Department of Philosophy and Classics
Permanent URI for this collectionhttp://197.255.125.131:4000/handle/123456789/23076
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Item Bioethics’ Duty to Conference in Qatar: Reply to Magnus(The American Journal of Bioethics, 2024) Jecker, N.S.; Savulescu, J.; Atuire, C.; et al.Is it unethical to host an international bioethics conference in Qatar? In an editorial in this issue, David Magnus (2024) argues that conferencing in Qatar or other places where human rights violations occur, is not ethically justified. According to Magnus, the International Association of Bioethics’ (IABs’) decision to host the 2024 World Congress of Bioethics (WCB) at a Qatari-based university was “a major mistake by the IAB board.” We hold a much different view. In the face of unjust laws and human rights violations, more than one response is ethically defensible, as some of us have argued (Jecker and Ravitsky 2023; Jecker et al. 2024a; Jecker et al. 2024b; Jecker, Verweij, et al. 2023; Ghaly, El Akoum, and Afdhal 2023). Boycotting is one way to seek to change an unjust situation, but so too is engaging with people who are willing to host, hear, and take seriously challenges and objections to their prevailing norms (Jecker, Ravitsky, et al., 2023). Qatari-based hosts have invited bioethicists from around the world to engage with them in an open exchange of ideas, and offered a conference venue where this can occur. Bioethicists should engage and should foster open and respectful dialogue. To avoid redundancy with arguments, some of us have developed elsewhere (Jecker and Ravitsky, 2023; Jecker et al. 2024a; Jecker et al. 2024b; Jecker, Verweij, et al. 2023; Ghaly, El Akoum, and Afdhal 2023), we limit our response mostly to points not considered previously.Item The Ethics of International Bioethics Conferencing: Continuing the Conversation(The American Journal of Bioethics, 2024) Jecker, N.S.; Atuire, C.; Ravitsky, V.; et al.Our article, “Proposed Principles for International Bioethics Conferencing: Anti-Discriminatory, Global and Inclusive,” urged a critical conversation with bioethicists around the globe on the ethics of international bioethics conferencing (Jecker et al., 2024). Focusing on site selection, we tentatively set forth seven principles: anti-discriminatory, international, green, fair-minded, leave no one behind, free exchange of ideas and epistemic justice. We appreciate the vigorous response our proposal generated and the overall recognition of the ethical importance of the topic. We are grateful to Van Der Graaf and colleagues, who were the first in the literature to pinpoint the need for sustained debate within bioethics on the ethics of ethics conferencing (Van Der Graaf et al., 2023). We cannot do justice to all the points colleagues raised across 15 separate commentaries. In this short response, we focus on objections and proposed addenda to the seven principles.Item Preparing ethical review systems for emergencies: next steps(BMC Medical Ethics, 2023) Wright, K.; Aagaard, N.; Atuire, C.; et al.Ethical review systems need to build on their experiences of COVID-19 research to enhance their preparedness for future pandemics. Recommendations from representatives from over twenty countries include: improving relationships across the research ecosystem; demonstrating willingness to reform and adapt systems and processes; and making the case robustly for better resourcing.Item The importance of getting the ethics right in a pandemic treaty(Personal View, 2023) Schaefe, G.O.; Atuire, C.A.; Kaur, S.; et al.The COVID-19 pandemic revealed numerous weaknesses in pandemic preparedness and response, including underfunding, inadequate surveillance, and inequitable distribution of countermeasures. To overcome these weaknesses for future pandemics, WHO released a zero draft of a pandemic treaty in February, 2023, and subsequently a revised bureau’s text in May, 2023. COVID-19 made clear that pandemic prevention, preparedness, and response reflect choices and value judgements. These decisions are therefore not a purely scientific or technical exercise, but are fundamentally grounded in ethics. The latest treaty draft reflects these ethical considerations by including a section entitled Guiding Principles and Approaches. Most of these principles are ethical—they establish core values that undergird the treaty. Unfortunately, the treaty draft’s set of principles are numerous, overlapping, and show inadequate coherence and consistency. We propose two improvements to this section of the draft pandemic treaty. First, key guiding ethical principles should be clearer and more precise than they currently are. Second, the link between ethical principles and policy implementation should be clearly established and define boundaries on acceptable interpretation, ensuring that signatories abide by these principles.Item Public health research using cell phone derived mobility data in sub-Saharan Africa: Ethical issues(Ethics of mobility data in sub-Saharan Africa, 2023) Rennie, S.; Atuire, C.; Mtande, T.; et al.The movements of humans have a significant impact on population health. While studies of such movements are as old as public health itself, the COVID-19 pandemic has raised the profile of mobility research using digital technologies to track transmission routes and calculate the effects of health policies, such as lockdowns. In sub-Saharan Africa, the high prevalence of cell phone and smartphone use is a source of potentially valuable mobility data for public health purposes. Researchers can access call data records, passively collected in real time from millions of clients by cell phone companies, and associate these records with other data sets to generate insights, make predictions or draw possible policy implications. The use of mobility data from this source could have a range of significant benefits for society, from better control of infectious diseases, improved city planning, more efficient transportation systems and the optimisation of health resources. We discuss key ethical issues raised by public health studies using mobility data from cell phones in sub-Saharan Africa and identify six key ethical challenge areas: autonomy, including consent and individual or group privacy; bias and representativeness; community awareness, engagement and trust; function creep and accountability; stakeholder relationships and power dynamics; and the translation of mobility analyses into health policy. We emphasise the ethical importance of narrowing knowledge gaps between researchers, policymakers and the general public. Given that individuals do not really provide valid consent for the research use of phone data tracking their movements, community understanding and input will be crucial to the maintenance of public trust.Item Pandemic preparedness and response: beyond the Access to COVID-19 Tools Accelerator(BMJ Global Health, 2023) Saxena, A.; Baker, B.K.; Atuire, C.A.; et al.Nationalism has trumped solidarity, resulting in unnecessary loss of life and inequitable access to vaccines and therapeutics. Existing intellectual property (IP) regimens, trade secrets and data rights, under which pharmaceutical firms operate, have also posed obstacles to increasing manufacturing capacity, and ensuring adequate supply, affordable pricing, and equitable access to COVID-19 vaccines and other health products in low income and middle- income countries. We propose: (1) Implementing alternative incentive and funding mechanisms to develop new scientific innovations to address infectious diseases with pandemic potential; (2) Voluntary and involuntary initiatives to overcome IP barriers including pooling IP, sharing data and vesting licences for resulting products in a globally agreed entity; (3) Transparent and accountable collective procurement to enable equitable distribution; (4) Investments in regionally distributed research and development (R&D) capacity and manufacturing, basic health systems to expand equitable access to essential health technologies, and non-discriminatory national distribution; (5) Commitment to strengthen national (and regional) initiatives in the areas of health system development, health research, drug and vaccine manufacturing and regulatory oversight and (6) Good governance of the pandemic prevention, preparedness and response accord. It is important to articulate principles for deals that include reasonable access conditions and transparency in negotiations. We argue for an equitable, transparent, accountable new global agreement to provide rewards for R&D but only on the condition that pharmaceutical companies share the IP rights necessary to produce and distribute them globally. Moreover, if countries commit to collective procurement and fair pricing of resulting products, we argue that we can greatly improve our ability to prepare for and respond to pandemic threats.