As the global numbers of COVID-19 infections and deaths surge, the unprecedented and rapidly changing emergency begs many ethical questions, such as how much personal freedom and privacy people are willing to sacrifice to contain the pandemic, how limited resources should be distributed, how vaccines and medicine could be developed faster under proper supervision, and how these goals can be achieved while protecting minorities.
These are direct and common moral challenges faced by governments, healthcare workers and the public worldwide.
A state of emergency requires fast responses and decisions. During this period, governments might attempt to suspend or forgo democratic mechanisms for checks and balances, and it is precisely under such circumstances that a more subtle and nuanced dialogue about ethics is needed.
What kinds of personal freedom and privacy are people prepared to forgo?
A major challenge in preventing disease from spreading is how to strike a balance between government power and personal freedom and privacy, such as the right to choose or refuse medical treatment.
There have been several unsettling developments; for instance, the Chinese government took people walking on the street in Wuhan into custody or dragged people away from their homes, and Australia plans to more widely implement emergency legislation — the Biosecurity Act, which was passed in 2015 — that would allow the government to put people suspected of posing a threat to public health and safety under lawful detention or quarantine. In Taiwan, several mayors and county commissioners have unilaterally announced travel bans on students and teachers up to the high-school level.
On Feb. 25, the Legislative Yuan passed the Special Act on COVID-19 Prevention, Relief and Restoration (嚴重特殊傳染性肺炎防治及紓困振興特別條例). Article 7 of the act gives the head of the Central Epidemic Command Center the power to “implement any necessary response measures for the purpose of disease prevention and control.” The authorization of such power raises the question of whether sufficient consideration of ethical issues and the rule of law have gone into the decision.
How should limited resources be distributed?
As the number of infections worldwide continues to increase, questions arise on whether the demand for supplies, facilities and healthcare personnel would quickly surpass existing resources. Another difficult question is how to distribute medicine, intensive care facilities, personal protective gear, research budgets and basic commodities in the most adequate manner.
The government must make decisions on several key aspects, such as who should receive treatment and where they should be treated, which patients should be given uncommon medical treatment or be treated with advanced technology, whose interests should be served by healthcare professionals and emergency services, and how they should be deployed, as well as how should food, protective clothing and other necessities be distributed.
When Italy adopted “wartime” triage criteria for the distribution of medical resources, it raised questions about whether that is a pragmatic approach that superseded the principle of protecting minorities. Another question is why the British government adopted a “natural selection” laissez-faire approach toward the epidemic. When it comes to the distribution of medical supplies, Taiwan’s system for purchasing masks and an upgraded online purchasing platform perhaps can serve as an example for other nations.
How can new medicine be promptly developed without sacrificing safety?
A pandemic caused by a new virus needs to be dealt with by researching and developing a vaccine and medical treatment. The issue is how to strike a balance between the unknown risks of a new drug and the urgent need to quickly curb the infection.
During the process of researching and developing a new treatment, the issue is how to ensure that clinical trials are being properly supervised and whether the testing period can be shortened or the number of volunteers reduced. Other questions include whether it is acceptable for a biotech company to bypass animal testing — a standard development procedure — to ensure drug safety and proceed directly to clinical trials, and if volunteers and patients are prepared to accept a higher risk if the drug has 70 percent effectiveness.
Amid the spreading epidemic and increasing panic, the public needs to work hard to uphold moral values, such as mutual respect, responsibility, fairness and care for minorities. It might be a challenging task when confronted by a pressing situation, as people tend to overlook or abandon certain values when they panic.
There are no simple answers to these questions, but at least it is time for people to start talking about these issues, look into the values that are most likely to be given up and think about whether they should forsake them so easily.
Huang Sue-ying is the founder and executive director of Taiwan Women’s Link.
Translated by Chang Ho-ming
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