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Ethics-driven policy framework for implementation of movement restrictions in pandemics

In the ongoing COVID-19 pandemic, countries across the globe undertook several stringent movement restrictions to prevent the virus spread. In April 2020, around 3.9 billion people in 90 countries were contained in their homes. Discourse on the ethical questions raised by such restrictions while his...

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Autores principales: Zadey, Siddhesh, Dharmadhikari, Surabhi, Mukuntharaj, Pradeeksha
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8183287/
https://www.ncbi.nlm.nih.gov/pubmed/34083240
http://dx.doi.org/10.1136/bmjgh-2021-005202
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author Zadey, Siddhesh
Dharmadhikari, Surabhi
Mukuntharaj, Pradeeksha
author_facet Zadey, Siddhesh
Dharmadhikari, Surabhi
Mukuntharaj, Pradeeksha
author_sort Zadey, Siddhesh
collection PubMed
description In the ongoing COVID-19 pandemic, countries across the globe undertook several stringent movement restrictions to prevent the virus spread. In April 2020, around 3.9 billion people in 90 countries were contained in their homes. Discourse on the ethical questions raised by such restrictions while historically rich is absent when it comes to pragmatic policy considerations by the decision-makers. Drawing from the existing literature, we present a unified ethical principles–pragmatic considerations–policy indicators framework flexibly applicable across different countries and contexts to assess the ethical soundness of movement-restricting policies. Our framework consolidates 11 unique but related ethical principles (harm, justifiability, proportionality, least restrictive means, utility efficiency, reciprocity, transparency, relevance, equity, accountability, and cost and feasibility). We mapped each ethical principle to answerable questions or pragmatic considerations to subsequently generate 34 policy indicators. These policy indicators can help policymakers and health practitioners to decide the ethically substantiated initiation of movement restrictions, monitor progress and systematically evaluate the imposed restrictions. As an example, we applied the framework to evaluate the first two phases of the largest lockdown (March–May 2020) implemented nationwide in India for its adherence to ethical principles. The policy indicators revealed ethical lapses in proportionality, utility efficiency and accountability for India’s lockdown that should be focused on in subsequent restrictions. The framework possesses value towards ensuring that movement-restrictive public health interventions across different parts of the world in the ongoing pandemic and possible future outbreaks are ethically sound.
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spelling pubmed-81832872021-06-17 Ethics-driven policy framework for implementation of movement restrictions in pandemics Zadey, Siddhesh Dharmadhikari, Surabhi Mukuntharaj, Pradeeksha BMJ Glob Health Analysis In the ongoing COVID-19 pandemic, countries across the globe undertook several stringent movement restrictions to prevent the virus spread. In April 2020, around 3.9 billion people in 90 countries were contained in their homes. Discourse on the ethical questions raised by such restrictions while historically rich is absent when it comes to pragmatic policy considerations by the decision-makers. Drawing from the existing literature, we present a unified ethical principles–pragmatic considerations–policy indicators framework flexibly applicable across different countries and contexts to assess the ethical soundness of movement-restricting policies. Our framework consolidates 11 unique but related ethical principles (harm, justifiability, proportionality, least restrictive means, utility efficiency, reciprocity, transparency, relevance, equity, accountability, and cost and feasibility). We mapped each ethical principle to answerable questions or pragmatic considerations to subsequently generate 34 policy indicators. These policy indicators can help policymakers and health practitioners to decide the ethically substantiated initiation of movement restrictions, monitor progress and systematically evaluate the imposed restrictions. As an example, we applied the framework to evaluate the first two phases of the largest lockdown (March–May 2020) implemented nationwide in India for its adherence to ethical principles. The policy indicators revealed ethical lapses in proportionality, utility efficiency and accountability for India’s lockdown that should be focused on in subsequent restrictions. The framework possesses value towards ensuring that movement-restrictive public health interventions across different parts of the world in the ongoing pandemic and possible future outbreaks are ethically sound. BMJ Publishing Group 2021-06-03 /pmc/articles/PMC8183287/ /pubmed/34083240 http://dx.doi.org/10.1136/bmjgh-2021-005202 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Analysis
Zadey, Siddhesh
Dharmadhikari, Surabhi
Mukuntharaj, Pradeeksha
Ethics-driven policy framework for implementation of movement restrictions in pandemics
title Ethics-driven policy framework for implementation of movement restrictions in pandemics
title_full Ethics-driven policy framework for implementation of movement restrictions in pandemics
title_fullStr Ethics-driven policy framework for implementation of movement restrictions in pandemics
title_full_unstemmed Ethics-driven policy framework for implementation of movement restrictions in pandemics
title_short Ethics-driven policy framework for implementation of movement restrictions in pandemics
title_sort ethics-driven policy framework for implementation of movement restrictions in pandemics
topic Analysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8183287/
https://www.ncbi.nlm.nih.gov/pubmed/34083240
http://dx.doi.org/10.1136/bmjgh-2021-005202
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