Gordon, Caitlin; Silaigwana, Blessing; Mathur, Roli; Edwards, Sarah; (2024) Ethics to inform decision making. In: Fisher, Dale, (ed.) Infectious Disease Emergencies: Preparedness and Response. (pp. 45-61). Singapore National University Press: Singapore.

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Abstract

Ethical considerations are an important part of decision-making processes at each stage of an infectious disease emergency. This chapter introduces the notion that ethical thinking begins with a process of clarification of the values and moral principles at work in decision-making, and evolves a set of procedures to reason morally in each decision-making context. Certain moral concepts are necessary to highlight in the ethics of infectious disease emergencies, particularly ideas of autonomy, beneficence, and justice. The chapter then works through the different phases of emergency response, introducing the key ethical issues and questions at each phase. Ethical thinking does not provide single ideal answers, but enables decision-makers to identify and articulate the value components of decisions, so as to balance, for example, considerations of individual liberties with public health outcomes in an emergency. Elaborate processes of consideration and consultation are often in tension with the challenges of making critical decisions rapidly and under uncertainty. That is why trustworthy institutions and continued community engagement are crucial, particularly in culturally diverse settings. The chapter concludes by emphasising the need for ongoing ethical reflection and preparedness to better manage future outbreaks, advocating for a sustained social conversation on the balance between protecting public health and respecting individual rights.

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