Costa, cancer and coronavirus: contractualism as a guide to the ethics of lockdown

Lockdowns, Bioethics, and the Public: Policy-Making in a Liberal Democracy

Commentaries on the ethics of Covid lockdowns nearly all focus on offering substantive guidance to policy-makers. Lockdowns, however, raise many ethical questions that admit of a range of reasonable answers. In such cases, policy-making in a liberal democracy ought to be sensitive to which reasonable views the public actually holds-a topic existing bioethical work on lockdowns has not explored in detail. In this essay, I identify several important questions connected to the kind of influence the public ought to have on lockdown decision-making, including how policy-makers ought to handle misinformed or morally suspect viewpoints, and how policy-makers ought to respond to minority viewpoints. I argue that questions like this, concerning the appropriate influence of the public on decision-making, will be central to the field of bioethics as it increasingly focuses on policy and population-level issues and therefore ought to be priorities for future work.

Values for victims and vectors of disease

John and Curran have convincingly shown that Scanlonian contractualism is a valuable resource for evaluating pandemic response policies, and that we should reject cost-benefit analysis in favour of a contractualist framework. However, they fail to consider the part of contractualism that Scanlon constructed precisely to deal with the question of when the state can restrict individuals from making choices that are harmful to themselves and others: the value of choice view (VoC). In doing so, they leave it open for opponents of lockdowns to misuse contractualism to justify mistaken policies. This is because the most powerful contractualist objections to locking down are likely to be based on the VoC.When we apply the value of choice view (VoC), we see that a lockdown policy's justifiability depends on the extent to which particular values of choice are found to be threatened by the policy in question, and what safeguards policy-makers have put in place to increase the value of choice and protect people from the harmful consequences of lockdown. Without the VoC, it is harder to explain why lockdowns, to be non-rejectable, must have certain features. With the VoC, the case for contractualism over cost benefit analysis (CBA) can be made even stronger.

Non-pharmaceutical Interventions and Social Distancing as Intersubjective Care and Collective Protection

The paper discusses non-pharmaceutical interventions (NPIs) as a collective form of protection that, in terms of health justice, benefits groups at risk, allowing them to engage in social life and activities during health crises. More specifically, the paper asserts that NPIs that realize social distancing are justifiable insofar as they are constitutive of a type of social protection that allows everyone, especially social disadvantaged agents, to access the public health sphere and other fundamental social spheres, such as the family and civil society.

Public justification and expert disagreement over non-pharmaceutical interventions for the COVID-19 pandemic

A wide range of non-pharmaceutical interventions (NPIs) have been introduced to stop or slow down the COVID-19 pandemic. Examples include school closures, environmental cleaning and disinfection, mask mandates, restrictions on freedom of assembly and lockdowns. These NPIs depend on coercion for their effectiveness, either directly or indirectly. A widely held view is that coercive policies need to be publicly justified-justified to each citizen-to be legitimate. Standardly, this is thought to entail that there is a scientific consensus on the factual propositions that are used to support the policies. In this paper, we argue that such a consensus has been lacking on the factual propositions justifying most NPIs. Consequently, they would on the standard view be illegitimate. This is regrettable since there are good reasons for granting the state the legitimate authority to enact NPIs under conditions of uncertainty. The upshot of our argument is that it is impossible to have both the standard interpretation of the permissibility of empirical claims in public justification and an effective pandemic response. We provide an alternative view that allows the state sufficient room for action while precluding the possibility of it acting without empirical support.