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Ethics of selective restriction of liberty in a pandemic

Liberty-restricting measures have been implemented for centuries to limit the spread of infectious diseases. This article considers if and when it may be ethically acceptable to impose selective liberty-restricting measures in order to reduce the negative impacts of a pandemic by preventing particul...

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Autores principales: Cameron, James, Williams, Bridget, Ragonnet, Romain, Marais, Ben, Trauer, James, Savulescu, Julian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8327318/
https://www.ncbi.nlm.nih.gov/pubmed/34059520
http://dx.doi.org/10.1136/medethics-2020-107104
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author Cameron, James
Williams, Bridget
Ragonnet, Romain
Marais, Ben
Trauer, James
Savulescu, Julian
author_facet Cameron, James
Williams, Bridget
Ragonnet, Romain
Marais, Ben
Trauer, James
Savulescu, Julian
author_sort Cameron, James
collection PubMed
description Liberty-restricting measures have been implemented for centuries to limit the spread of infectious diseases. This article considers if and when it may be ethically acceptable to impose selective liberty-restricting measures in order to reduce the negative impacts of a pandemic by preventing particularly vulnerable groups of the community from contracting the disease. We argue that the commonly accepted explanation—that liberty restrictions may be justified to prevent harm to others when this is the least restrictive option—fails to adequately accommodate the complexity of the issue or the difficult choices that must be made, as illustrated by the COVID-19 pandemic. We introduce a dualist consequentialist approach, weighing utility at both a population and individual level, which may provide a better framework for considering the justification for liberty restrictions. While liberty-restricting measures may be justified on the basis of significant benefits to the population and small costs for overall utility to individuals, the question of whether it is acceptable to discriminate should be considered separately. This is because the consequentialist approach does not adequately account for the value of equality. This value may be protected through the application of an additional proportionality test. An algorithm for making decisions is proposed. Ultimately whether selective liberty-restricting measures are imposed will depend on a range of factors, including how widespread infection is in the community, the level of risk and harm a society is willing to accept, and the efficacy and cost of other mitigation options.
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spelling pubmed-83273182021-08-19 Ethics of selective restriction of liberty in a pandemic Cameron, James Williams, Bridget Ragonnet, Romain Marais, Ben Trauer, James Savulescu, Julian J Med Ethics Feature Article Liberty-restricting measures have been implemented for centuries to limit the spread of infectious diseases. This article considers if and when it may be ethically acceptable to impose selective liberty-restricting measures in order to reduce the negative impacts of a pandemic by preventing particularly vulnerable groups of the community from contracting the disease. We argue that the commonly accepted explanation—that liberty restrictions may be justified to prevent harm to others when this is the least restrictive option—fails to adequately accommodate the complexity of the issue or the difficult choices that must be made, as illustrated by the COVID-19 pandemic. We introduce a dualist consequentialist approach, weighing utility at both a population and individual level, which may provide a better framework for considering the justification for liberty restrictions. While liberty-restricting measures may be justified on the basis of significant benefits to the population and small costs for overall utility to individuals, the question of whether it is acceptable to discriminate should be considered separately. This is because the consequentialist approach does not adequately account for the value of equality. This value may be protected through the application of an additional proportionality test. An algorithm for making decisions is proposed. Ultimately whether selective liberty-restricting measures are imposed will depend on a range of factors, including how widespread infection is in the community, the level of risk and harm a society is willing to accept, and the efficacy and cost of other mitigation options. BMJ Publishing Group 2021-08 2021-05-31 /pmc/articles/PMC8327318/ /pubmed/34059520 http://dx.doi.org/10.1136/medethics-2020-107104 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Feature Article
Cameron, James
Williams, Bridget
Ragonnet, Romain
Marais, Ben
Trauer, James
Savulescu, Julian
Ethics of selective restriction of liberty in a pandemic
title Ethics of selective restriction of liberty in a pandemic
title_full Ethics of selective restriction of liberty in a pandemic
title_fullStr Ethics of selective restriction of liberty in a pandemic
title_full_unstemmed Ethics of selective restriction of liberty in a pandemic
title_short Ethics of selective restriction of liberty in a pandemic
title_sort ethics of selective restriction of liberty in a pandemic
topic Feature Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8327318/
https://www.ncbi.nlm.nih.gov/pubmed/34059520
http://dx.doi.org/10.1136/medethics-2020-107104
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