention and Preparedness 167 References 169 501392_1_En_9_Chapter_OnlinePDF 171 10 Allocating and Prioritizing Health Care in Times of Scarcity and Abundance 171 10.1 Introduction to Justice and Allocation 172 10.1.1 Contexts in Which Allocation Decisions Are Made 173 10.2 Essential Goods 174 10.3 Who is Responsible for Allocating Essential Goods 175 10.3.1 Legal Authority and Responsibility 175 10.4 Justice and Allocation 178 10.4.1 Bioethics 178 10.4.2 Bioethics and Allocation 180 10.4.3 Crisis Standards of Care 183 10.4.4 Critiques of CSC 188 10.5 Conclusion 191 References 196 501392_1_En_10_Chapter_OnlinePDF 199 11 Addressing Pandemic Disparities: Equity and Neutral Conceptions of Justice 199 11.1 Racial and Ethnic Health Disparities During the COVID-19 Pandemic 201 11.2 Modelling Why Pandemic Disparities Arise 203 11.3 Health Disparities as Inequities 204 11.4 What Does Justice Require? 206 11.5 Can Neutral Interventions Promote Equity? 207 11.6 Beyond Neutrality 208 11.7 Equity and Allocation of Resources 209 11.8 An Alternative Approach 212 11.9 Conclusion 216 References 220 501392_1_En_11_Chapter_OnlinePDF 223 12 COVID-19 in Skilled Nursing Homes and Other Long-Term Care Facilities (LTCFs): Could Stronger Public-Health Measures Have Made a Difference? 223 12.1 Introduction 225 12.2 Healthcare Workers’ Responsibility to Provide Care During an Influenza Pandemic 226 12.3 Responsibility of Workers in Critical Industries During an Influenza Pandemic 229 12.4 Balancing the Rights of the Individual and the Need to Protect the Public 231 12.5 Prioritization and Use of Limited Resources During an Influenza Pandemic 233 12.6 Conclusion 234 References 238 501392_1_En_12_Chapter_OnlinePDF 241 13 The UN System, COVID-19 Responses, and Building Back Better: Toward an Inclusive, Accessible and Sustainable World 241 13.1 The Situation of Persons with Disabilities and Leaving no One Behind 243 13.2 Building Back Better 246 501392_1_En_BookBackmatter_OnlinePDF 249 Index 249