I have been very quiet lately online – I left Facebook and have taken a break from blogging for some time. It’s been the most difficult semester of my working life – not that this is different from anyone else’s situation (and in fact I’m better off than most, which I understand and appreciate).

I thought I would share a wiki workshop assignment, below, I built for my Bio-Medical Ethics class this semester. All my University’s classes moved online a month ago, and I have been using Microsoft Teams and other tools to host my 3 classes (Research in Philosophy, Environmental Ethics, and Bio-Medical Ethics). Please feel free to use or revise this for your own purposes – it amounts to a mini-syllabus on COVID-19, but of course some of it (like reference to virtue ethics) is specific to where I am with this class right now.

 

Wiki Workshop on COVID-19

Bio-Medical Ethics

Spring 2020

 

Instructions

Much of our class has been dedicated to building the following skills: contextualizing debates in bioethics within history; increasing awareness of the social and political dimensions of medicine; and learning about various approaches to familiar (and unfamiliar) debates in the use and applications of evolving medical technologies. I hope the work of the last many weeks will put us in good stead to consider these matters in connection to COVID-19.

To facilitate our class response and discussion of this urgent, emerging, and local/global matter, I put together the below questions for our consideration. As usual, I assigned sections of the questions for each group. Each group has four questions, which you may want to divide among yourselves for ease. I also provided links to 3 relevant readings for each section, below, to help with possible responses. You can feel free to use and link to other sources as desired. [If you want to add or revise questions for your section please get in touch with me! COVID-19 is an evolving issue and I’m learning, too. Thanks.]

Please discuss these with your group members (either on Teams or some other way), and then assign a person or persons to edit the Wiki with your group’s responses.

 

COVID-19 and Rationing (Group 1)

Readings:

1. Guidance from a bioethics research institute, the Hastings Center https://www.thehastingscenter.org/ethicalframeworkcovid19/ – especially the Introduction and Duty to Guide sections;
2. On scarcity, also from the Hastings Center: https://www.thehastingscenter.org/scarcity-in-the-covid-19-pandemic/;
3. On rationing from Discover magazine: https://www.discovermagazine.com/health/covid-19-the-ethical-anguish-of-rationing-medical-care

Questions:

1. What are the 3 most important ethical considerations for deciding how to allocate scarce resources? (example response – prognosis for patient)
2. Should we use a lottery system to determine who among the sick can have access to ventilators, since there aren’t enough of them?
3. Should access to ventilators be based on ability to pay?
4. What can medical professionals do, if anything, to improve the situation with regard to rationing and COVID-19?

 

COVID-19 and Virtue Ethics (Group 2)

Readings:

1. On the possible virtue of transparency: https://www.thehastingscenter.org/report-from-china-ethical-questions-on-the-response-to-the-coronavirus/
2. On governmental response: https://jamanetwork.com/journals/jama/fullarticle/2761556 (how can a government display virtue in response to the crisis?);
3. On individual response: https://www.houstonmethodist.org/blog/articles/2020/mar/coronavirus-and-self-quarantine-who-should-do-it-and-how-to-do-it/ (is self-quarantine a virtue?)

Questions:

1. What does a virtuous government do in response to COVID-19?
2. What does a virtuous person do in response to COVID-19? (e.g. is it virtuous to wear a mask and gloves? why specifically?)
3. List and explain 3 key virtues in the time of coronavirus. How did your group come up with these virtues?
4. Are new virtues emerging? Why and how? For example, what is the new “mean”, if any, between vicious extremes when it comes to being cautious about one’s health?

 

COVID-19 and Race (Group 3)

Readings:

1. Report from the New York Times regarding disproportionate rates of infection in the US among black Americans: https://www.nytimes.com/2020/04/07/us/coronavirus-race.html;
2. Response to COVID-19 is racialized, from the Kaiser Health Network: https://khn.org/news/covid-19-treatment-racial-income-health-disparities/;
3. Racism against Chinese in response to coronavirus, reported in the New York Times: https://www.nytimes.com/2020/04/05/nyregion/coronavirus-chinese-americans-supplies.html

Questions:

1. What are some key actions medical professionals can take now in order to help mitigate disproportionate impacts of COVID-19 on people of color?
2. Consider the concerns represented in our Biopolitics textbook (ed. Obasogie and Darnovaky) about gathering medical information about race. How best can we gather data about race and COVID-19? Should we be gathering this data? Why? (Is it possible that other data is more important?)
3. Is restricting travel for public health reasons from a particular country or region reasonable? Why or why not? (This question should be more difficult than it first appears.)
4. What specific steps can you take to help promote racial justice in your communities with regard to COVID-19?

 

COVID-19 and Risk (Group 4)

Readings:

1. On social solidarity: https://jacobinmag.com/2020/03/coronavirus-donald-trump-solidarity-profits [NOTE: this piece is political/polemic];
2. On the gig economy and risk: https://www.thehastingscenter.org/coronavirus-response-is-insufficient-for-vulnerable-new-yorkers/;
3. Report on unique risks in the American South, from the Atlantic Monthly https://www.theatlantic.com/politics/archive/2020/04/coronavirus-unique-threat-south-young-people/609241/

Questions:

1. What is the best way to “pool” risk for COVID-19 together as communities? (In other words, how can we share risks in order to reduce them? Is that possible?)
2. What are 3 political reasons (i.e., structural matters that can be otherwise if we so decide) why risk is higher for some groups than others? Give examples.
3. How can workers in essential roles be better protected from risk? Give specific ways.
4. Is risk for COVID-19 significantly political? Or is it, somehow, natural? Explain.

 

COVID-19 and Disability (Group 5)

Readings:

1. From disabled bioethicist Joseph Stramondo: http://www.bioethics.net/2020/03/covid-19-triage-and-disability-what-not-to-do/;
2. From disabled activist Alice Wong (also reprinted on BIOPOLITICAL PHILOSOPHY): https://www.vox.com/first-person/2020/4/4/21204261/coronavirus-covid-19-disabled-people-disabilities-triage;
3. In response to disability critiques of New York State Task Force report by Joseph Fins: https://www.thehastingscenter.org/disabusing-the-disability-critique-of-the-new-york-state-task-force-report-on-ventilator-allocation/

Questions:

1. Does the New York State Task Force report on ventilator allocation discriminate against disabled people? Why or why not?
2. What are the most important issues for disabled people when it comes to triage for COVID-19? (i.e. why are disabled people reacting to triage as a justice/ethical issue that is specific to them?)
3. What can we learn from disabled people in the time of coronavirus? (i.e. do they have unique insights or skill sets to offer that are valuable to people who are positioned as “abled” for dealing with this crisis?)
4. What sort of triage protocol would be more just for disabled people?