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During the Covid-19 pandemic, public health decision makers haven’t always been transparent with the public, often failing to adequately explain the reasoning behind their decisions about interventions such as mask mandates, quarantine and isolation policies, mandatory testing, and transitions to remote work and learning. In many cases, public health leaders simply stated that they were “following the science,” without acknowledging that the data models they were relying on have varying degrees of accuracy and reliability, that the available evidence would evolve and require reevaluation, and that reasonable people could disagree about how to translate data into policy. In fact, officials sometimes relied on “noble lies,” intentionally misrepresenting facts in order to support their decisions, simplify communications, or maintain calm.1 Oftentimes a policy was characterized as ethically appropriate simply because it was legally permissible.
These tactics eroded public trust, hindered adoption of Covid mitigation measures, and fueled social movements opposing health policies and officials. Once “follow the science” was exposed as an overly simplistic mantra, various segments of the public chose for themselves what guidance they would follow.
One way to avert the resulting ineffective public health campaigns and further polarization of the population might have been to embed ethicists in public health teams. Although this approach might not have prevented all the missteps that were taken, ethicists could have warned policymakers of the dangers associated with inadequate transparency and nudged them toward a more candid and accountable approach.
Yet more than 2 years into the Covid-19 pandemic — and despite heated battles over how to balance health, economic, societal, and educational concerns — public health officials have rarely integrated systematic input from ethicists into their decision-making processes. Instead, they have relied primarily on ethical analyses by physicians, epidemiologists, and other public health practitioners, most of whom don’t have extensive training or experience in applied ethics. Since public health ethics has its own set of norms and principles, much can be gained from collaborations with seasoned ethicists.
Public health institutions...