The Collapse of Medical Ethics During COVID-19

The response to the COVID-19 pandemic did not follow established pandemic plans. In fact, the responses were closer to the exact opposite of what appeared in these plans. For example the U.K. Influenza Pandemic Preparedness Strategy 2011 said:

It will not be possible to halt the spread of a new pandemic influenza virus. …

During a pandemic, the Government will encourage those who are well to carry on with their normal daily lives. …

The response will continue to be evidence based… based on ethical principles.

The strategy also suggested that the approaches outlined could be adapted and deployed for other respiratory viruses and gave as an example the first SARS virus. These plans were based on thorough reviews of the available evidence, decades of experience in managing previous pandemics and also on accepted public health principles and ethics.

So, in departing from these plans we also departed from accepted principles and ethics. This occurred in the wider public health response by the imposition of non-pharmaceutical interventions (NPIs) such as quarantining of contacts, social distancing, the enforcement of mask wearing and business and school closures, as eloquently described by Oxford University’s Euzebiusz Jamrozik. It also occurred in the response to individuals with the COVID-19 vaccine rollout and in their medical care during the pandemic, as Dr. Clayton Baker outlined.

This erosion of medical ethics, and specifically the departure from obtaining properly informed consent during the pandemic, is addressed in a recent pre-print article by myself and other members of the HART group. In this article we critically examine consent practices before and during the COVID-19 pandemic and then outline how things could be improved to help ensure that patients genuinely get to decide, without any pressure or coercion, what they want medically. To do this we present a new ‘tool’ to help explain to patients key data on the benefits and risks of treatments, and suggest a more rigorous process for seeking informed consent in the future.

Next time, we must do much better.

Dr. Alan Mordue is a retired Consultant in public health medicine.