Ethics and Morality During COVID-19

The Coronavirus pandemic is complex and multidimensional; and seems to be unfolding faster than our understanding of it and capacity to respond in a fully effective and comprehensive fashion. We are, however, learning a lot from the experiences of other countries with the pandemic and from a few states that were among the first to be hit hard by rapidly growing infection rates.

The Coronavirus pandemic is complex and multidimensional; and seems to be unfolding faster than our understanding of it and capacity to respond in a fully effective and comprehensive fashion. We are, however, learning a lot from the experiences of other countries with the pandemic and from a few states that were among the first to be hit hard by rapidly growing infection rates. One of the major concerns is the many ethics and morality issues arising from the public policy challenges of the pandemic, especially as it relates to medical care decision-making and the fairness of policies implemented to contain the pandemic and care for its victims. We still have a lot to learn, and we could benefit from an urgent national conversation about these issues regarding ethics and morality. In this section of our COVID-19 website we will be posting and occasionally commenting on articles that we think are useful in understanding the most critical ethical challenges and dilemmas and the most just responses to them.

Ethical issues are among the most difficult topics that the public and policy makers must address in the formulation of public policy. Meanwhile, the temptation to avoid them or delay addressing them is often very strong. In the case of this national emergency, however, evasions and delays in recognizing our obligations as a society to come to terms with the urgency of the ethical dimensions of our experience will be impossible if we are to avoid a moral catastrophe. Such ethical and moral collapse will damage our ability to administer uniformly effective containment and care strategies and erode national morale at a time when maintaining the nation’s morale has rarely been as important. We welcome responses from the readers of our site as we attempt to further a conversation on ethics and morality during COVID-19.

Important Links

• Vaccine distribution ethics: monotheism or polytheism? (Journal of Medical Ethics)
• Polis issues order allowing at-capacity Colorado hospitals to transfer patients, deny new admissions (The Denver Channel)
• To Lock Down or Not to Lock Down? (Project Syndicate)
• There’s a Word for Why We Wear Masks, and Liberals Should Say It (The New York Times)
• What Strength Really Means When You’re Sick (The Atlantic)
• WHO chief calls herd immunity approach to COVID-19 ‘simply unethical’ (The Hill)
• As my twin fights for his life, all Trump does is assure me the virus is no big deal (The Washington Post)
• The 200,000 coronavirus deaths are an American tragedy of our own making (The Guardian)
• A Failure of Empathy Led to 200,000 Deaths. It Has Deep Roots. (The Atlantic)
• Building a Society That Values Care (Public Books)
• An Immodest Proposal (LA Review of Books)
• ‘Hell has frozen over’: The pharmaceutical industry stands in for a politically impaired FDA (STAT)
• Who should get the COVID-19 vaccine first? (Science Daily)
• ‘Without evidence’: Once again, FDA expands use of COVID-19 treatment without research to back it up (USA Today)
• FDA’s Hahn Apologizes For Overselling Plasma’s Benefits As A COVID-19 Treatment (npr)
• More than 176,000 in US have died of COVID-19; 57% of Republicans polled say that is ‘acceptable’ (USA Today)
• The Complicated Ethics of Keeping a COVID-19 Patient Breathing (The New Yorker)
• U.S. Hospitals Prepare Guidelines For Who Gets Care Amid Coronavirus Surge (npr)
• COVID-19 Pandemic and Ageism: A Call for Humanitarian Care (The Gerontologist)
• The Challenge of Long-Term Care (Next Avenue)
• Businesses Want a Shield Against COVID-19 Lawsuits. But What About Customer Safety? (PEW)
• Trump administration steps in as advocacy groups warn of Covid ‘death panels’ (Politico)
• How a single sentence in The Atlantic annihilated Trump’s coronavirus response (AZcentral)
• Ageism and cost-cutting in the age of coronavirus (The Hill)
• One Man’s COVID-19 Death Raises The Worst Fears Of Many People With Disabilities (wbur)
• Covid-19 and the Limits of American Moral Reasoning (The New Republic)
• Our ‘Pursuit of Happiness’ Is Killing the Planet (The New York Times)
• The Cult of Selfishness Is Killing America (The New York Times)
• ‘It’s like you injected adrenaline into them’: Facebook’s vaccine misinformation problem faces a new test with Covid-19 (STAT)
• Who will get the first shot when the coronavirus vaccine arrives? (The Philadelphia Inquirer)
• A pandemic ethical conundrum: Must health care workers risk their lives to treat Covid-19 patients? (STAT)
• People with disabilities and older adults deserve life-saving COVID-19 treatment (Houston Chronicle)
• American Individualism Is My Climate Fear (New Republic)
• Liberalism Has Failed (Newsweek)
• How to decide who gets the Covid-19 vaccine first (CNN)
• How Elderly People Are Left Behind During Medical Care Rationing (wbur)
• Quadriplegic man’s death from covid-19 spotlights questions of disability, race and family (The Washington Post)
• America’s looming experiment in health-care rationing (The Week)
• Pervasive Ageism in the Response to the Pandemic (American Sociological Association)
• Is Age Discrimination Acceptable? (Project Syndicate)
• Sacrifice the old to help the economy? Texas official’s remark prompts backlash (Los Angeles Times)
• Before Deliberately Infecting People With Coronavirus, Be Sure It’s Worth It (The New York Times)
• When a Covid-19 vaccine becomes available, who should get it first? (STAT)
• Respecting Disability Rights — Toward Improved Crisis Standards of Care (New England Journal of Medicine)
• Me and we: Individual rights, common good and coronavirus (AP News)
• Rationing Ventilators During the COVID-19 Epidemic (New England Journal of Medicine)
• You Can Save One Person or Five. But Not All Six. (The New York Times)
• America’s Covid-19 hot spots shed a light on our moral failures (Vox)
• The pandemic has amplified ageism. ‘It’s open season for discrimination’ against older adults (LA Times)
• Pandemic ethics: The case for experiments on human volunteers (The Washington Post)
• ‘Our ageism is linked to the economy’: Author challenges discussion of who is expendable (AlterNet)
• Infect volunteers with Covid-19 in the name of research? A proposal lays bare a minefield of issues (STAT)
• The ‘Terrible Moral Choice’ of Reopening (The Atlantic)
• It didn’t have to be this way (aeon)
• How Government ‘Failed the Elderly’ in the Coronavirus Pandemic (The New York Times)
• Structural Racism, White Fragility, and Ventilator Rationing Policies (The Hastings Center)
• Why New Jersey’s ventilator guidelines may favor younger, whiter patients (Politico)
• Are We All in This Together? (The New York Times)
• Many parts of America have already decided to sacrifice the elderly (The Washington Post)
• Age must not be used as primary criteria to deny treatment (The Hill)
• Health-care rationing is a choice we’re already making (Orlando Sentinel)
• Is It Ethically Okay to Get Food Delivered Right Now? (The Atlantic)
• What Do You Owe Your Neighbor? The Pandemic Might Change Your Answer (The New York Times)
• The Way We Ration Ventilators Is Biased (The New York Times)
• People With Disabilities Fear Pandemic Will Worsen Medical Biases (NPR)
• GOP Congressman: Lawmakers Must “Put On Our Big Boy and Big Girl Pants” and Let Americans Die (Vanity Fair)
• Professionalism drives health care workers to treat patients with Covid-19. We mustn’t jeopardize it (STAT)
• To the baby boomers: We’re toast (Boston Globe)
• The Staggeringly Complicated Ethics of Ventilating Coronavirus Patients (The New Republic)
• How To Ration Ventilators: There’s A System, But It’s Still Agonizing (WBUR)
• A Nurse Bought Protective Supplies for Her Colleagues Using GoFundMe. The Hospital Suspended Her. (ProPublica)
• Thinking Through The Unthinkable: How Mass. Hospitals May Decide Who Gets A Ventilator In The COVID-19 Surge (WBUR)
• Who gets a ventilator? New gut-wrenching state guidelines issued on rationing equipment (Boston Globe)
• Who gets a shot at life if hospitals run short of ventilators? (The Washington Post)
• Nursing Homes Have Thousands Of Ventilators That Hospitals Desperately Need (KHN)
• New York surgeon writes haunting letter about rationing care for patients who don’t have the coronavirus (CNN)
• Ageism Is Making the Pandemic Worse (The Atlantic)
• In a Pandemic, Do Doctors Still Have a Duty to Treat? (The New York Times)
• Justice in Aging Rejects Ruthless Utilitarian Policies that Devalue the Lives of Older Adults (Justice in Aging)
• Here are rules doctors can follow when they decide who gets care and who dies (The Washington Post)
• Are older lives less worthy in a pandemic? (Association of Health Care Journalist)
• The ethical minefield of prioritizing health care for some with Covid-19 (CNN)
• Wall Street titans lobby for a cut of small business bailout (Politico)
• He Was Already Sick. Was His Life Worth Less Than Yours? (The New York Times)
• As California stops releasing data about health workers’ coronavirus infections, nurses cry foul (San Francisco Chronicle)
• Hospitals Have Left Many COVID-19 Patients Who Don’t Speak English Alone, Confused and Without Proper Care (ProPublica)
• At the Top of the Covid-19 Curve, How Do Hospitals Decide Who Gets Treatment? (The New York Times)
• Ageist “Triage” Is a Crime Against Humanity (LA Review of Books)

Reports

• Quality Adjusted Life Years (QALY): The Threat to Older Americans (Pioneer Institute)

Image courtesy of Reuters / Marko Djurica