Throughout the COVID-19 pandemic, the Nuffield Council on Bioethics has consistently raised the importance of transparency in decision-making, especially the values that inform decisions.

Our latest publication 'Ethics tools for decision-makers: Responding to public health threats' aims to help decision-makers with this.

Drawing on our in-depth work on public health ethics, these tools explain what action decision-makers can take to develop a proportionate response to public health threats, guided by important public values such as reducing suffering, being fair and being respectful.

Key points include:

  • There are no easy answers but responses to public health threats can be guided by the values of reducing suffering, treating people with respect, and fairness.
  • Options for public health interventions range from doing nothing to removing choice altogether.
  • Decision-makers should aim for a proportionate response that takes into account the nature and degree of the harm posed, the certainty of the evidence, the intrusiveness of the intervention, and the views of those affected.
  • Decision-makers need to be alert to the need for transparency and accountability in decision making processes.

The tools include a version of our widely used ladder for public health interventions, adapted with examples for responding to COVID-19.

Katharine Wright, lead author and Assistant Director of the Nuffield Council on Bioethics, said:

Public health threats such as COVID-19 are ethically challenging because they cannot be managed effectively by individuals alone, and any action taken will have broad and relatively indiscriminate impact. We believe looking at the problem through an ethics lens can help us reach good decisions about how to respond.