@angelobottone@qoto.org

Breda O'Brien: We have failed our older and more vulnerable citizens

https://www.irishtimes.com/opinion/we-have-failed-our-older-and-more-vulnerable-citizens-1.4237079

How religious practice in Ireland is adapting to the lockdown https://ionainstitute.ie/how-religious-practice-in-ireland-is-adapting-to-the-lockdown/

How Should We Approach Triage in the Crisis? #covid19ethics https://ionainstitute.ie/how-should-we-approach-triage-in-the-crisis/

The ethics of a lockdown (III) Proportionality and pandemics. A difficult assessment. https://ionainstitute.ie/proportionality-and-pandemics-a-difficult-assessment/ #covid19ethics

Rationing healthcare mainly by age is unacceptable https://ionainstitute.ie/rationing-healthcare-mainly-by-age-is-unacceptable/

CW long post, original content

On the balance of goods

Risk is the probability that damage happens. In these difficult days both the damage due to the Corona virus and its probability to happen have reached unprecedented and critical levels.

Obviously, risk assessment is the task of specialists. They esteem the reliability of data and the possible future variations. Their models present different plausible scenarios and then political authorities, and society in general, have to take decisions based not only on our knowledge but on our values as well.

Decision-making involves both technical and evaluative elements. Once we know of the conceivable advantages of possible scenarios, we need to choose the one we prefer and this is when ethics becomes relevant as it helps us to create a hierarchy of values aimed at guiding our choices.

What goods have to be thrown into the scale? Which ones should we prefer?

Health is a public good, no doubt, but it is not the only one. Moreover, if our first imperative is to save lives, we still need to question whether a certain policy, for instance a strong limitation of movements and contacts, has an impact on our lives that is equally detrimental, if not even more harmful. Long-term as well as short-term consequences need to be evaluated.

Car accidents happen but we don’t close all the roads to prevent them. We close a road when it is dangerous, when it presents an unbearable risk.

So, how do you “flatten the curve” without flattening society altogether? There are no fast answers.
Every policy has costs, not simply in economic terms but also from the point of view of human relationships, mental health, the environment, civic liberties, etc.

In order to tackle Covid-19 most countries have chosen a politics of mitigation that avoids overwhelming the health system and buys time, with the hope that a vaccine for the virus will be available reasonably soon.
However, we need to set out different considerations regarding the good that this politics produces or precludes.

The restriction in the circulation of people, commodities and services has profound impact on our society.
It freezes entire sectors such tourism and hospitality, sport and public entertainment.
It impedes long-term migration and temporary travelling, it limits public worship and the mourning of our deaths, it frustrates education at all level and research, whether it happens locally of far from home.
The overall impact on the economy is devastating and it might even generate conflicts between nations on the long term.

House confinement also affects physical health, due to lack of movements or to the inability to access necessary treatments and services. Checks and procedures are postponed, access to medications becomes arduous. And, similarly, we can imagine the ill consequences on our mental health and our psychological moods.

A rise in domestic violence, divorces, intergenerational conflicts within the family and disputes with the neighbors can be foreseen.
And there is also the political significance of restricting fundamental freedoms to be considered.

This reflection is not meant to be a direct critique of a specific policy. Rather, it is in attempt to highlight how the ethical implications of the current pandemic have a wide scope.
All the examples just stated are goods that contribute to a just and flourishing society. Tragically, whatever we chose to do will deprive us of some of them.

CW long post

Ethical questions in a pandemic

The current epidemic raises a number of profound ethical questions. We are facing unprecedented events under the pressure of time and of limited resources. In the name of urgency and necessity we are experiencing exceptional restrictions of fundamental liberties, and a significant alteration of our familiar ways of living.
After the initial shock, when energies are inevitably focused on emergency measures, it is now time to address more fundamental issues that this epidemic has highlighted.
Why do we need a debate about ethics now? In the current exceptional circumstances, it seems that many decisions are not free choices, but they are rather dictated by necessity. Nonetheless, practical deliberations are always inspired by values. Either consciously or unconsciously, we all operate within a moral framework. We decide to pursue a certain course of action, rather than another, because we deem certain principles more important than others. This is obvious when we face conflictual duties – for instance, saving lives and preserving freedom – and we ultimately follow a certain road because of our deep philosophical commitments.
Strategic decisions are now led more by the assessments of the experts than the democratic mandate which legitimizes our political representatives. National and international bureaucratic structures define our common tasks in terms of measurable effectiveness to the point that we feel we are living in a tyranny of the specialists, legitimated by their scientific expertise.
Nothing should be done against science, but the problem is that science is not about ends, it is about means. Medicine tell us how to save lives but doesn’t tell us which lives should or shouldn’t be saved, and why they should be saved at all. Experts disagree, not only on purely scientific grounds – for instance, which treatment works better – but also on what we ultimately want to achieve. Different policies are expression of different values and it would be foolish to move through an epoch-defining outbreak without having a debate about what we ultimately want and why.
We need a debate about ends. What are we here for? The good life in a community, says an old tradition that goes back to our Greek philosophical roots.
What clearly emerges in front of our eyes these days is that we can’t understand ourselves as individuals. We are members of a community. My life depends on what other people around me do. My best efforts will count nothing without everybody else’s best efforts. More than ever, this epidemic requires us to think and act in solidarity, which literally means being strong together. This solidarity is necessary not only in action but firstly in the way we frame and approach our problems.
We are operating in fear and isolation, under the pressure of unprecedented events. We hear that we are forced to trade different values against each other. But to think according to an ethics of solidarity means that conflicts and tensions should be framed not in terms of opposition but as if they all together threaten to the same end, which is the common good.
It would be wrong to present our dilemmas in terms of exclusive interests: for instance, should we care for the sick or for the one who might lose his job? If we address this problem through the prism of solidarity, we will realise that it is the same person who is at risk of getting sick and losing their job, it is the same family, it is the same community.
Roles are now swiftly exchangeable – a health carer becomes a patient – and the same person often embodies many roles – someone who works from home may also be a carer or a patient. There is no family or group that is not potentially impacted. Traditional categories such as social class, gender, ethnicity, are now insignificant. We are all one and should think in solidarity.
In a competitive struggle for scarce resources, we give priority to those we consider more valuable, overlooking the rest. In a solidaristic approach, we give precedence to those who are most in need.
As every epidemic, this one is significantly impairing what constitutes a community, such as the acting physically together. Everything that is communal is currently affected, from mourning our deaths to celebrating sports, from worshipping to travelling. However, the present epidemic is different when compared with the big ones of the past, think of the Black Death, because contemporary means of communication allows us to be united in spirit with those who are distant. Even if only virtually, certain expressions of solidarity are easier to perform.
As part of a community, we have a duty to limit some of our legitimate desires and demands if they put others at risk. And risk should be understood not simply in the sense of physical health. There is a risk of cutting meaningful relationships, of compromising the education of the younger generations, of impairing mental wellbeing, of destroying business and charitable work, of neglecting those who suffer for other reasons, etc.
The wide scope of risk is what makes this epidemic difficult to manage and it is not the role of ethics to identify what is practically appropriate in each circumstance. Our task, instead, is to inquire what goods we want to achieve and what moral principles should guide us.
I will address in a separate article the moral dilemma of prioritizing access to scarce medical resources but the general principle I am proposing, inspired by an ethics of solidarity, is that everyone should be cared according to their needs, rather than ability or, more often, inability to contribute to society.
An ethics of solidarity involves sacrifice. However, the question should not be formulated in terms of who we are willing to sacrifice for the common good. It is rather, what should be sacrificed? No one should be discriminated because is less abled, has less prospect of life, or can’t pay.
Different approaches and strategies employed to tackle this pandemic reflect who we care most. In any assessment of a balance of goods we should remember the dignity of the most vulnerable. Solidarity means that it is precisely those who are weaker that we hold stronger.
Measures have to be proportionate but what is a fair proportion cannot be determined in advance. By definition, this depends on the circumstances. What, instead, can and should be discussed is what society we wish for when promoting public health.
We won’t be able to do all the good we would like to accomplish but have we established what this good is? Let’s have this conversation.

Ethical questions in a pandemic https://ionainstitute.ie/ethical-questions-in-a-pandemic/

Breda O'Brien: Need to prove guilt beyond reasonable doubt protects us all https://www.irishtimes.com/opinion/need-to-prove-guilt-beyond-reasonable-doubt-protects-us-all-1.4226195