Public health ethics: critiques of the “new normal”

Jamrozik, Euzebiusz

doi:10.1007/s40592-022-00163-7

Cited by 10 publications

(5 citation statements)

References 47 publications

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“…Our investigation revealed that few COVID-19 public health guidelines considered values and preferences, which may have contributed to unpopular pandemic policies and led to an erosion of trust in public health (35)(36)(37)(38)(74)(75)(76)(77).This erosion of trust may present a challenge for managing future crises, which may again require cohesive and coordinated efforts from the public.…”

Section: Discussionmentioning

confidence: 96%

Values and preferences in COVID-19 public health guidelines: A systematic review

Kirsh,

Ling,

Jassal

et al. 2024

Preprint

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Background: Internationally accepted standards for trustworthy guidelines include the necessity to ground recommendations in values and preferences. Considering values and preferences respects the rights of citizens to participate in health decision–making and ensures that guidelines align with the needs and priorities of the communities they are intended to serve. Early anecdotal reports suggest that COVID–19 public health guidelines did not consider values and preferences. Objective: To capture and characterize whether and how COVID–19 public health guidelines considered values and preferences. Methods: We performed a systematic review of COVID–19 public health guidelines. We searched the eCOVID19 RecMap platform–a comprehensive international catalog of COVID–19 guidelines–up to July 2023. We included guidelines that made recommendations addressing vaccination, masking, isolation, lockdowns, travel restrictions, contact tracing, infection surveillance, and school closures. Reviewers worked independently and in duplicate to review guidelines for consideration of values and preferences. Results: Our search yielded 129 eligible guidelines, of which 43 (33.3%) were published by national organizations, 73 (56.6%) by international organizations, and 14 (10.9%) by professional societies and associations. Twenty–six (20.2%) guidelines considered values and preferences. Among guidelines that considered values and preferences, most did so to assess the acceptability of recommendations (23; 88.5%) and by referencing published research (24; 92.3%). Guidelines only occasionally engaged laypersons as part of the guideline development group (6; 23.1%). None of the guidelines performed systematic reviews of the literature addressing values and preferences. Conclusion: Most COVID–19 public health guidelines did not consider values and preferences. When values and preferences were considered, it was suboptimal. Disregard for values and preferences in guidelines might have partly contributed to divisive and unpopular COVID–19 policies. Given the possibility of future health emergencies, we recommend guideline developers identify efficient methods for considering values and preferences in crisis situations.

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Section: Discussionmentioning

confidence: 96%

Values and preferences in COVID-19 public health guidelines: A systematic review

Kirsh,

Ling,

Jassal

et al. 2024

Preprint

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“…Further, it is now well recognised that the harms of stringent public health measures are often concentrated among disadvantaged groups. 41 If the transmission dynamics of Nipah virus were to significantly change toward higher risk of human-to-human spread among casual contacts, wider public health measures may, under certain conditions, become more ethically acceptable. However, such measures are not currently justifable given that most spread of Nipah virus occurs among close contacts, and the previous Kerala outbreak in 2018 was controlled without extreme measures such as lockdown -with the response instead focusing on healthcare settings in particular 22 .…”

Section: Use Of Excessively Stringent Public Health Measuresmentioning

confidence: 99%

Ethical issues in Nipah virus control and research: addressing a neglected disease

Johnson,

Jamrozik,

Hurst

et al. 2023

J Med Ethics

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Nipah virus is a priority pathogen that is receiving increasing attention among scientists and in work on epidemic preparedness. Despite this trend, there has been almost no bioethical work examining ethical considerations surrounding the epidemiology, prevention, and treatment of Nipah virus or research that has already begun into animal and human vaccines. In this paper, we advance the case for further work on Nipah virus disease in public health ethics due to the distinct issues it raises concerning communication about the modes of transmission, the burdens of public health surveillance, the recent use of stringent public health measures during epidemics, and social or religious norms intersecting with preventive measures. We also advance the case for further work on Nipah virus disease in research ethics, given ethical issues surrounding potential vaccine trials for a high-fatality disease with sporadic spillover events, the different local contexts where trials may occur, and the potential use of unproven therapeutics during outbreaks. Further bioethics work may help to ensure that research and public health interventions for Nipah virus disease are ethically acceptable and more likely to be effective.

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“…Substantial mathematical modeling efforts have focused on health and economic impacts of severe acute respiratory syndrome (SARS), pandemic influenza, and coronavirus disease 2019 (COVID- 19), as well as the impacts of public health interventions (7,8). However, although numerous ethical considerations are directly relevant to the justification of epidemic control policies (9,10), investigations of the ethical implications of pandemic response in general and the COVID-19 response in particular have typically focused on allocation of scarce resources (9,(11)(12)(13)(14), disparities in health outcomes (15), and issues of research ethics (16,17), as opposed to quantitatively informed ethical analysis of the benefits and harms of control policies and individual compliance with public health measures. This article examines mathematical modeling techniques that we have developed to explore how individual and collective behavior changes can affect two specific outcomes: (i) the probability that an epidemic becomes established in a population and (ii) the total number of infections that occur once an epidemic is established.…”

Section: Introductionmentioning

confidence: 99%

Quantifying the impact of individual and collective compliance with infection control measures for ethical public health policy

Roberts¹,

Jamrozik

Heriot

et al. 2023

Sci. Adv.

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Infectious disease control measures often require collective compliance of large numbers of individuals to benefit public health. This raises ethical questions regarding the value of the public health benefit created by individual and collective compliance. Answering these requires estimating the extent to which individual actions prevent infection of others. We develop mathematical techniques enabling quantification of the impacts of individuals or groups complying with three public health measures: border quarantine, isolation of infected individuals, and prevention via vaccination/prophylaxis. The results suggest that (i) these interventions exhibit synergy: They become more effective on a per-individual basis as compliance increases, and (ii) there is often substantial “overdetermination” of transmission. If a susceptible person contacts multiple infectious individuals, an intervention preventing one transmission may not change the ultimate outcome (thus, risk imposed by some individuals may erode the benefits of others’ compliance). These results have implications for public health policy during epidemics.

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Public health ethics: critiques of the “new normal”

Cited by 10 publications

References 47 publications

Values and preferences in COVID-19 public health guidelines: A systematic review

Values and preferences in COVID-19 public health guidelines: A systematic review

Ethical issues in Nipah virus control and research: addressing a neglected disease

Quantifying the impact of individual and collective compliance with infection control measures for ethical public health policy

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