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Decrease transmission through physical distancing

New cases can be decreased with masks and staying apart.

  • Public health laws should provide authority for appropriate actions that might be necessary in the event of a public health emergency. WHO Ethics in Pandemic Flu
  • Public health laws should clearly delineate the procedures that must be followed to institute particular public health measures. WHO Ethics in Pandemic Flu
  • Public health laws should recognize the importance of grounding public health actions in scientific evidence. WHO Ethics in Pandemic Flu
  • Public health laws should pay attention to ethical principles of necessity, proportionality, social justice, liberty, confiden­tiality, reciprocity, fair process, efficiency, trans­parency and accountability. WHO Ethics in Pandemic Flu
  • Public health laws should protect the confidentiality and security of per­sonal information and limit the disclosure of personal health information to the minimum necessary to achieve legitimate public health ob­jectives; information should be shared only for legitimate public health purposes, and to the maximum extent possible individuals should be informed about third parties’ access to their per­sonal information, the intended use of the infor­mation and the reasons the information is being shared. WHO Ethics in Pandemic Flu
  • In considering whether to adopt particular public health strategies, countries should rely on the best available scientific evidence. WHO Ethics in Pandemic Flu
  • Plans related to the isolation of symptomatic individuals and quarantine of their contacts should be voluntary to the greatest extent possible (see Box 4); mandatory measures should only be in­stituted as a last resort, when voluntary meas­ures cannot reasonably be expected to succeed, and the failure to institute mandatory measures is likely to have a substantial impact on public health. WHO Ethics in Pandemic Flu
  • Requirements for mandatory liberty-limiting and social distancing interventions should be imposed only in cases in which voluntary actions seem unlikely to be effective. CDC Ethics in Pandemic Flu
  • Restrictions on individual liberties should not be adopted un­less there is a reasonable expectation that they will have a significant impact on containing the spread or mitigating the impact of the disease, and they should be terminated when they no longer appear to offer significant benefits. WHO Ethics in Pandemic Flu
  • In enacting any measure where personal freedom is limited, the least restrictive, effective measure should be taken. Enactment of these measures should be based on the best available scientific evidence. CDC Ethics in Pandemic Flu
  • The protocol should be founded upon the principles of proportionality and least restrictive means, should balance individual liberties with protection of public from harm, and should build in safeguards such as the right of appeal. University of Toronto
  • Ensure that resulting interventions have the least restrictions necessary to protect the public. APHA Code of Ethics, 4.2.8.
  • Ensure that reasonable alternative options are considered and evaluated and that final public health policies and plans are designed to most effectively accomplish stated goals while minimizing the potential for harm. APHA Code of Ethics, 4.5.9.
  • Plans related to social-distancing measures should provide employment protection for workers who comply with social-distancing measures against the wishes of their employers. WHO Ethics in Pandemic Flu
  • Agencies responsible for imposing restrictions such as quarantine, isolation or other limitations must take into consideration the fact that the impacted population, their family members, and other dependents will require adequate access to food, water and other essential services. CDC Ethics in Pandemic Flu
  • Governments and the health care sector should institute measures and processes to guarantee provisions and support services to individuals and/or communities affected by restrictive measures, such as quarantine orders, implemented during a pandemic [COVID19] emergency. University of Toronto
  • Plans should state in advance what backup support will be available to help those who are quarantined (e.g., who will do their shopping, pay the bills, and provide financial support in lieu of lost income). University of Toronto
  • Governments should have public discussions of appropriate levels of compensation in advance, including who is responsible for compensation. University of Toronto
  • Plans related to the isolation of symptomatic individuals and quarantine of their contacts should provide for infection control measures appropri­ate to each confinement context (such as hospi­tals, temporary shelters, or homes) in order to protect others from infection. WHO Ethics in Pandemic Flu
  • Plans related to the isolation of symptomatic individuals and quarantine of their contacts should ensure safe, habitable, and humane conditions of confinement, including the provision of basic necessities (food, water, clothing, medical care, etc) and, if feasible, psychosocial support for people who are confined. WHO Ethics in Pandemic Flu
  • Plans related to the isolation of symptomatic individuals and quarantine of their contacts should consider the development of mechanisms to ad­dress the potential financial and employment consequences of confinement. WHO Ethics in Pandemic Flu
  • Plans related to the isolation of symptomatic individuals and quarantine of their contacts should protect the interests of household members of individuals who are isolated and treated at the household level, including recommending or providing alternative housing if living with the isolated patient is likely to put them at significant risk of illness (for example, immunocompromised family members). WHO Ethics in Pandemic Flu
  • Plans related to the isolation of symptomatic individuals and quarantine of their contacts should provide fair procedures for making decisions about affected individuals; in extraordinary cir­cumstances, exceptions to normal procedural protections may be appropriate where immedi­ate action is essential to protect the health of others, but in all cases legal recourse should be available to individuals to challenge their isola­tion or quarantine. WHO Ethics in Pandemic Flu
  • Restrictions on personal freedom should be equitably applied. CDC Ethics in Pandemic Flu
  • Ensure that resulting interventions do not have a disproportionately negative impact on minority or otherwise vulnerable populations (including children and elders) and that there is an effort to enhance the resilience of populations and ecosystems to prevent future harm. APHA Code of Ethics, 4.2.9.
  • Avoid unintentional stigmatization of specific groups within the community. APHA Code of Ethics, 4.5.5.
  • Consider and, where possible, address determinants of health that reside outside a person’s genetic endowment and personal behaviors, including the circumstances in which people grow, live, work, and age. These determinants might include individual resources, community resources, hazardous exposures, and opportunity structures. APHA Code of Ethics, 4.5.7.
  • Reduce or eliminate negative impacts on communities and the environment, particularly as these negative impacts tend to be disproportionately experienced by individuals already faced with health inequities. APHA Code of Ethics, 4.5.8.
  • There should be no unwarranted invasions of privacy and the mechanisms for maintaining confidentiality of private information should be secure. CDC Ethics in Pandemic Flu
  • Governments and the health care sector should include measures in their pandemic influenza preparedness plans to protect against stigmatization and to safeguard the privacy of individuals and/or communities affected by quarantine or other restrictive measures. University of Toronto
  • Promote policies that enhance community health and well-being and collaboratively respect the privacy, dignity, and civil liberties of individuals and communities affected by the policies and plans. APHA Code of Ethics, 4.5.3.
  • Plans related to social-distancing measures should to the extent possible, provide means of miti­gating adverse cultural, economic, social, emo­tional, and health effects for individuals and communities. WHO Ethics in Pandemic Flu
  • When closure of public venues is being considered, determination must be made of which public venues are more essential in maintaining the functioning of society and may need to remain open with some constraints on level of access. CDC Ethics in Pandemic Flu
  • A process should be in place for objections to be heard, restrictions appealed, and for new procedures to be considered prior to implementation. CDC Ethics in Pandemic Flu
  • Water cannons fired at COVID protesters in Belgium (video). BBC News, November 22, 2021.
  • Mass protests against lockdowns and vaccines in Prague, Rome, Amsterdam. EuroNews, November 20, 2021.
  • Why Healthcare workers are quitting in droves. The Atlantic, November 16, 2021.
  • NHS doctor receives 20-30 abusive messages a day (video). BBC News, January 13, 2021.
  • Retail workers have become public health enforcers and have been met with violent reactions. The New York Times, May 15, 2020.
  • Pandemic shaming is directed at those perceived as violating social-distancing rules. However, complete isolation is not sustainable and has had negative consequences on individuals. The Atlantic, May 11, 2020

 

 



What is Pandemic Ethics?

A pandemic is pervasive in scope and touches virtually every human-made system. In this dashboard, we focus on ethics in a government’s or an employer’s actions in a pandemic.

Public health ethics addresses the relationship between those governing or administrating and the population or employees they serve. They are best summarized by the Public Health Code of Ethics of the American Public Health Association.

Contact Jim Thomas