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'I think all of us should have […] much better training in ethics.' Ethical challenges in policy making during the COVID-19 pandemic: Results from an interview study with Swiss policy makers and scientists

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Názov: 'I think all of us should have […] much better training in ethics.' Ethical challenges in policy making during the COVID-19 pandemic: Results from an interview study with Swiss policy makers and scientists
Autori: Brall, C., Gille, F., Schlaufer, C., Porz, R., Jox, R.J.
Zdroj: BMC Med Ethics
BMC Medical Ethics, Vol 25, Iss 1, Pp 1-11 (2024)
BMC medical ethics, vol. 25, no. 1, pp. 129
Informácie o vydavateľovi: Springer Science and Business Media LLC, 2024.
Rok vydania: 2024
Predmety: Ethics, Policy advice, R723-726, Medical philosophy. Medical ethics, SARS-CoV-2, Research, Health Policy, Decision Making, Administrative Personnel, COVID-19 pandemic, COVID-19, 06 humanities and the arts, 0603 philosophy, ethics and religion, Research Personnel, Interviews as Topic, 03 medical and health sciences, 0302 clinical medicine, Policy making, Humans, COVID-19/epidemiology, Switzerland, Policy Making, Pandemics, Decision Making/ethics, Administrative Personnel/ethics, Qualitative Research, Research Personnel/ethics, Decision-making
Popis: Background The COVID-19 pandemic posed many unprecedented challenges to health care systems and public health efforts worldwide. Policy making and science were deeply intertwined, in particular with regard to the justification of health policy measures. In this context, ethical considerations were often at the core of decision-making trade-offs. However, not much is known about the actual ethical challenges encountered by policy makers and scientists involved in policy advice. With this study, we therefore aim to explore the ethical challenges during COVID-19-related political decision-making in Switzerland as perceived by policy makers and scientists involved in policy making. We also explore the role ethics advice had during the pandemic response and what can be learned for future public health crises. Methods We conducted thirteen qualitative expert interviews with policy makers and scientists involved in decision-making on COVID-19 policy responses in Switzerland on the regional and national level. We used inductive content analysis to analyse the interviews. Results Among the multitude of ethical challenges highlighted, interviewees perceived making trade-offs between the common good vs. the individual good and between economic welfare vs. health of the population, as well as proportionality of the policy measures, and the capacity of the public to accept uncertainty as central. Interviewees had diverging opinions on whether ethical considerations were sufficiently raised and discussed on the Swiss policy level during the COVID-19 pandemic. Among the reasons why ethics was not sufficiently discussed, they mentioned a lack of time in the fast-paced dynamic of the pandemic, ethics as a complex subject area, the interconnectedness between ethics and law, too much focus on few topics (mostly on vaccination-related ethical questions), and power relationships, such as dominance of medical professionals over ethicists. They evaluated ethics support to have been adequately present in the decision-making process, but wished for ethics training, involvement of the public in the discourse and for accompanying communication to build trust among the population for the future. Conclusions The study provides empirical insights into the ethical considerations of COVID-19 policy making in practice in Switzerland. It can help to develop ethics assistance for future crises and inform ethical health policy and decision-making not only in Switzerland, but also in other countries.
Druh dokumentu: Article
Other literature type
Popis súboru: application/pdf
Jazyk: English
ISSN: 1472-6939
DOI: 10.1186/s12910-024-01132-x
DOI: 10.48620/76493
Prístupová URL adresa: https://pubmed.ncbi.nlm.nih.gov/39543543
https://doaj.org/article/40e029600ec24a76abb365ad7056ed42
http://nbn-resolving.org/urn/resolver.pl?urn=urn:nbn:ch:serval-BIB_F5D94C051F179
https://serval.unil.ch/notice/serval:BIB_F5D94C051F17
https://serval.unil.ch/resource/serval:BIB_F5D94C051F17.P001/REF.pdf
Rights: CC BY
Prístupové číslo: edsair.doi.dedup.....cb151b7d6b75560cb7046df2d06b69ec
Databáza: OpenAIRE
Popis
Abstrakt:Background The COVID-19 pandemic posed many unprecedented challenges to health care systems and public health efforts worldwide. Policy making and science were deeply intertwined, in particular with regard to the justification of health policy measures. In this context, ethical considerations were often at the core of decision-making trade-offs. However, not much is known about the actual ethical challenges encountered by policy makers and scientists involved in policy advice. With this study, we therefore aim to explore the ethical challenges during COVID-19-related political decision-making in Switzerland as perceived by policy makers and scientists involved in policy making. We also explore the role ethics advice had during the pandemic response and what can be learned for future public health crises. Methods We conducted thirteen qualitative expert interviews with policy makers and scientists involved in decision-making on COVID-19 policy responses in Switzerland on the regional and national level. We used inductive content analysis to analyse the interviews. Results Among the multitude of ethical challenges highlighted, interviewees perceived making trade-offs between the common good vs. the individual good and between economic welfare vs. health of the population, as well as proportionality of the policy measures, and the capacity of the public to accept uncertainty as central. Interviewees had diverging opinions on whether ethical considerations were sufficiently raised and discussed on the Swiss policy level during the COVID-19 pandemic. Among the reasons why ethics was not sufficiently discussed, they mentioned a lack of time in the fast-paced dynamic of the pandemic, ethics as a complex subject area, the interconnectedness between ethics and law, too much focus on few topics (mostly on vaccination-related ethical questions), and power relationships, such as dominance of medical professionals over ethicists. They evaluated ethics support to have been adequately present in the decision-making process, but wished for ethics training, involvement of the public in the discourse and for accompanying communication to build trust among the population for the future. Conclusions The study provides empirical insights into the ethical considerations of COVID-19 policy making in practice in Switzerland. It can help to develop ethics assistance for future crises and inform ethical health policy and decision-making not only in Switzerland, but also in other countries.
ISSN:14726939
DOI:10.1186/s12910-024-01132-x