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Re-thinking Public Ethics
The complexity of public heallth requires an different ethical framework to conventional medical ethics and how a divergence in our public ethics needs urgent attention.
Background
Covid-19 as radically transformed the way in which we see society. The pandemic has humbled us in more ways than one. As a direct consequence of globalisation, the spread of the virus has disrupted our economic, political and cultural systems to the extent that we have begun to question the merits of a globalised society. We have seen the entire world has come together in a show of solidarity with a plethora of ways in which civic society has pooled resources - human and financial - to build back community resilience. However, the pandemic has also shone a light on our inherently divergent views on public health ethics, and by extension our 'goals' as a society. Lockdowns, vaccinations, track-and-trace have diminished individul and economic liberrty in favour of
Key Ideas
Firstly, we must ecknoqledge the complexity of public ethics and public health. Healthcare, as it is already understood, compromises of healthcare delivery frrom medical instutitions to individual patients. Here, the principles of medical ethics - autonomy, justice, beneficience, non-malificience - play central roles in determining what ought to be done, and what ought not to be done. Public health - of which Covid-19 is very much a crisis - is an entirely different ball game. It focuses on population health, not individual; it deals with social determinants of health beyond the healthcare system; and it requires collective - often state-backed- intervention of multiple actors, and as such, can be related to the legal system. All in all, it makes for a complex system, where the ethics are not clear cut.
Secondly, based on the inherent complexity of the system and it seeking 'population-level' intervention, we are confronted with the dilemma of figuring out what values we - as a society, not individuals - hold in highest regard. Do we, for instance, respect individual liberty over all other values? Do we hold good health and equity of access to healthcare above all other values? Or, do we have a more pluralist approach and hold multiple, and at times contravening values - each at least partically incommensurable to one another? How do we decide whether imposing an economic lockdown is justified? Who wins and who loses? Are we moving towards a paternalistic state? All these questions comprise the dilemma of figuring out what goods or ultimate goals we hold as a society.
Thirdly, understanding that divergence is not a necessarily a public 'bad', can we reconcile as to whether states are truly autonomous in their assertion of their values, or whether a globalised world makes this less so.
Who wins and who loses?
Future
Without a clear normative framework of assessing the validity and 'rightness' of state or collective actions, we lack the moral courage to know what to do in times of crisis. Political ideologies and notions of what is good for society run the the policies and rhetoric. Instead of first ackowledging whether our actions and policies are in accordance with a guiding set of principles, we run the risk of being run at the whim of a government who is no more clued up about their ethical duties and other global players.
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