Nikola Biller-Andorno and Giovanni Spitale published a new article on NEJM Catalyst. This work focuses on the identification and definition of the most relevant ethical challenges posed by the pandemic; as crisis scenarios tend to evolve rapidly - and thus new unforeseen issues or priorities can and do emerge - the approach proposed combines philosophical analysis and natural language processing to generate dynamic analyses.
From an ethical perspective, the Covid-19 pandemic is like a prism: It helps us see the spectrum of issues clearly and distinctly. Here, the authors outline what they consider top ethics concerns, grouped around five moral and societal core values: autonomy, privacy, equity, proportionality, and trust. They probe these concerns with some examples related to vaccination of health care professionals, contact tracing, global access to vaccines, lockdowns, and crisis communication. The authors recognize that the dynamic, cross-sectoral, multilevel impacts of both the coronavirus itself and the clinical and societal measures taken to contain it are too complex to be fully captured without an exhaustive accounting. Instead, they propose a value-based topic list, centered around five core moral values that are unlikely to change over time and that will allow health care leaders to systematically analyze ethical issues arising in their institutions. For each of the items on the Core Five Enduring Values List, the authors include a dynamic presentation of emerging topics (in the form of a word cloud or any other suitable format) that can and will change; these are generated with a natural language processing approach, using an open-source topic tracking algorithm as a means of tackling the exploding volume of literature on bioethics and Covid-19, allowing for quick overview of thematic priorities.