Ethical Reasoning During a Pandemic: Results of a Five Country European Study

Abstract

Introduction: There has been no work that identifies the hidden or implicit normative assumptions on which participants base their views during the COVID-19 pandemic, and their reasoning and how they reach moral or ethical judgements. Our analysis focused on participants’ moral values, ethical reasoning and normative positions around the transmission of SARS-CoV-2.Methods: We analyzed data from 177 semi-structured interviews across five European countries (Germany, Ireland, Italy, Switzerland and the United Kingdom) conducted in April 2020.Results: Findings are structured in four themes: ethical contention in the context of normative uncertainty; patterns of ethical deliberation when contemplating restrictions and measures to reduce viral transmission; moral judgements regarding “good” and “bad” people; using existing structures of meaning for moral reasoning and ethical judgement.Discussion: Moral tools are an integral part of people’s reaction to and experience of a pandemic. ‘Moral preparedness’ for the next phases of this pandemic and for future pandemics will require an understanding of the moral values and normative concepts citizens use in their own decision-making. Three important elements of this preparedness are: conceptual clarity over what responsibility or respect mean in practice; better understanding of collective mindsets and how to encourage them; and a situated, rather than universalist, approach to the development of normative standards.

Keywords:

• Ethics
• qualitative research
• pandemics
• SARS-COV-2
• COVID-19
• infectious disease
• moral judgements

Acknowledgements

This publication has been made possible by the joint work of the members of the SolPan research commons. Thanks to Professor Ian Kerridge for a helpful review of a later draft of this paper.

Declaration of interest statement

The authors report no conflict of interest.

Data availability statement

Due to the nature of this research, participants of this study did not agree for their data to be shared publicly, so supporting data is not available.

Consent

All participants in this research have given written consent to the inclusion of anonymised material pertaining to themselves.

Notes

1 Here we take normative in opposition to descriptive: while descriptive claims depict a state of affairs, normative claims make claims on us, they command, oblige, recommend, or guide CARTER, S. M. 2018. Valuing Healthcare Improvement: Implicit Norms, Explicit Normativity, and Human Agency. Health Care Analysis, 26, 189-205.

Additional information

Funding

This research was funded in whole, or in part, by the Wellcome Trust Grant number 221038/Z/20/Z and Wellcome Center Grant (203132/Z/16/Z), the ERC grant agreement No 771217, the German Federal Ministry of Education and Research [Grant number 01Kl20510], the University of Basel Research Fund [Grant number 3BE1003].