News9th June 2026

Nuffield Council on Bioethics publish a rapid ethics assessment to support time-constrained policymakers

The Nuffield Council on Bioethics, working in collaboration with the University of Birmingham and Faculty of Public Health, have developed a new Rapid Ethics Assessment and Learning method, seeking to support policymakers to embed ethics into their time-pressured work.

In time-constrained or crisis situations, when uncertainty can be high and evidence incomplete, dealing with fairness, proportionality and trade-offs is often inconsistent. This can lead to an exacerbation of inequalities or unintended harms.

While long-established processes exist to encourage scrutiny of scientific evidence, there is a lack of frameworks able to surface and interrogate ethical implications within time-pressured situations. In recognition of this, the Nuffield Council on Bioethics (NCOB) has worked with partners to develop a new prototype Rapid Ethics Assessment and Learning (REAL) method.

REAL intends to be a 5-stage pragmatic decision-support which policy professionals and institutions can use to quickly identify and address ethical challenges. Its design is based upon insights gathered through consultation and testing events with more than 170 participants from around 30 UK policy and public sector organisations.

Steven Bow, Chair of the Faculty of Public Health’s Ethics Committee said:

Decisions about public health policy and strategy are driven not only by technical considerations and expertise, but by the ethics and values which form the foundation of our work. Much of our energy is taken up by the former – but this cannot come at the expense of good ethical practice.

In times of urgency and crisis, decision-makers may not have the time or resources for extensive philosophical deliberations. We need practical resources that we can use quickly to guide our actions. This tool – a product of ongoing collaboration between the Faculty of Public Health, the University of Birmingham, and the Nuffield Council on Bioethics – is designed to fill this gap.”

The difficulties and barriers policy professionals can experience when trying to effectively embed ethical considerations into their fast decision-making are not unique to the UK. Evidence from the ESRC funded Ethics and Expertise (E&E) project has identified similar issues in how ethics advice is provided to, and accessed by, Governments and policymakers in the UK, Germany and Australia.

REAL incorporates some of these international insights, attempting to support policymakers in their identification and clarification of the potential risks, trade-offs and harms present in different policy contexts. The hope is that in doing this, REAL can help its users to make ethically informed decisions and be transparent in their justification for any necessary intervention.

Dr Marija Antanavičiūtė who joined the NCOB on a 12-month E&E secondment to lead on the development of REAL said:  

The REAL method provides a structured way to identify and think through the ethical tensions involved in policy decision-making, while maintaining pace. Developed collaboratively with policy professionals, the method is designed to be practical, accessible, and adaptable across different public sector contexts. I hope it will contribute to more transparent and accountable policymaking, support better management of future risks, and enhance ethics capabilities across the public sector.”

The REAL evidence report published today summarises the research underpinning its design, and the lessons learnt thus far in its co-design and development process. This is accompanied by a user guide that seeks to demonstrate how REAL could fit into the policy design cycle.

Danielle Hamm, Director of the Nuffield Council on Bioethics said:

We often hear from deadline-focused policymakers that they simply lack the time needed to incorporate ethics meaningfully into their work. While we are sympathetic to this, a route through is needed as overlooking ethics can risk causing real harm. This prototype REAL method is an attempt to build something that can enable faster and more consistent ethical reflection. We look forward to further testing the method and seeing how it fairs in an array of policy contexts.”

The version of REAL we have published today is a working prototype we are keen to test and refine further. As such, for the next stage of this project, we are seeking UK policymakers we can work with to apply and assess the useability of REAL in retrospective, current or yet-to-happen real-world situations. These experiences will then be captured as case studies demonstrating how the REAL method can be embedded within different teams and adapted to a variety of internal processes, statutory duties, and existing guidance frameworks.

Steven Bow continued:

The contributors to this report are committed to supporting the further development of this prototype over the coming years. Please use it, feedback to us about how it performs in action, and suggest how we can refine future iterations.”

If you or your team would be interested in working with us to test REAL, please get in touch via press@nuffieldbioethics.org.