Ethical moments and institutional expertise in UK Government COVID-19 pandemic policy responses: where, when and how is ethical advice sought?

Abstract

Background:The emergency response to the COVID-19 pandemic has required a rapid acceleration of policy decision making, and raised a wide range of ethical issues worldwide, ranging from vaccine prioritisation, welfare and public health ‘trade-offs’, inequalities in policy impacts, and the legitimacy of scientific expertise. Aims and objectives:This paper explores the legacy of the pandemic for future science-advice-policy relationships by investigating how the UK government’s engagement with ethical advice is organised institutionally. We provide an analysis of some key ethical moments in the UK Government response to the pandemic, and institutions and national frameworks which exist to provide ethical advice on policy strategies. Methods:We draw on literature review, documentary analysis of scientific advisory group reports, and a stakeholder workshop with government ethics advisors and researchers in England. Findings:We identify how particular types of ethical advice and expertise are sought to support decision making. Contrary to a prominent assumption in the extensive literature on ‘governing by expertise’, ethical decisions in times of crisis are highly contingent. Discussion and conclusions:The paper raises an important set of questions for how best to equip policymakers to navigate decisions about values in situations characterised by knowledge deficits, complexity and uncertainty. We conclude that a clearer pathway is needed between advisory institutions and decision makers to ensure ethically-informed debate.