Ethics, moral values and society’s feedback that should be taken into account, along with scientific data, when deciding policies about public health were discussed in the inaugural event of Cyprus Epidemiology and Public Health Association (CyEPHA), titled ‘Public Health Risks and Moral Responsibility: the case of the coronavirus pandemic”.
Dr Jessica Nihlen Fahlquist, Associate Professor at the Centre for Research Ethics and Bioethics of the University of Uppsala was the key speaker of event, held during the European Public Health (EUPHA) Week, whose message was “Building resilient health systems”.
Dr Nihlen Fahlquist said that it was clear that there were ethical aspects to discuss during the pandemic. She noted that based on the same evidence, countries chose to follow different strategies to combat the pandemic. She put those risk-management strategies in three categories: the “laissez-faire” strategy, where only few, if any, measures were taken, the “herd immunity” strategy, where measures were left on a voluntary basis and the “aggressive” strategy, where governments followed stringent interventions, limiting civil rights. This shows, she said, that it’s not just about the scientific evidence, but different views on acceptable risk, ethics and moral responsibility also play a key role, when deciding how to act.
She went on to present three ethical theories: utilitarianism, where you maximize utility, considering the consequences, the deontological theory, which is based on complying with duties, regardless of consequences and virtue theory, where on acts as a virtuous person would.
Dr Nihlen Fahlquist suggested that the conventional risk management is based on utilitaranism, where risk-benefit analysis is used to make decisions on morally acceptable risk, including the notion that a risk to one person might be outweighed by a benefit to another.
She noted that in the vaccination debate there were some problematic views, but not all of them were unjustified. Some of people’s views were shaped based on the known versus the new risk, the natural versus artificial risks, voluntariness and control, cultural, social, political views. “We cannot make conclusions about ethical values directly from knowing what people think, but at least some of these are normatively justifiable”, she said.
The responsibility of the government was to take into account considerations, such as how to minimize the spread and fatalities, protecting the health care system, protecting the economy and the education system, preventing mental illness. In doing so, it wasn’t just about balancing risk-benefit, but also taking into account other values, such as trust, empathy, solidarity, responsibility, she said.
Both governments and individuals need to take action and responsibility, she noted. “Unless there are also behavioural changes among the individuals, long-term change is unlikely to occur, she said, adding that “we need to develop some character traits, such as solidarity, responsibility for other people”.
When asked, Dr Nihlen Fahlquist said that family, society and the system are responsible to set an example for children, in order for them to grow up to be empathetic, have solidarity. “Family and society can facilitate virtue”, she noted.
Also, during the discussion, she said that it is important for governments to be transparent. “We need ethical debate in society”. “It’s very important to be opened”, she added.
Receive feedback from society, include them in the decision making
During the panel discussion, in the second part of the event, the importance of including the society in the decision-making process was emphasized. Dr Andrie Panayiotou, Associate Professor at Cyprus University of Technology, answering how to avoid misinformation and disinformation during a crisis, said that ignorance was just one of the factors for the spread of misinformation.
“Knowledge is just one factor. Especially in health-related issues, it is important to emphasise for public to become part of a community that provides feedback, especially in society values”, she said. “Science shouldn’t dictate policy; it should inform it”, she noted, adding that “we need to become better in communicating risk and uncertainty and get feedback from society. Unless we are open about the risk and benefit, we are counter-productive and open the door on misinformation,” she concluded.
In her intervention, Dr Dinike Zeegers Paget, Executive Director of EUPHA, talking about a more resilient health system, said that it is important to innovate, check what worked in the past and what not, be attentive towards inequalities, learn from the evidence and how to present them. She especially emphasized that a well-trained work force is essential, since health care workers got a burnout and students stopped their health studies.
Dr Ourania Kolokotroni, Assistant Professor at Cyprus University of Technology, noted on the same subject that “we need to help people built a higher sense of solidarity and trust on what governments are doing. You need transparency and inclusiveness to do that. It wasn’t only about having the resources but also about respecting the fact that healthcare workers got a burnout. Cultivating trust needs transparency, inclusiveness and including people in decisions”.
Dr Georgios Nikolopoulos, Associate Professor at the University of Cyprus, and President of the Interim Board of the newly formed CyEPHA, said that it is important to educate people on the ethical parameters and to involve in the decision making the community affected.
Cyprus Epidemiology and Public Health Association is newly formed and already an official member of EUPHA. Dr Dineke Zeegers Paget, Executive Director of EUPHA greeted the event, congratulating the CyEPHA for their initiative.
Dr Georgios Nikolopoulos, President of CyEPHA said that an announcement will follow in the next few weeks for people interested to join the association.
Source: Cyprus News Agency