The COVID-19 pandemic: a time for ethical reflection?
Authors: Henri-Corto Stoeklé, Achille Ivasilevitch, Christian Hervé
Journal: The Lancet (2021)

Kayvan Bozorgmehr1Bozorgmehr K Power of and power over COVID-19 response guidelines.Lancet. 2020; 396: e67Summary Full Text Full Text PDF PubMed Scopus (5) Google Scholar highlighted the need to bring ethical reflections into the debate about guidelines on managing the COVID-19 pandemic.1Bozorgmehr K Power of and power over COVID-19 response guidelines.Lancet. 2020; 396: e67Summary Full Text Full Text PDF PubMed Scopus (5) Google Scholar, 2Stoeklé HC Hervé C COVID-19: act first, think later.Am J Bioeth. 2020; 20: W1Crossref PubMed Scopus (5) Google Scholar Indeed, Bozorgmehr poses questions about the medical and moral pertinence of the public health policy implemented in Germany since the start of the COVID-19 pandemic, particularly concerning the management of migrants. According to Bozorgmehr, mass quarantine was imposed in almost 70% of refugee centres with the assistance of police, private security companies, or the army. The refugees are staying in unsanitary conditions that do not meet various guidelines, least of all the primary rule of physical distancing. If these allegations are true, this policy is an immense ethical issue, but not the only issue at stake. It is important to remember that ethics are not morals and do not apply standards or values; ethics address questions about the feasibility and desirability of actions to benefit society.3Massé R Anthropology of morals and ethics.Presses de l'Université de Laval. 2015; 221 (in French).: 340Google Scholar Seemingly in Germany, and probably also in other countries, the interests of migrants were not sufficiently considered during the development of these guidelines. Moving forward, governments and administrative agencies need to think about what will happen after the COVID-19 pandemic, which is far from over, to prepare for any possible pandemics in the future.4Stoeckle HC Hervé C COVID-19: what's next for bioethics?.Can J Bioeth. 2020; 3 (in French).: 93-94Google Scholar Health-care providers and research institutions worldwide should engage in a veritable reflection of practical ethics to adapt their guidelines to the clinical and scientific reality during this time and to improve the experience of doctors and scientists. Over the past few months, these specialists have been confronted with an entirely new situation that merits the development of an ethical vision of actions. The legitimate needs and fears of populations also need to be factored in, without forgetting the constraints inherent in an increasingly globalised world. This reflection should lead to the embodiment of practical ethics that can mediate tensions between health and economics, and between individuals and the community, by distinguishing cultural and temporal aspects. Indeed, identifying identical solutions for all countries and transforming heterogeneous health systems is difficult. A practical, pragmatic, and rational ethical reflection is therefore needed to include these different elements. At the start of the COVID-19 pandemic, it was time to act and apply guidelines.2Stoeklé HC Hervé C COVID-19: act first, think later.Am J Bioeth. 2020; 20: W1Crossref PubMed Scopus (5) Google Scholar Almost a year later, the goal is to define an ethical vision capable of bringing countries together, while considering their specific characteristics. Now is the time to call into question the subsidiarity of health at a worldwide level to arrive at useful functional coexistences between systems on the basis of different standards and cultural values. We declare no competing interests. Power of and power over COVID-19 response guidelinesThe COVID-19 pandemic has shown that ignorance or political influence of scientifically grounded health policies does not pay off.1 Germany's COVID-19 response is evaluated as reasoned and scientifically grounded; however, it has exposed undue political influence on national scientific guidelines due to migration policy concerns. Full-Text PDF