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Rheeder AL. The Ethical Assessment of the Stay-At-Home Order in South Africa in Light of The Universal Declaration of Bioethics And Human Rights (UNESCO). JOURNAL OF BIOETHICAL INQUIRY 2024; 21:229-237. [PMID: 37882951 PMCID: PMC11288983 DOI: 10.1007/s11673-023-10304-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 08/30/2023] [Indexed: 10/27/2023]
Abstract
The South African government announced the much-discussed stay-at-home order between March 27 and April 30, 2020, during what was known as lockdown level 5, which meant that citizens were not allowed to leave their homes. The objective of this study is to assess the stay-at-home order against the global principles of the UDBHR. It is deducible that, in reference to the UDBHR, the government possessed the right to curtail individual liberty, thereby not infringing on Article 5 of the UDBHR and therefore, in this context, passes the test of the UDBHR. However, it remains uncertain at present whether the limitation of freedom imposed by the South African stay-at-home order was successful in controlling the spread of COVID-19 and protecting individuals from harm. Initial investigations also indicate that individuals who are particularly vulnerable may not have received equitable treatment in accordance with the principle outlined in Article 10, therefore, it can be cautiously and modestly argued that the stay-at-home order does not withstand scrutiny when assessed against the UDBHR. Given the continued discussion about the efficacy of limiting freedom to control the spread of COVID-19, and the growing conviction that the advancement of justice is being called into question, the notion of least restriction ought to be considered seriously. Ten Have (2022) is correct in asserting that global bioethics should also seriously consider other principles beyond an almost exclusive focus on limiting individual freedom. The preliminary conclusion is that the potential implementation of the stay-at-home order in the future must be seriously reconsidered.
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Affiliation(s)
- A L Rheeder
- Faculty of Theology, North-West University, Potchefstroom Campus, Private Bag X 6001, Potchefstroom, 2520, South Africa.
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Kraaijeveld SR, Gur-Arie R, Jamrozik E. A Scalar Approach to Vaccination Ethics. THE JOURNAL OF ETHICS 2023; 28:145-169. [PMID: 38375445 PMCID: PMC10874331 DOI: 10.1007/s10892-023-09445-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 07/28/2023] [Indexed: 02/21/2024]
Abstract
Should people get vaccinated for the sake of others? What could ground-and limit-the normative claim that people ought to do so? In this paper, we propose a reasons-based consequentialist account of vaccination for the benefit of others. We outline eight harm-based and probabilistic factors that, we argue, give people moral reasons to get vaccinated. Instead of understanding other-directed vaccination in terms of binary moral duties (i.e., where people either have or do not have a moral duty to get vaccinated), we develop a scalar approach according to which people can have stronger or weaker moral reasons to get vaccinated in view of the moral good of vaccination. One advantage of our approach is that it can capture why a person might have strong moral reasons to get vaccinated with Vaccine A, but only weak moral reasons to get vaccinated with Vaccine B. We discuss theoretical strengths of our approach and provide a case study of vaccination against COVID-19 to demonstrate its practical significance.
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Affiliation(s)
- Steven R. Kraaijeveld
- Wageningen University & Research, Hollandseweg 1, 6700 EW Wageningen, The Netherlands
| | - Rachel Gur-Arie
- Edson College of Nursing and Health Innovation, Arizona State University, 550 N 3rd St., Phoenix, AZ 85004 USA
- Oxford-Johns Hopkins Global Infectious Disease Ethics (GLIDE) Collaborative, Oxford, United Kingdom, Baltimore, MD USA
| | - Euzebiusz Jamrozik
- Wellcome Centre for Ethics and Humanities, Big Data Institute, University of Oxford, Li Ka Shing Centre for Health Information and Discovery, Old Road Campus, Oxford, OX3 7LF UK
- Royal Melbourne Hospital Department of Medicine, University of Melbourne, Parkville, 3052 Australia
- Monash Bioethics Centre, Monash University, Clayton, 3168 Australia
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Kraaijeveld SR. The Ethical Significance of Post-Vaccination COVID-19 Transmission Dynamics. JOURNAL OF BIOETHICAL INQUIRY 2023; 20:21-29. [PMID: 36542290 PMCID: PMC9768787 DOI: 10.1007/s11673-022-10223-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 10/27/2022] [Indexed: 05/04/2023]
Abstract
The potential for vaccines to prevent the spread of infectious diseases is crucial for vaccination policy and ethics. In this paper, I discuss recent evidence that the current COVID-19 vaccines have only a modest and short-lived effect on reducing SARS-CoV-2 transmission and argue that this has at least four important ethical implications. First, getting vaccinated against COVID-19 should be seen primarily as a self-protective choice for individuals. Second, moral condemnation of unvaccinated people for causing direct harm to others is unjustified. Third, the case for a harm-based moral obligation to get vaccinated against COVID-19 is weak. Finally, and perhaps most significantly, coercive COVID-19 vaccination policies (e.g., measures that exclude unvaccinated people from society) cannot be directly justified by the harm principle.
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Kraaijeveld SR, Mulder BC. Altruistic Vaccination: Insights from Two Focus Group Studies. HEALTH CARE ANALYSIS 2022; 30:275-295. [PMID: 36454320 PMCID: PMC9713734 DOI: 10.1007/s10728-022-00453-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2022] [Indexed: 12/03/2022]
Abstract
Vaccination can protect vaccinated individuals and often also prevent them from spreading disease to other people. This opens up the possibility of getting vaccinated for the sake of others. In fact, altruistic vaccination has recently been conceptualized as a kind of vaccination that is undertaken primary for the benefit of others. In order to better understand the potential role of altruistic motives in people's vaccination decisions, we conducted two focus group studies with a total of 37 participants. Study 1 included three focus groups on the subject of HPV vaccination for boys. Study 2 included three focus groups on the subject of pertussis and measles vaccination for childcare workers. We found substantial evidence of other-regarding motives across all focus groups, which suggests that altruistic motives could be an important factor when it comes to people's vaccination decisions. We address the significance of these findings for vaccination policy surrounding HPV vaccination for boys and vaccination for childcare workers. We also extend the findings to normative work on vaccination for the sake of others more generally.
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Affiliation(s)
- Steven R Kraaijeveld
- Philosophy Group, Wageningen University & Research, Wageningen, The Netherlands.
| | - Bob C Mulder
- Strategic Communication Group, Wageningen University & Research, Wageningen, The Netherlands
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Kraaijeveld SR, Jamrozik E. Moralization and Mismoralization in Public Health. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2022; 25:655-669. [PMID: 36045179 PMCID: PMC9432796 DOI: 10.1007/s11019-022-10103-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 05/09/2022] [Accepted: 07/07/2022] [Indexed: 11/19/2022]
Abstract
Moralization is a social-psychological process through which morally neutral issues take on moral significance. Often linked to health and disease, moralization may sometimes lead to good outcomes; yet moralization is often detrimental to individuals and to society as a whole. It is therefore important to be able to identify when moralization is inappropriate. In this paper, we offer a systematic normative approach to the evaluation of moralization. We introduce and develop the concept of 'mismoralization', which is when moralization is metaethically unjustified. In order to identify mismoralization, we argue that one must engage in metaethical analysis of moralization processes while paying close attention to the relevant facts. We briefly discuss one historical example (tuberculosis) and two contemporary cases related to COVID-19 (infection and vaccination status) that we contend to have been mismoralized in public health. We propose a remedy of de-moralization that begins by identifying mismoralization and that proceeds by neutralizing inapt moral content. De-moralization calls for epistemic and moral humility. It should lead us to pull away from our tendency to moralize-as individuals and as social groups-whenever and wherever moralization is unjustified.
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Affiliation(s)
| | - Euzebiusz Jamrozik
- Oxford-Johns Hopkins Global Infectious Disease Ethics Collaborative, Johns Hopkins University, Baltimore, United States
- Ethox and Wellcome Centre for Ethics and Humanities, University of Oxford, Oxford, United Kingdom
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Galasso I. Inequalities in the Challenges Affecting Children and their Families during COVID-19 with School Closures and Reopenings: A Qualitative Study. Public Health Ethics 2022; 15:240-255. [PMID: 36727102 PMCID: PMC9883729 DOI: 10.1093/phe/phac030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Indexed: 12/15/2022] Open
Abstract
School closure is one of the most debated measures undertaken to contain the spread of the Coronavirus disease (COVID-19) pandemic. The pandemic has devastating health and socio-economic effects and must be contained, but schools play a vital role in present and future well-being, capabilities and health of children. We examine the detrimental consequences of both the closure and reopening of schools, by focusing on inequalities in the challenges affecting children and their families. This paper is grounded on Irish and Italian data from a multi-national longitudinal qualitative interview study. Research participants articulated a variety of issues and challenges that highlight inequalities in access to education during school closures, in the supportiveness of home setting, and in school preparedness to reopen, often mirroring or exacerbating pre-existing inequalities. The reported unequal lived experiences indicate that some harms are actionable, and already suggest some potential harm mitigation strategies. We conclude by advocating for enhanced public consultation to help mitigate the consequences of public dilemmas in general, and to help detect and tackle inadequacies and inequalities for school children through and beyond the pandemic, by learning from the experience of the concerned actors.
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Chongloi H. Trial by media: evaluating the role of mainstream media and fact-checking agencies during the COVID-19 pandemic. INTERNATIONAL JOURNAL OF HUMAN RIGHTS IN HEALTHCARE 2022. [DOI: 10.1108/ijhrh-07-2022-0070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Purpose
The purpose of this paper is to critically assess the function of the media during the COVID-19 pandemic. It tries to understand how media corporations selectively polish a certain narrative against the other. It will also take into consideration the role of fact-checking agencies and its reliability in determining what is right and wrong.
Design/methodology/approach
This study uses qualitative methods and relies on secondary data available in academic domains. In this paper, a specific case related with the COVID-19 pandemic is taken up. Conflicting accounts of health professionals both in academic and industry are compared and analysed. Professional integrity of fact-checking agencies as well goes through scrutiny.
Findings
After conducting a critical analysis, it is observed that media houses have violated certain ethics while presenting news and opinions during the COVID-19 pandemic. Without any consideration of fair presentation, the mainstream media resorted to presenting vaccine hesitancy as conspiracy and deplatformed such voice from the media. This violates one’s freedom to free speech and expression.
Research limitations/implications
It is a viewpoint from the side of a free speech abolitionist.
Practical implications
Press will realize that it failed in a number of occasions to uphold and protect its ethical values.
Originality/value
A study questioning the role of media during the COVID-9 pandemic is rare. In this regard, adequate literature is always a difficulty considering the amount of censorship imposed by health agencies, academic institutions and the media. This particular study is built of limited yet reliable information made available by academicians and independent health professionals. As such, the value of work which focuses on the alternative perspectives is believed to add value to health professionals, policymakers, media professionals and the general population.
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Schaefer GO, Ballantyne A. Ethics of digital contact tracing wearables. JOURNAL OF MEDICAL ETHICS 2022; 48:611-615. [PMID: 33990428 PMCID: PMC8127281 DOI: 10.1136/medethics-2020-106958] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 02/27/2021] [Accepted: 05/04/2021] [Indexed: 06/12/2023]
Abstract
The success of digital COVID-19 contact tracing requires a strategy that successfully addresses the digital divide-inequitable access to technology such as smartphones. Lack of access both undermines the degree of social benefit achieved by the use of tracing apps, and exacerbates existing social and health inequities because those who lack access are likely to already be disadvantaged. Recently, Singapore has introduced portable tracing wearables (with the same functionality as a contact tracing app) to address the equity gap and promote public health. We argue that governments have an ethical obligation to ensure fair access to the protective benefits of contract tracing during the pandemic and that wearables are an effective way of addressing some important equity issues. The most contentious issues about contact tracing apps have been the potential infringements of privacy and individual liberty, especially where the use of apps or other technology (such as wearables or QR codes) is required for access to certain spaces. Here we argue that wearables, as opposed to apps alone, will make a digital contact tracing mandate more practical and explain some conditions under which such a mandate would be justified. We focus on Singapore as a case study that has recently deployed contact tracing wearables nationally, but also reference debate about wearables in Australia and New Zealand. Our analysis will be relevant to counties trialling similar portable tracing wearables.
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Affiliation(s)
- G Owen Schaefer
- Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Angela Ballantyne
- Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand
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Schippers MC, Ioannidis JPA, Joffe AR. Aggressive measures, rising inequalities, and mass formation during the COVID-19 crisis: An overview and proposed way forward. Front Public Health 2022; 10:950965. [PMID: 36159300 PMCID: PMC9491114 DOI: 10.3389/fpubh.2022.950965] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 07/25/2022] [Indexed: 01/24/2023] Open
Abstract
A series of aggressive restrictive measures were adopted around the world in 2020-2022 to attempt to prevent SARS-CoV-2 from spreading. However, it has become increasingly clear the most aggressive (lockdown) response strategies may involve negative side-effects such as a steep increase in poverty, hunger, and inequalities. Several economic, educational, and health repercussions have fallen disproportionately on children, students, young workers, and especially on groups with pre-existing inequalities such as low-income families, ethnic minorities, and women. This has led to a vicious cycle of rising inequalities and health issues. For example, educational and financial security decreased along with rising unemployment and loss of life purpose. Domestic violence surged due to dysfunctional families being forced to spend more time with each other. In the current narrative and scoping review, we describe macro-dynamics that are taking place because of aggressive public health policies and psychological tactics to influence public behavior, such as mass formation and crowd behavior. Coupled with the effect of inequalities, we describe how these factors can interact toward aggravating ripple effects. In light of evidence regarding the health, economic and social costs, that likely far outweigh potential benefits, the authors suggest that, first, where applicable, aggressive lockdown policies should be reversed and their re-adoption in the future should be avoided. If measures are needed, these should be non-disruptive. Second, it is important to assess dispassionately the damage done by aggressive measures and offer ways to alleviate the burden and long-term effects. Third, the structures in place that have led to counterproductive policies should be assessed and ways should be sought to optimize decision-making, such as counteracting groupthink and increasing the level of reflexivity. Finally, a package of scalable positive psychology interventions is suggested to counteract the damage done and improve humanity's prospects.
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Affiliation(s)
- Michaéla C. Schippers
- Department of Technology and Operations Management, Rotterdam School of Management, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - John P. A. Ioannidis
- Department of Medicine, Stanford University, Stanford, CA, United States
- Department of Epidemiology and Population Health, Stanford University, Stanford, CA, United States
- Department of Biomedical Data Science, Stanford University, Stanford, CA, United States
- Department of Statistics, Stanford University, Stanford, CA, United States
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, United States
| | - Ari R. Joffe
- Division of Critical Care Medicine, Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada
- John Dossetor Health Ethics Center, University of Alberta, Edmonton, AB, Canada
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Davies B, Savulescu J. Institutional Responsibility is Prior to Personal Responsibility in a Pandemic. THE JOURNAL OF VALUE INQUIRY 2022; 58:1-20. [PMID: 35001972 PMCID: PMC8721471 DOI: 10.1007/s10790-021-09876-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/12/2021] [Indexed: 06/14/2023]
Affiliation(s)
- Ben Davies
- Oxford Uehiro Centre for Practical Ethics, Suite 8, Littlegate House, St Ebbe’s Street, Oxford, OX1 1PT UK
| | - Julian Savulescu
- Oxford Uehiro Centre for Practical Ethics, Suite 8, Littlegate House, St Ebbe’s Street, Oxford, OX1 1PT UK
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Kavaliunas A, Lindfeldt I, Kyhlstedt M. Reply to a commentary on Swedish policy analysis for Covid-19. HEALTH POLICY AND TECHNOLOGY 2021; 10:100550. [PMID: 34307010 PMCID: PMC8282938 DOI: 10.1016/j.hlpt.2021.100550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Affiliation(s)
- Andrius Kavaliunas
- Department of Clinical Neuroscience, Tomtebodavägen 18A:05, 171 77 Stockholm, Sweden
| | - Isis Lindfeldt
- Department of Sociology and Uppsala Antibiotic Center, Uppsala University, Uppsala, Sweden
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