Difficult trade-offs in response to COVID-19: the case for open and inclusive decision making

Norheim, Ole Frithjof; Abi-Rached, Joelle M.; Bright, Liam Kofi; Bærøe, Kristine; Ferraz, Octávio Luiz Motta; Gloppen, Siri; Voorhoeve, Alex

doi:10.1038/s41591-020-01204-6

Cited by 78 publications

(57 citation statements)

References 14 publications

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“…While policies taken against the pandemic differ from one place to another, there are two divergent views on the effect that different political regimes may have in preserving national public health. Some scholars argue, on the one hand, that democratic governments are disadvantaged in combatting the spread of formidable diseases, like COVID-19, because the respect for individual rights and freedom precludes them from taking aggressive or drastic measures which their authoritarian counterparts could adopt ( Alsan et al, 2020 ; Norheim et al, 2020 ; Thomson & Ip, 2020 ). A series of recently published papers show that democratic countries suffer from more COVID-19 deaths than authoritarian states ( Cepaluni et al, 2020 ; Cheibub et al, 2020 ; Frey et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Political regime, data transparency, and COVID-19 death cases

Annaka

2021

SSM - Population Health

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The COVID-19—the worst pandemic since the Spanish flu—has dramatically changed the world, with a significant number of people suffering from and dying of the disease. Some scholars argue that democratic governments are disadvantaged in coping with the current pandemic mainly because they cannot intervene in their citizens' lives as aggressively as their authoritarian counterparts. Other scholars, however, suggest that possible data manipulation may account for the apparent advantage of authoritarian countries. Taking such a possibility seriously, this paper analyzes the relationship between political regimes, data transparency, and COVID-19 deaths using cross-national data for over 108 countries, obtained from Worldometer COVID-19 Data, Polity V Project, Variety of Democracy (V-Dem) Project, HRV Transparency Project among other sources. Regression analyses indicate that authoritarian countries do not necessarily tend to have fewer COVID-19 deaths than their democratic counterparts after controlling for other factors, especially data transparency. The transparency variable itself, on the other hand, is positively correlated with the number of death cases more consistently ( P <0.05). Overall, the estimation results point to the possible data manipulation, not the nature of regime characteristics itself, as a more significant source for the seemingly low casualty rates in authoritarian countries.

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Section: Introductionmentioning

confidence: 99%

Political regime, data transparency, and COVID-19 death cases

Annaka

2021

SSM - Population Health

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“…89 As such, public and patient involvement provides an important moral foundation for difficult ethical decisions in the reset phase and beyond. 90 Our review maintained methodological rigour by including a systematic search strategy where possible and double screening and double coding 25% of sources. Team discussions to develop the coding framework and reflect on emerging findings were also ongoing throughout.…”

Section: Open Accessmentioning

confidence: 99%

Which ethical values underpin England’s National Health Service reset of paediatric and maternity services following COVID-19: a rapid review

et al. 2021

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ObjectiveTo identify ethical values guiding decision making in resetting non-COVID-19 paediatric surgery and maternity services in the National Health Service (NHS).DesignA rapid review of academic and grey literature sources from 29 April to 31 December 2020, covering non-urgent, non-COVID-19 healthcare. Sources were thematically synthesised against an adapted version of the UK Government’s Pandemic Flu Ethical Framework to identify underpinning ethical principles. The strength of normative engagement and the quality of the sources were also assessed.SettingNHS maternity and paediatric surgery services in England.ResultsSearches conducted 8 September–12 October 2020, and updated in March 2021, identified 48 sources meeting the inclusion criteria. Themes that arose include: staff safety; collaborative working – including mutual dependencies across the healthcare system; reciprocity; and inclusivity in service recovery, for example, by addressing inequalities in service access. Embedded in the theme of staff and patient safety is embracing new ways of working, such as the rapid roll out of telemedicine. On assessment, many sources did not explicitly consider how ethical principles might be applied or balanced against one another. Weaknesses in the policy sources included a lack of public and user involvement and the absence of monitoring and evaluation criteria.ConclusionsOur findings suggest that relationality is a prominent ethical principle informing resetting NHS non-COVID-19 paediatric surgery and maternity services. Sources explicitly highlight the ethical importance of seeking to minimise disruption to caring and dependent relationships, while simultaneously attending to public safety. Engagement with ethical principles was ethics-lite, with sources mentioning principles in passing rather than explicitly applying them. This leaves decision makers and healthcare professionals without an operationalisable ethical framework to apply to difficult reset decisions and risks inconsistencies in decision making. We recommend further research to confirm or refine the usefulness of the reset phase ethical framework developed through our analysis.

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“…Beyond HHGE, calls for PSE linked to science policy development for emerging technologies have arisen in recent years for topics ranging from nanotechnology, human embryo research, and shale gas to vaccine mandates (International Society for Stem Cell Research, 2021;Jones, 2014;Norheim et al, 2021;Pham, 2016;NRC, 2012;NASEM, 2017;North et al, 2014;Jasanoff, 2004;Warnock, 1984). However, it is often unclear what PSE is, what its goals are, how to achieve them, and ultimately how the data collected from PSE can be used effectively to inform policy recommendations and decision making.…”

Section: Introductionmentioning

confidence: 99%

Public and Stakeholder Engagement in Developing Human Heritable Genome Editing Policies: What Does it Mean and What Should it Mean?

2021

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As scientific research pushes the boundaries of knowledge, new discoveries and technologies often raise ethical and social questions. Public responses vary from surprise, to unrealistic optimism about imminent new treatments, confusion, and absolute opposition. Regardless of the intent, the use of a precise gene editing tool on human embryos, such as CRISPR-Cas9, is an example of such a controversial emerging technology. Substantive disagreement about the appropriate research pathways and permissible clinical applications is to be expected. Many ethical concerns, especially related to genetic manipulation of human embryos, are rooted in deeply held moral, religious, or ideological beliefs that science alone cannot address. Today, more scientists and scientific societies as well as policy makers are calling for public and stakeholder engagement in developing guidelines and policies governing scientific practice. We conducted a critical interpretive review of the literature on public and stakeholder engagement in science policy development regarding emerging technologies to determine the ideals that should guide engagement efforts of entities developing recommendations or guidelines on policy for such technologies. We identify and describe five ideals. To illustrate possible applications of these ideals, we review the engagement efforts described in three reports on heritable human genome editing and assess those efforts in light of these ideals. Finally, we recommend possible avenues for engagement that would advance those goals.

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Difficult trade-offs in response to COVID-19: the case for open and inclusive decision making

Cited by 78 publications

References 14 publications

Political regime, data transparency, and COVID-19 death cases

Political regime, data transparency, and COVID-19 death cases

Which ethical values underpin England’s National Health Service reset of paediatric and maternity services following COVID-19: a rapid review

Public and Stakeholder Engagement in Developing Human Heritable Genome Editing Policies: What Does it Mean and What Should it Mean?

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