Back in February the World Health Organisation held a meeting in Geneva about the gathering coronavirus epidemic. Several bioethicists have summarised the discussions about ethical principles in an article in the journal Public Health Ethics. Amongst the five authors is Ezekiel Emanuel, a former Obama adviser whom President-elect Joe Biden has named to his Covid-19 task force.
The principles are not the four familiar ones taught in medical schools: respect for autonomy, beneficence, non-maleficence, and justice. Here are the main concerns which emerged from the meeting:
Solidarity, “the practice of standing up together and acting in common”. “Just as infection spreads through connection, our ethical response requires us to act together to ensure recognition of our common nature, needs and value.”
Equal Moral Respect. “There can be no room for disagreement regarding the equal moral respect that is owed to every individual. In short, equal moral respect serves as a fundamental precondition for fair and equitable treatment.”
Equity. “Treating people equitably means treating like cases alike, e.g. treating people in accordance with their unique needs.”
Autonomy. “An autonomous individual is able to control what happens to their bodies and lives. Autonomous people may also forego making choices.”
Vulnerability. “Its core ethical function is to mark out the need for additional ethical consideration—or, heightened ethical scrutiny in the context of research—towards the risks and threats faced by a person or group regarded as potentially vulnerable.”
Trust. “During public health emergencies, such as COVID-19, action is required to ensure the maintenance of trustworthiness in those given responsibility for the response.”
Interestingly, solidarity is the first cab off the rank, not autonomy, which has been the default principle in most contemporary ethical discourse. Does this reflect a growing feeling that – in the words of Craig Klugman — that
“Bioethics has pushed too far in the direction of the individual and needs to have a turn toward the importance of the community and the common good”?
Michael Cook – editor of BioEdge