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COVID-19 ethics resources

Last updated 8 April 2020

The Nuffield Council has drawn together a list of resources which focus on ethical aspects of the COVID-19 pandemic. These are split into the following sections:

  • Opinions and blog
  • Other news pieces
  • Journal articles
  • Guidance and policy
  • Multimedia content
  • Resource collections on other websites

This resource will be updated regularly by the Nuffield Council’s Executive. If you would like to suggest an addition to this list, please contact Sophia Griffiths.

**The contents of this page do not constitute the opinion of the Nuffield Council on Bioethics. For the Council’s work on COVID-19, see this page of our website.**

Opinions and blogs

Barristers contribute to their chamber’s blog in a piece which argues that there is an urgent need for a national policy on allocation and withdrawal of ventilation. (Serjeants’ Inn, 6 April 2020)

Daniel Tigard (Munich Institute for History and Ethics of Medicine) explores the bioethical implications and concerns around ‘immunity passports’ (Bioethics.net, 6 April 2020)

Carly Kind, Director of the Ada Lovelace Institute, discusses the implications of COVID-19 for data governance, and suggests that “beneath the veneer of high-tech solutions, the coronavirus response is exposing the cracks in the data governance ecosystem”. (Ada Lovelace Institute, 2 April 2020)

Sir John Chisholm, the Chair of the British Medical Association’s Medical Ethics Committee, comments on the organisation’s guidance for doctors on how to ensure resource allocation decisions are ethical. (The Guardian, 1 April 2020)

Joseph Fins (Division of Medical Ethics at Weill Cornell Medical College) discusses 2015 guidelines on allocating ventilators during public health emergencies drawn up by the New York State Task Force on Life and the Law. He rebuts criticism that the guidelines discriminate against people with disabilities. (The Hastings Center, 1 April 2020 (discussing an opinion piece in The New York Times by Ari Ne’eman, 23 March 2020)

Hollister M (World Economic Forum blog, 30 March 2020) AI can help with the COVID-19 crisis - but the right human input is key

Klitzman R (The Hill, 29 March 2020) How hospitals will decide who lives and who dies in the COVID-19 crisis

Zohny H (Practical Ethics, 24 March 2020) Pandemic ethics: Covid-19 shows just how much of ethics depends on (good) data

Stall N and Sinha S (The Globe and Mail, 26 March 2020) COVID-19 isn’t the only thing that’s gone viral. Ageism has too

Savulescu J (The Guardian, 25 March 2020) Is it right to cut corners in the search for a coronavirus cure?

Morley G (JME Blog, 25 March 2020) COVID-19 and the moral community: a nursing ethics perspective

Marckmann G (Deutsche Welle, 24 March 2020) Coronavirus and ethics: ‘act so that most people survive

Rainey S (Practical Ethics, 24 March 2020) Politics, ethics, and shutting down in the face of COVID-19

Blakely T (Pursuit (University of Melbourne blog) 22 March 2020) The maths and ethics of minimising COVID-19 deaths

Baggini J (Prospect, 20 March 2020) How is the medical profession to cope with the appalling moral dilemmas it now faces?

Sokol D (The BMJ Opinion, 20 March 2020) The life and death decisions of COVID-19

Food Ethics Council (19 March 2020) Ethics in our food response to COVID-19

Marika Warren discusses what role healthcare ethicists might play in responding to the COVID-19 pandemic (Impact Ethics, 18 March 2020)

Faden R (MV Times, 18 March 2020) Bioethics during the COVID-19 crisis: ‘We need an epidemic of kindness’

Slim H (The New Humanitarian, 18 March 2020) This age of COVID-19 demands new emergency ethics

Savulescu J and Wilkinson D (ABC News, 17 March 2020) Who gets the ventilator in the coronavirus pandemic? These are the ethical approaches to allocating medical care

Johns Hopkins Berman Institute of Bioethics (17 March 2020) Coronavirus: ethical concerns in planning a response

Gandhi R and Patel A (Scientific American, 16 March 2020) What if two COVID-19 victims need ventilators and just one is available?

McBride K (Poynter, 16 March 2020) When should you name COVID-19 patients and other ethical decisions US newsrooms will face this week

Parsons J (Ricochet, 16 March 2020) COVID-19 outbreak in Canada calls for an ethics of collective care

Ives J (The Guardian, 14 March 2020) Coronavirus may force UK doctors to decide who they’ll save

Fernandez E (Forbes, 13 March 2020) The COVID-19 coronavirus is now a pandemic – can we ethically deal with lockdowns?

Symons X (The Sydney Morning Herald, 13 March 2020) Rationing care to cope with COVID-19 should never be based on age alone

Wetsman N (The Verge, 12 March 2020) Personal privacy matters during a pandemic – but less than it might at other times

Wynia M and Hick J (STAT News, 10 March 2020) If Covid-19 gets bad, triage will be needed. Are we ready for that?

Pagel C (9 March 2020) Covid-19: how to triage effectively in a pandemic

Sandberg A (Practical Ethics, 4 March 2020) Pandemic ethics: the unilateralist curse and Covid-19, or why you should stay home

Wilkinson D (The Conversation, 26 February 2020) Coronavirus: should frontline doctors and nurses get preferential treatment?

Other news pieces

The New York Times reports that the UK Government has drafted criteria which sets out an approach for triaging patients who have COVID-19 but, to avoid panic, has decided not to publish or disclose this document. The document had originally been planned to be released at the end of March. (The New York Times, 3 April 2020)

Ira Bedzow and Lila Kagedan (New York Medical College) discuss resource allocation decisions that healthcare practitioners will have to face as part of their response to COVID-19. (CNN Opinion, 1 April 2020)

New York is an early COVID-19 ‘hotspot’ in the US. This article discusses how the city’s healthcare workers will have to make decisions over which patients receive, or do not receive, aggressive treatment measures. (The New York Times, 1 April 2020)

The decisions and dilemmas that will face US healthcare workers, and how they will interpret existing state guidelines on resource allocation in the face of the COVID-19 pandemic are explored in a piece which also notes that there is no federal guidance on rationing. (Vox, 31 March 2020)

The Irish Times (30 March 2020) Coronavirus: medical staff may face ‘emotional distress’ over patient prioritisation

Decisions around triage and resource allocation are no longer abstract. How can guidance help healthcare providers make difficult decisions for COVID-19 patients? (Undark, 29 March 2020)

An exploration of how the pandemic in Italy, how the US might be affected, and how American healthcare decision-makers might approach resource allocation. Includes comment from Arthur Caplan. (Inside Science, 27 March 2020)

Ethicists and healthcare experts discuss the lack of preparedness in some US states for rationing and triage decisions, highlighting the lack of a national conversation about how such decisions will be made. The prospect of ‘lottery’ or ‘first come first served’ systems are also highlighted. (Politico, 27 March 2020)

The role of ethics in guiding who decisions about who gets treated, and who doesn’t, for COVID-19. Includes comments from Ezekiel Emanuel (University of Pennsylvania), and Francis Collins (Director, NIH). (USA Today, 23 March 2020)

Ethicists, public health experts, and historians discuss the dilemmas around who should get treatment, who should not, and why. (Los Angeles Times, 19 March 2020)

A discussion of the use and prospective uses of mobile phone data – including to monitor people’s movements during the pandemic – from a US perspective, including the impact on people’s privacy. (Wired, 18 March 2020)

Q&A with Christine Mitchell (Center of Bioethics, Harvard Medical School) on the medical ethical implications of the COVID-19 pandemic. (The New Yorker, 11 March 2020)

Journal articles

Arie S (2020) Covid-19: can France’s ethical support units help doctors make challenging decisions? BMJ369: m1291

Berger ZD, Evans NG, Phelan AL et al. (2020) Covid-19: control measures must be equitable and inclusive BMJ 368: m1141

Emanuel EJ, Persad G, Upshur R et al. (2020) Fair allocation of scarce medical resources in the time of Covid-19 New England Journal of Medicine

Gopichandran V, and Subramaniam S (2020) Response to Covid-19: an ethical imperative to build a resilient health system in India Indian Journal of Medical Ethics

Lewnard JA, and Lo NC (2020) Scientific and ethical basis for social-distancing interventions against COVID-19 The Lancet Infectious Diseases

Rosenbaum L (2020) Facing Covid-19 in Italy – ethics, logistics, and therapeutics on the epidemic’s front line New England Journal of Medicine

Truog RD, Mitchell C, and Daley GQ (2020) The toughest triage - allocating ventilators in a pandemic New England Journal of Medicine

White DB, and Lo B (2020) A framework for rationing ventilators and critical care beds during the COVID-19 pandemicJAMA

Zhang H, Shao F, Gu J et al. (2020) Ethics committee reviews of applications for research studies at 1 hospital in China during the 2019 novel coronavirus epidemic JAMA

Guidance and policy

European Group on Ethics in Science and New Technologies (3 April 2020) Statement on European solidarity and the protection of fundamental rights in the COVID-19 pandemic

Scottish Government (3 April 2020) Coronavirus (COVID-19): ethical advice and support framework

Irish Department of Health (1 April 2020) Ethical framework for decision-making in a pandemic

British Medical Association (1 April 2020) COVID-19: ethical issues

Royal College of Physicians (31 March 2020) Ethical dimensions of COVID-19 for frontline staff

National Bioethics Commission of Mexico (30 March 2020) Bioethics in the face of the COVID-19 pandemic

German Ethics Council / Deutscher Ethikrat (27 March 2020) Solidarity and responsibility during the coronavirus crisis

UNESCO (26 March 2020) Ethics in research in times of pandemic COVID-19

UNESCO's International Bioethics Committee (IBC) and UNESCO World Commission on the Ethics of Scientific Knowledge and Technology (COMEST) (26 March 2020) Statement on COVID-19: ethical considerations from a global perspective.

European Disability Forum (24 March 2020) Updated statement: ethical medical guidelines in COVID-19: disability inclusive response

Royal College of Psychiatrists (20 March 2020) COVID-19: ethical considerations

NICE (26 March 2020) Supporting clinical decision making (COVID-19 context)

Blavatnik School of Government, University of Oxford (25 March 2020-present) Oxford COVID-19 government response tracker

Swiss Academies of Arts and Sciences and the Swiss Society for Intensive Care Medicine (SGI) (24 March 2020) Intensive care medicine: triage in case of bottlenecks

World Health Organization (21 March 2020) Ethical standards for research during public health emergencies: distilling existing guidance to support COVID-19 R&D

Health Research Authority(20 March 2020) COVID-19: guidance for sponsors, sites and researchers

Department of Health and Social Care (19 March 2020) COVID-10: ethical framework for adult social care

Italian Society for Anesthesia Analgesia Resuscitation and Intensive Care (16 March 2020) Clinical ethics recommendations for the allocation of intensive care treatments in exceptional, resource-limited circumstances

Social Science in Humanitarian Action (March 2020) Key considerations: online information, mis- and disinformation in the context of COVID-19

Coalition for Epidemic Preparedness Innovations (CEPI) (2019) Clinical trials policy

Multimedia content

Radio 4 (5 April 2020) Sunday: includes a discussion on ethical principles which underscore the decisions around providing life-saving treatment during the pandemic.

The New Yorker podcast (20 March 2020) Radio hour: includes discussion on the ethical quandaries facing doctors on the frontline of the COVID-19 response in the US.

Radio 4 (1 April 2020) The global philosopher – pandemic ethics

WYPR (27 March 2020) Ruth Faden: medical ethics during the COVID-19 pandemic

Philosophical disquisitions (17 March 2020) Ethics in the time of corona

The Moral Maze (4 March 2020)

Ethics Talk podcast: COVID-19 pandemic response (March 2020)

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