Adherence to Pandemic Ethics during India’s Covid-19 Lockdown

Ethics is indispensable to public health because of the great trade-off between the “voluntary versus coercive” measures often employed in health policies. In ethics, this trade-off is described as “the common and the good” (Gostin and Wiley 2016). The “common” good such as the mandatory use of masks in public places undermines the individual “good” or the freedom to choose wearing a mask. During pandemics, this is accentuated in general, and more so, during a pandemic caused by a novel virus strain, the knowledge of whose origin, nature, transmission, and management is evolving. During these extraordinary times, it is worth reiterating that “public” is central to public health. The centrality of public in public health, as argued by experts, is primarily due to two reasons: first, individual measures and actions alone, such as procuring food, housing and medical care cannot achieve public health, and second, all public health measures are accountable to the public itself (Gostin and Wiley 2016). Consequently, like other policies dealing with the public, this makes ethics integral to public health policy (Mack et al 2007).

The worldwide devastation that this pandemic has brought to health, economies and livelihoods are due to both the virus as well as colossal mismanagement in many instances. Therefore, adherence to known principles of pandemic ethics during these times is very important. The practical pandemic considerations could undermine individual liberties and can be best understood through Geoffrey Rose’s (1981) “Prevention Paradox”—preventive measures that are beneficial for the population offer little advantage to individuals. “Do ethics change during epidemics?” Victoria Sutton famously answered yes, stating that uncertainties, scepticism, and differences of opinion are bound to happen during the fight against an epidemic for which we lack full scientific knowledge (Mack et al 2007). Lawrence Gostin (2004: 572) remarked, “the only safeguard is the adoption of ethical values in formulating and implementing public health decisions.” Experts argue and emphasise that during pandemics, ethics should take precedence to health emergency law enforcements (Sutton 2005). More importantly, ethics should not be limited to “content” of the policies but extended to the “processes” (Mack et al 2007), failing which, they are bound to exacerbate inequalities and injustices.