A Possible Framework for Uncovering the Ethical Framing of Public Health Policies
Davide Vecchi, Giorgio Airoldi
Organização:  Philosophy of Science Association/Institute for the Future of Knowledge
11 / 05 / 2021

In our opinion, one pivotal lesson stemming from the current pandemic crisis concerns the need for a more transparent public debate regarding the ethical framing of public health policies in the light of a limited but constantly growing evidential basis. This relative epistemic ignorance has necessarily transpired to the political and societal debate: as a consequence, the crucial trade-off between the costs and benefits of non-pharmaceutical interventions on public health, the economy, society and democracy has been mostly addressed in a fragmented fashion, often leading to governments’ decisions that appear idiosyncratic or even erratic to citizens. In this talk, we illustrate an analytic framework tailored to clarify the ethical rationale of the various public health strategies for epidemics management. First, we classify the possible public health targets (e.g., eradication, effective management) in terms of infection rate R. Secondly, we show how different strategies (e.g. local suppression, containment, mitigation) might, individually or in combination, achieve these targets. We shall focus on population-immunity strategies and characterise, in particular, the so-called “herd-immunity” variant. In this context, we shall frame the immunity debate by discussing the mismatch between the original conception of herd immunity and its contemporary version, by suggesting how population immunity can be pursued through a calibrated and evolving mix of pharmaceutical and non-pharmaceutical interventions (e.g., vaccination, natural exposure of the population to infection, targeted non-pharmaceutical interventions) and, finally, by identifying the possible ethical rationale of herd-immunity strategies. We shall argue that the proposed analytic framework has the potential to partially clarify the ethical framing of public health policies and, as a consequence, to facilitate the terms of the public debate in the context of health emergencies.

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