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Moral Frameworks for Collective Action in Epidemics22 May 2023 Effective and equitable responses to epidemics and pandemics require some degree of collective action and coordination, but in reality, this is often difficult to achieve. Beyond the practical challenges posed by the prospect of collective action, ethical reasons may exist to support actions that run counter to collective action, such as self-preservation, protecting national interests, and so forth. While political and health leaders often make reference to ethical values in epidemic preparedness and response to promote collective action, such as solidarity, some remain unconvinced that such ethical values offer a satisfactory moral framework to support collective action. Given the importance of collective action for epidemic preparedness and response. This webinar, the second in our series on epidemics and collective action, examined the value of different moral frameworks to justify and support collective action in epidemic preparedness and response. It was chaired by Barbara Prainsack, and featured contributions from Anant Bhan, Rachel James, >Diane le Corvec, and Diego Silva. |
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Avian influenza: Ethical preparedness27 March 2023 Concerns about an H5N1 avian influenza pandemic have been renewed following some of the largest ever outbreaks of H5N1 in wild and farmed animals around the world. During 2021-22, outbreaks of a novel strain of H5N1 led to the deaths of over 100 million infected and potentially infected birds. Documented infections in dozens of mammalian species provide evidence both that the strain can jump from birds to mammals, and be transmitted between mammals, raising concerns about impacts on human health. This seminar, was chaired by Helen Branswell, with contributions from Lyle Fearnley, Ngo Thi Hoa, and Ross Upshur explored the distinctive ethical questions and considerations raised by an avian influenza pandemic and discuss priorities for ethical preparedness. |
Collective threats, collective responsibilities and collective action13 March 2023 Epidemics and pandemics represent collective threats to humanity's health and well-being. Effective and equitable responses to epidemics and pandemics arguably require collective action. Collective action is also arguably needed to address some of the causes of epidemics and pandemics, such as climate change. In practice, responding to collective threats can be challenging due to conflicts that can arise between individual interests and collective interests. Even when collective action at a local, national or international level may make individuals, organisations or governments better off, they may fail to cooperate because their individual interests discourage cooperative action. This seminar, which represents the first in a series focused on epidemics and collective action, examined the nature and role of individual and collective responsibility in relation to epidemics, while considering how ethics can help provide a framework for promoting collective action. It was chaired by Professor Adrian M Viens and featured contributions from Professor Caesar Atuire, Professor Daniel S. Goldberg, Professor Sir Nicholas J. White and Professor Vijay Kumar Yadavendu. |
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Public Health emergencies in the Latin America and Caribbean (LAC) region perspective: ethical reflections regarding gendered impacts27 February 2023 Public Health Emergencies (PHE) have been shown to have immediate and long-lasting gendered impacts. The Latin American and Caribbean (LAC) region has been disproportionately impacted by Zika and now COVID-19. Women and girls in the most vulnerable contexts are part of the most affected group in PHEs. This raises urgent ethical questions that challenge us to reflect on how to prepare, research, and respond to current and future PHEs. Gender is important in epidemics and pandemics. A gender-sensitive lens when evaluating PHEs and their impacts can strengthen how we prepare and act in the current and future ones. From a Latin American and Caribbean region perspective, this seminar aims to centre the discussion on the urgent ethical issues exposed by the gendered impacts of PHEs, particularly COVID-19. It was chaired by Dr Luciana Brito and featured panelists Dr Suzanne Serruya, Prof. Gabriela Arguedas-Ramírez and Prof. Maria Elvira Diaz Benitez. |
Beginnings and endings of epidemics and pandemics: ethical dimensions30 January 2023 Several epidemiological metrics exist to inform determinations of whether an epidemic or pandemic has ended, e.g., when a disease has become relatively stable, predictable, and manageable, and disease rates have been reduced to an 'acceptable' level. However, decisions about whether and when the pandemic has 'begun' or 'ended' inherently have social, cultural, political, economic, and ethical dimensions and implications. Important questions arise about who should be involved in decision-making about matters such as what constitutes an 'acceptable' level of disease, and about considerations that should inform such determinations. This seminar, was chaired by Patricia Kingori, and featured panelists Suerie Moon, Ruipeng Lei, and Calvin Ho, and examined the ethical dimensions of determinations of when epidemics and pandemics begin and end. |
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Ethical responses to Ebola: applying lessons learned7 November 2022 In 2014-2016, the largest Ebola outbreak to date, caused by the Zaire ebolavirus strain, was designated as a public health emergency of concern. The Ebola-Zaire strain, which has caused the majority of outbreaks and cases to date, has been the subject of significant research, including the development and licensing of two vaccines. In contrast, for the first time in over a decade, the current outbreak in Uganda is caused by the rarer Ebola-Sudan strain, for which vaccines are currently under development. This seminar, was chaired by Ross Upshur and featured panelists Gloria Mason Ross, David K. Kaawa-Mafigiri and Jerome Singh, and looked at how lessons from previous Ebola outbreaks can contribute to embedding ethics in responses to the current and future ebolavirus outbreaks. |
Long COVID: Minding the Gap Between Infectious Disease and Chronic Condition10 October 2022 'Long COVID', otherwise referred to as 'post-COVID condition' or 'post-acute COVID-19 syndrome', is characterized by the persistence of a wide range of symptoms several weeks beyond the initial onset of symptoms. The incidence and prevalence of long COVID remains unclear, yet the recently published Lancet Commission on lessons for the future from the COVID-19 pandemic suggests that "long COVID might itself be an emerging pandemic". This webinar will explore ethical questions and considerations raised by long COVID, including how to set research priorities, how to care for long COVID patients, what obligations we have to prevent and mitigate SARS-CoV-2 infections given the prospect of long COVID, and how to tackle these challenges in a context of an unsettled definition and diagnostic criteria for long COVID. The webinar was chaired by Voo Teck Chuan, and featured panelists Rachel Grob, Ifeanyi M. Nsofor and Janet Diaz. |
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Monkeypox: How should we ethically respond?13 September 2022 Monkeypox is an Orthopoxvirus that has been endemic to Central and West Africa for several decades. During 2022, monkeypox has spread to over 100 countries, many of which are seeing their first cases of the disease. As a result, on the 23rd of July 2022, the World Health Organization declared monkeypox a public health emergency of international concern, and made a series of recommendations for a global response. These include strengthening public health measures in affected settings and accelerating research into vaccines and therapeutics. However, preventive and treatment options are limited and other public health measures, such as contact tracing and risk communication, have proved challenging. This virtual seminar was chaired by Michael Parker, and featured contributions from Ayodele Jegede, David Heymann and Hayley Macgregor. It examined the ethical considerations arising when responding to monkeypox. |
Ethical priorities for a new international instrument on pandemic prevention, preparedness and response25 July 2022 In December 2021 the World Health Assembly agreed to establish an intergovernmental negotiating body (INB) to develop a WHO instrument to strengthen pandemic prevention, preparedness and response. Currently under development, the ‘pandemic treaty’ aims to protect and promote the well-being of all people and help to keep future generations safer from the impacts of pandemics. This webinar explores the ways in which such a treaty should ensure that the intrinsically ethical values and judgements which inform decisions about how pandemic priorities should be addressed at multinational, national, institutional and individual levels are identified, and appropriately addressed. It was chaired by Ross Upshur, and featured contributions from Calvin Ho, Alexandra Phelan and Mohga Kamal-Yanni. |
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Indigenous communities, 'vulnerability' and the COVID-19 pandemic20 June 2022 Indigenous populations around the world have historically experienced--and continue to experience--both social and economic marginalization, and as a result are at disproportionate risk during public health emergencies. This has led to significant inequities during the COVID-19 pandemic. Unfortunately, measures taken in response to the pandemic have in some instances also created or exacerbated inequities experienced by Indigenous populations. This webinar will explore ethical challenges experienced by Indigenous populations during the COVID-19 pandemic, how explicit and implicit 'vulnerabilities' are portrayed and experienced in this context, and the role that traditional knowledge and practices have played as a source of resiliency. The seminar was chaired by Caesar Atuire, and featured contributions from Nicole Blackman, Nora Parore, Dr Lindsey MacDonald and Joziléia Daniza Jagso, |
Migrant Communities and the COVID-19 Pandemic: Ethical considerations6 June 2022 During the COVID-19 pandemic, migrants have often been denied rights and placed in situations which put them at heightened risk of disease. This webinar looks at migrant communities' explicit and implicit vulnerabilities in relation to COVID-19 and will also consider the ethics of implementing selective and restrictive public health measures for such communities. The webinar was chaired by Professor Lisa Eckenwiler, and featured contributions from Dr Thalia Arawi, Dr Jane Lim, and Professor Vanessa Grotti. |
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‘Vulnerability’ and ‘othering’ during the COVID-19 pandemic16 May 2022 The COVID-19 pandemic has been marked by discourses of ‘vulnerability’ (e.g., identifying groups at increased risk of infection or disease) and practices of ‘othering’ (i.e., acts that target marginalized groups, often as if something is ‘wrong’ with them). For instance, some populations have been deemed ‘vulnerable’ due to socioeconomic factors beyond their control, which has often led to stigmatization, and whole countries have been blamed for negative outcomes, e.g., for the emergence of new variants of concern, which has often led to discrimination and exclusion. If we take the concepts of solidarity and justice seriously, we must consider how pandemic preparedness and response activities can proceed in a manner that avoids stigmatizing, blaming, and othering. This seminar will explore these ideas and will be followed up by additional seminars focusing on how 'vulnerability' and 'othering' have been experienced by specific population groups. This seminar was chaired by Florencia Luna and featured contributions from Tamara Giles-Vernick, Professor Thomas Shakespeare, and Dr. Aqsa Shaikh. |
Using 'unproven' clinical interventions during public health emergencies: Ethical considerations11 April 2022 Epidemics and pandemics of novel pathogens are often characterized by a lack of known therapeutic or preventive interventions. It is therefore imperative to rapidly conduct research to study and develop countermeasures in these contexts. Yet, with research underway and no 'proven' therapeutic or preventive interventions, a question exists as to whether individuals, groups, or populations should be offered 'unproven' preventive and/or therapeutic interventions outside of clinical trials, including “off-label” interventions. This seminar will explore the use of 'unproven' clinical interventions during public health emergencies, coinciding with the recent publication of the World Health Organization's guidance document, 'Emergency use of unproven clinical interventions outside clinical trials: ethical considerations'. It was chaired by Professor Ross Upshur and featured contributions from Dr Alison Bateman-House, Dr Ignacio Mastroleo, and Dr Marta Lado Castro-Rial. |
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Ethics, misinformation, and the COVID-19 pandemic28 March 2022 The COVID-19 pandemic has been accompanied by an infodemic: an overabundance of information – some accurate and some not – that makes it hard for people to find trustworthy sources and reliable guidance when they need it. In this context, misinformation and disinformation can spread at an alarming rate, which can in turn influence public opinion, undermine or support public health responses, and impact the length and intensity of outbreaks. Infodemic management, which includes attempts to understand tactics employed my malicious actors to spread information and 'social listening' – the regular and systematic aggregation, filtering, and monitoring of conversations and public discourse – has become crucial, but raises a number of important ethical considerations and questions. This seminar explored the nature and role of ethics as it relates to the infodemic, misinformation, and infodemic management. It was chaired by Professor Patricia Kingori, and featured contributions from Professor Timothy Caulfield, Ms Noran Adly, Dr Sam Martin and Carolina Batista. |
Trust, trustworthiness and the COVID-19 pandemic14 March 2022 Trust in government and other institutions is said to play a key role in the success of pandemic response. Mistrust and distrust can therefore impede the effectiveness of response measures, leading some countries to fare worse than others despite similarities in epidemiological context and health system infrastructure. So, how exactly does this relationship between trust and successful pandemic response work? What key things should be done to strengthen trust? Insofar as trust has an historical element and can take significant time and effort to build, what can governments and public health authorities do during a crisis when operating with low levels of public trust? Finally, what is the difference between promoting trustworthiness as opposed to promoting trust, and what is the relevance of this distinction for pandemic response efforts? This seminar was chaired by Professor Michael Parker, and featured contributions from Professor Doris Schroeder, Mr Ethan Greenwood, and Dr Lauren Paremoer. |
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Re-visiting mandatory vaccination for COVID-19: evidence and ethics14 February 2022 Vaccines are one of the most effective tools for protecting people against COVID-19. Consequently, some governments and institutions have made COVID-19 vaccination ‘mandatory’ to increase vaccination rates and achieve public health goals, and others may be considering doing the same. Yet, given the rapidly evolving nature of the COVID-19 pandemic and evolving evidence regarding the effectiveness of COVID-19 vaccines against novel variants of concern (e.g., Omicron), the number of doses necessary to achieve public health objectives, and durability of protection, the scientific and ethical justification for mandatory vaccination for COVID-19 is similarly shifting and may be waning. This seminar will take stock of where countries find themselves with respect to the pandemic and explore this present context for evaluating the ethics of mandatory vaccination for COVID-19. It was chaired by Professor Effy Vayena, and featured contributions from Professor Ezekiel Emanuel, Professor Christiane Druml, and Mr Allan Achesa Maleche. |
Ethics and pandemic policies: democracy in crisis31 January 2022 In the context of the COVID-19 pandemic, ethics guidance has valuably informed some health policies and practices, such as oversight of research and crisis standards of care. However it has been less effective at addressing broader questions about how we should live together in this and future pandemics. A recent report by the Hastings Centre suggests that a key barrier to developing ethically informed health policies on major societal questions is the erosion of social cohesion driven by a lack of trust of both institutions and individuals. This trust deficit is a consequence of fundamental socioeconomic conditions marked by wealth inequality and widespread financial precarity, and changes to the information economy, including the rise of social media. This joint webinar hosted by Epidemic Ethics and the Hastings Centre will explore the role of restoring societal decision-making capabilities, in order to rebuild trust, social cohesion and shape ethics-informed pandemic policies and responses. It was chaired by Mildred Z. Solomon, and featured contributions from Bruce Jennings, Eduardo J. Gómez, and Michael K. Gusmano. Download the briefing paper [pdf 113k] |
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Governance, Ethics, and the ACT-Accelerator13 December 2021 The Access to COVID-19 Tools (ACT) Accelerator is a global collaborative effort to accelerate the development, production, and equitable access to COVID-19 tests, therapies, and vaccines (the latter being pursued through its COVAX pillar). Key to accomplishing its mission is establishing which organizations are playing which roles in ACT-A decision-making and ensuring such decision-making is informed by a robust ethical decision-making framework. This seminar will explore the challenges and opportunities related to the governance and ethics of the ACT-Accelerator. This seminar was chaired by Prof Ross Upshur, and featured contributions from Prof Suerie Moon, Dr Owen Schaefer, and Ms Katy Kydd Wright Read the briefing note. |
Restricting population movement during COVID-19: ethics and justifications8 November 2021 In the COVID-19 pandemic, varying approaches to restricting population movements have been implemented globally with the aim of limiting transmission and providing time to scale up diagnostic, prevention and treatment capacities. However broad restrictions, including lockdowns, are associated with significant social and economic burdens, which are inequitably distributed. This seminar reviews questions about when and how restrictions can be ethically justified in a pandemic, and when they should be lifted. It was chaired by Dr Voo Teck Chuan, and featured contributions from Martina di Folco, Ruipeng Lei, and Dr Roberta Andraghetti. |
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Epidemic Ethics: COVID-19 Vaccine Boosters: when & why?30 September 2021 Chaired by Professor Michael Parker and featuring panelists Professor Sir Andrew Pollard, Dr Kate O'Brien, and Dr Ayoade Olatunbosun-Alakija, this Epidemic Ethics virtual seminar explored the ethical considerations surrounding the provision of COVID-19 vaccination boosters. Given significant inequities in access to COVID-19 vaccines within and between countries, the panel sought to answer a range of questions not just about the value of providing boosters to specific populations, but also whether and how boosters might be justifiable while so many are still waiting for their initial vaccine doses. This seminar was chaired Professor Michael Parker, and featured contributions from Professor Sir Andrew Pollard, Dr Kate O’Brien, and Dr Ayoade Olatunbosun-Alakija. |
Epidemic Ethics & GFBR joint seminar: The impact of COVID-19 on mental health research practice: ethical issues27 September 2021 Global Forum on Bioethics in Research (GFBR) and Epidemic Ethics jointly hosted virtual seminar explored the ethics of how mental health research practice has changed due to the COVID-19 pandemic. Discussion included the ethical implications of transferring face-to-face research online and what safeguards are needed to protect the wellbeing of participants at a time when support from the research team or external services may be reduced due to social distancing and other restrictions. How do we ensure ethically robust mental health research in the time of COVID-19 and how best can researchers involve people with lived experience in the design of research as it transitions to the digital world? The seminar was chaired by Professor Ross Upshur and featured contributions from Professor Ellen Townsend, Dr Abhishek Ghosh and Professor Jackie Hoare. |
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Epidemic Ethics: Children and COVID-19 Vaccination: Ethical impacts and considerations13 September 2021 This timely Epidemic Ethics webinar focused on the topic of vaccinating children against COVID-19. Chaired by Dr Lisa Forsberg, and a featuring contributions from Professor Beate Kampmann, Dr Govind Persad and Dr Anthony Skelton, it sought to explore a range of ethical issues and challenges relating to paediatric vaccinations against COVID-19, including known risks and benefits in the context of uncertainty, vaccine mandates, off-label prescribing, and finally, whether that, given the fact COVID-19 is a mild illness in children, should paediatric vaccinations be delayed until the most vulnerable are vaccinated globally? Briefing note Children and COVID 19 vaccination blog article
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Epidemic Ethics: Balancing COVID-19 with other priority health needs19 July 2021 This webinar sought to answer how we can balance addressing COVID-19 with other priority health needs? Chaired by Dr Adnan Hyder, and featuring panellists Professor Debora Diniz, Professor Caesar Atuire, and Dr Bridget Pratt considered a range of questions, including what are other priority health needs and how has the pandemic impacted these, and how should we strike the balance between addressing COVID-19 and other health priorities in both the context of public health, healthcare, and research? |
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Epidemic Ethics: Governing Global Health in Pandemics: Evolution and Lessons Learned21 June 2021 Chaired by Professor Lawrence O. Gostin and featuring panellists Professor EK Yeoh, Professor Suerie Moon, and Dr Mark Eccleston-Turner, this webinar discussed where and how global health governance has succeeded in managing the COVID-19 pandemic, where and how it has failed, and finally what are the key ethical lessons we've learned in terms of governing during a global pandemic. |
Epidemic Ethics: Challenges and ethical implications of distinguishing between research and rollout in pandemic responses24 May 2021 The scale and pace of health research in the COVID-19 pandemic has resulted in an exceptionally rapidly evolving evidence base, with governments and public health authorities rolling out strategies for COVID-19 diagnosis, treatment and prevention at an unprecedented rate. In such circumstances, it can be challenging to distinguish between research and public health, particularly when the interventions being researched may also be implemented in evolving public health responses. This seminar looks at the moral grounds for drawing distinctions between research activities and public health practices in a pandemic, and the implications of such distinctions for how they are conducted, governed, and communicated about with relevant populations. It was chaired by Professor Lisa M. Lee, and featured contributions from Professor Jim Lavery, Professor Jerome Singh and Dr Rieke van der Graaf. |
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Epidemic Ethics: Adapting ethics review to the COVID-19 pandemic10 May 2021 It is of critical importance to conduct research during public health emergencies, such as the COVID-19 pandemic. Yet, research and the ethical review of research in these contexts present unique challenges, including the rapidity with which research and ethical review must occur. This seminar will explore the unique challenges associated with the ethical review of research during the COVID-19 pandemic, highlight the manner in which ethical review has adapted to address these challenges over the past year, and identify future opportunities for ethical review of research during public health emergencies. It was chaired by Carla Saenz and featured contributions from Maureen Kelley, Roli Mathur, and Raffaella Ravinetto. |
Epidemic Ethics: Ethical considerations in alternative COVID-19 vaccination strategies26 April 2021 Faced with scarce and uncertain COVID-19 vaccine supplies, many countries are considering adopting vaccination schedules that differ from the recommendations of vaccine manufacturers. Some have extended the interval between doses for two-dose vaccines to provide at least some protection for a larger number of people sooner. Others are looking at maximizing the number of people receiving some degree of protection by administering partial doses or foregoing the second dose of two-dose vaccines altogether. A third approach under consideration is whether two different COVID-19 vaccines could be given at the same time, to complete a two-dose vaccination regimen in one visit. Deviations from manufacturer's recommendations could be seen as experimental, and have the capacity to threaten public confidence, but they might also avert substantial morbidity and mortality in populations. This seminar explored the ethical considerations that ought to guide decision-making regarding adopting alternative vaccination strategies or implementing vaccine manufacturer recommendations. It was chaired by Professor Ross Upshur, and featured contributions from Dr Raji Tajudeen, Professor Jonathan Wolff and Cassandra J. Opikokew Wajuntah. Read the full briefing here | Read the associated publication here |
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Epidemic Ethics: Vaccine diplomacy during the COVID-19 pandemic12 April 2021 COVID-19 vaccines are one of the most important resources on the planet. Consequently, how these precious resources are used and shared (or not) has the capacity to significantly impact relationships between countries. Indeed, COVID-19 vaccines can and have been used and shared (or not) as a means of building or managing international relations. As a result, some have argued that vaccine production capacity and/or excess vaccine supply can position countries as diplomatic and moral powerhouses. Given commitments and efforts to distribute COVID-19 vaccines fairly, vaccine diplomacy warrants ethical scrutiny to ensure it helps to further this aim. This seminar explores the ethics of vaccine diplomacy during the COVID-19 pandemic and was chaired by Professor Mike Parker, with contributions from Professor Annelien Bredenoord, Professor Keymanthri Moodley, and Professor Françoise Baylis. |
Epidemic Ethics: A Grand Experiment: Ethical responsibilities in the global rollout of COVID-19 vaccines29 March 2021 The unprecedented speed and scale of global rollouts of COVID-19 vaccines is playing a critical role in effectively responding to the pandemic. Decisions about global vaccine rollout have been made rapidly, informed by best available clinical research findings. What ethical responsibilities arise to monitor the safety and effectiveness of pandemic vaccines which are rolled out while still being evaluated in clinical trials? Globally, as over eight million doses of COVID-19 vaccines are received per day, what mechanisms should exist to ensure the sustained capacity to monitor and evaluate the outcomes of vaccination? This seminar was chaired by Professor Gagandeep Kang, and featured contributions from Professor Marc Lipsitch, Professor Dirceu Greco, and Dr Pearson Nkhoma. |
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Epidemic Ethics: Mandates and special privileges for COVID-19 vaccination15 March 2021 With COVID-19 vaccination underway or on the horizon in many countries, many are turning their attention to whether the vaccination should be made mandatory, and if so, under what conditions, for whom, and in what contexts. This webinar will explore the ethics of mandatory COVID-19 vaccination both in general and in particular settings (e.g., health care settings), as well as examine the ethics of affording special privileges to those who are vaccinated, e.g., to travel and to gather in large groups. This seminar was chaired by Maxwell J. Smith, and featured contributions from Effy Vayena, Jonathan Montgomery, and Maya Peled-Raz. |
Epidemic Ethics: Effective COVID-19 vaccine(s)?14 December 2020 The development of a safe and effective COVID-19 vaccine will represent a significant triumph. Yet, perhaps counter-intuitively, this could raise rather complex ethical questions and challenges for other COVID-19 vaccine clinical trials. For instance, if a vaccine were to be authorized for emergency use, would it be unethical for vaccine trials to continue to employ placebo control arms? If not, should trial participants be discouraged from withdrawing from trials and accessing authorized vaccines? What methodological approaches should be used to generate evidence on COVID-19 vaccines after interim results for vaccines are available and vaccines are authorized or approved for use outside of clinical trials? This seminar will explore the ethical implications of promising COVID-19 vaccine candidates for vaccine research in 2021. It was chaired by Ross Upshur, and featured contributions from Joe Millum, Dorcas Kamuya and Beatriz Thome. |
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Epidemic Ethics & GFBR Joint Seminar: Ethics of research in pregnancy30 November 2020 Recent evidence suggests that pregnant women are at a higher risk of morbidity and mortality from COVID-19, compared with age-matched women who are not pregnant. Yet the historical and systematic exclusion of pregnant women from research continues in the context of the COVID-19 pandemic, resulting in a lack of evidence for this population. How can pregnant women be ethically and safely included in research and what part should researchers play in this? What role is there for community engagement to reconcile cultural norms and beliefs with the ethical and clinical rationale for research during pregnancy? And how do current governance mechanisms and regulation help or hinder the inclusion of pregnant women in research? It was chaired by Maggie Little, and featured contributions from Marian Knight, Loulou Kobeissi, and Sonali Kochhar. Read the full briefing and find further details and background reading. |
Epidemic Ethics & GFBR Joint Seminar: Ethics of adaptive trial designs16 November 2021 The urgency of the COVID-19 pandemic has necessitated the investigation of multiple potential therapies in a timely way. In this context, adaptive trials are taking place to investigate multiple treatments and that are intended to continue beyond the evaluation of any one treatment. These complex trials have the potential to answer more questions efficiently and improve care for research participants by dropping therapies that are shown to be ineffective, but they present challenges. How should the risks and benefits be communicated to participants, understanding that the benefit:harm ratio may change over the course of the study? What consent model is appropriate for such dynamic trials? And how can regulators and research ethics committees be supported to understand and evaluate these statistically and logistically complex trials? This seminar was chaired by Ross Upshur and featured contributions from Srinivas Murthy, Fyezah Jehan, and Jerome Singh. |
Please watch these two introductions before the main seminar |
| Epidemic Ethics and GFBR Joint Seminar: Ethics of data sharing in health research
2 November 2020 Data sharing has the potential to increase scientific efficiency by maximising the availability and utility of data, and can be critical to generating knowledge during a public health emergency. But how can we share for maximum benefit and least harm, and without exacerbating existing inequalities between researchers from well-resourced and low-resourced settings? What do we need to do to ensure that data sharing policies and processes are respectful of participants and communities and what governance mechanisms need to be in place before patient data can be shared and used in health research? This seminar was chaired by Robert Terry, and featured contributions from Phaik Yeong Cheah, Gloria Mason Ross and Oommen John. |
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Epidemic Ethics: COVID-19 vaccination in an era of vaccine hesitancy10 August 2020 In 2019, WHO named vaccine hesitancy one of the ten greatest threats to global health. Now, in the midst of the COVID-19 pandemic, when many are pinning their hopes for a return to normalcy on an effective vaccine, understanding vaccine hesitancy takes on greater urgency and complexity. In a public bombarded by misinformation, subjected to unprecedented restrictions in the name of public health, affected by increasingly polarised/politicised debate, will COVID-19 vaccine programs gain the acceptance and trust needed to be successful? (And what will happen if they don't?) This seminar was chaired by Katherine Littler and featured contributions from Professor Maya J. Goldenberg, Professor Heidi Larson, and Professor Charles Shey Wiysonge. |
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Epidemic Ethics: Setting priorities for COVID-19 vaccine allocation21 September 2020 If and when a safe and effective COVID-19 vaccine becomes available, there will not be enough to vaccinate everyone who wants it. Difficult decisions will have to be made about the allocation of available vaccines both between and within countries. What values should guide vaccine allocation in a world where governments face competing obligations to their own people and to the global community, and in societies where COVID-19 and control measures have such disparate outcomes for different people? This seminar was chaired by Professor Michael Parker and featured contributions from Professor Anant Bhan, Professor Ruth Faden and Ms Sophie Mathewson. |
Epidemic Ethics: COVID: A case for research exceptionalism?10 August 2020 The current COVID-19 pandemic has reignited calls to amend, adapt and short-cut the research design process. But does the current pandemic and the need for an urgent response necessitate that we rethink our current research models? What can we learn from the discussions that have occurred in and following past outbreaks on appropriate research design, especially the 2014-15 Ebola outbreak? Does there necessarily need to be a trade-off between scientific rigour and speed? What role can ethicists play in supporting the global research community to undertake scientifically and ethically robust research in this current pandemic? This seminar was chaired by Professor Ross Upshur and featured contributions from Professor Clement Adebamowo, Professor Alex John London and Katherine Wright. |
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Epidemic Ethics: Ethicists advising public health authorities: opportunities and challenges27 July 2020 The COVID-19 pandemic has raised a number of distinctive and profound ethical challenges. It is therefore unsurprising that public health authorities have turned to ethicists for advice when developing and implementing policies and measures in their pandemic response. This has created many opportunities for ethicists to enhance the moral quality of public health decision-making; however, it has also raised a number of challenges, both substantive and procedural. This seminar presents the experiences and perspectives of ethicists who have played key roles in advising public health authorities in four countries during the COVID-19 pandemic. This seminar was chaired by Professor Michael Parker and featured contributions from Alena Buyx, Professor Florencia Luna, and Professor Maxwell J. Smith. |
Epidemic Ethics: An Epidemic of Research: publication ethics during a public health emergency29 June 2020 The urgency and global nature of the COVID-19 pandemic has resulted in health research being undertaken at an unprecedented scale. This has been accompanied by a race to disseminate, share and publish data and findings, which in turn has led to retractions, questionable peer review, and pre-publication peer review via twitter, resulting in confusion amongst researchers, regulators, and the public. What has this meant for credibility of science and trust in the scientific enterprise? What are the real costs here? How can publishing models accommodate our need for urgency, research integrity and trustworthiness when they're needed most? This seminar was chaired by Professor Ross Upshur, Professor Ezekiel J. Emanuel, and Dr Laragh Gollogly |
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Epidemic Ethics: Beyond ‘good enough’: How to engage communities with COVID-19 research quickly and effectively15 June 2020 Response to COVID-19 requires rapid research to develop vaccines, treatments and other kinds of urgently needed knowledge. Previous public health emergencies have demonstrated that good community engagement helps move research forward, ensures it is feasible, relevant, and accepted, and that its findings are taken up. But how can it be done quickly, and in the midst of lockdowns? On this webinar we will explore these questions, and hear from the experts how to bring Good Participatory Practices to COVID-19 research. This seminar was chaired by Lisa Schwartz and featured contributions from John Marshall, Noni Mumba, Phaik Yeong Cheah, and Alun Davies. |
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Epidemic Ethics: COVID-19 Human Challenge Studies: Is it OK for research participants to volunteer to be infected?18 May 2020 As widespread use of safe and efficacious vaccines for COVID-19 could save many lives and enable governments to ease restrictive control measures, there is an urgent ethical imperative for well-designed and carefully conducted research to develop such vaccines and increase relevant scientific knowledge regarding SARS-CoV-2. Controlled human infection studies, also known as human challenge studies, have been proposed as one means of testing the many vaccine candidates for SARS-CoV-2. While this has attracted considerable attention with wide calls for COVID-19 challenge studies, the research community is divided over their ethical acceptability. This seminar was chaired by Professor Claudia Emerson, Dr Euzebiusz Jamrozik, Joshua Morrison, and Seema K. Shah. |
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Epidemic Ethics: Why should ethics be front and centre to the response to COVID-19. Is it?20 April 2020 This is the first online seminar from Epidemic Ethics, the newly launched global community of bioethicists, established to provide real-time, trusted, contextual support to communities, policy makers, researchers, and responders in relation to the ethical issues arising out of global health emergencies. This seminar was chaired by Professor Michael Parker, and Katherine Littler, and featured contributions from Professor Emily Chan, Professor Jerome Singh, and Professor Ross Upshur. |