The government can’t just follow the science – we need ethics to guide us out of lockdown

Signage has been of particular importance throughout the pandemic. Like exit signs on the motorway, the mantra “stay home – protect the NHS – save lives” was a clear and consistent message that by following this path, the UK would find itself more or less in one piece after lockdown.

Now, as the UK looks to come out of lockdown, we find ourselves following a road map, a yellow brick road purportedly drawn by “the science”, that will lead us to safety. Many have criticised this map, questioning how and who developed it. But there’s also the question of whether it is the right road map of the many possible ones we could follow.

The UK government has been clear all along that it is “following the science”, but as I, alongside respected medical ethicists in the UK, have recently argued, this perpetuates a myth about that science: that it is somehow morally neutral, objective and illuminates only one way forward for navigating the crisis. This is not the case. Instead, there are many roads out of the pandemic, each one dependent on how we value the science used to draw the map. In a sense, all roads lead to Rome, but which road we take determines the difficulty of the voyage itself, and most importantly, in what state the UK will be in when it gets there.

We need leadership that openly and transparently consults with ethicists to determine the best, most ethical, way for our country to navigate the pandemic. Ethics is the cartographer that can show us the right road to take. It can help us determine not what we can do, but what we should do.

For example, we can collect personal data through track and trace technology, but what should we do with that data? How do we use it in such a way that it protects the public, while also preserving privacy, avoiding use of that data to discriminate or profit from those affected by the virus? We need to follow the ethics just as much as the government claims to be following the science in order to answer those questions.

Until now there has been very little transparency from the government about how they have been informed by ethics in their response to the pandemic. The government has a Moral and Ethical Advisory Group (MEAG), but despite its briefing to provide clear, national guidance for pandemics, it has been curiously quiet. It is as if the government knows they must show they are aware there will be issues of ethical concern but has no desire to truly map them.

In the vacuum left by a lack of national guidance, ethical frameworks and approaches have sprung up in individual surgeries, hospitals, trusts, and across professional bodies. It is a confusing and inconsistent message that signals there is an “ethical” way to act in the pandemic, but no guidance. To return to the government’s road map analogy, where the ethics signposts should be used to indicate which exits, which side roads to take to best reach our destination, the sat-nav is instead leading us into terra incognita. This will not do.

It is not enough to say, “there be dragons”, and walk away. Ethicists are needed to advise on the development of robust policy for Covid-19 immunity testing, vaccines, track and trace, virus research ethics, health inequalities, frontline staff safety, rationing of resources, end-of-life planning, and the list goes on. These are not value-neutral concepts.

Presenting the solution to be as simple as “following the science” misleads the public into thinking that science alone will save us. This approach also allows politicians to distance themselves from their responsibilities to the public. If they make a mistake with policy or implement measures, it was not their fault, it was “science” that got it wrong.

Already the “science” has been blamed for the government’s mistakes. However, science, and the policy it informs, is not neutral. How we value what science tells us is linked to what we value in our society. Policy is the operationalisation of this value; it takes what we consider most important and turns that into rules around how we act.

Government cannot just follow the science. It has a role, but there are value decisions to be made that will shape society for the coming months and beyond, and these need to be made by politicians who have first been guided by ethicists.

Dr Alexis Paton is a lecturer in social epidemiology and the sociology of health at Aston University, chair of the Committee for Ethical Issues in Medicine at the Royal College of Physicians, and a trustee of the Institute of Medical Ethics