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Institute of Biomedical Ethics and History of Medicine (IBME)

Dissertation Giovanni Spitale

Ethical Dilemmas in the Time of COVID-19: mapping, understanding, building systemic resilience


The outbreak of COVID-19 has posed unprecedented challenges to public health officials and ethicists alike. The response to the pandemic has forced us to grapple with a number of ethical issues that have arisen in the context of quarantining, risk communication, and patient care. In this dissertation, I aim to explore some of the emerging ethical issues that have arisen during the pandemic and to identify possible solutions to these ethical dilemmas. I begin by providing an overview of the ethical principles that have been invoked in debates about the ethics of quarantine and risk communication (Chapter 2). Chapter 3 details a novel approach to retrieve and map large amounts of literature applying smart iterative search strategies and natural language processing (NLP). In Chapter 4 I further develop the approach detailed in Chapter 3 and apply it to map the large body of literature on emerging ethical issues connected to COVID-19. This NLP-based analysis provides a comprehensive overview of the current state of research on emerging ethical issues in COVID-19. Next, Chapter 5 presents the protocol for PubliCo, a study/intervention that aims to improve bidirectional risk and crisis communication between public health officials and members of the public, incorporating active social listening methodologies. Chapter 6 explores ‘the dark side’ of social listening, i.e. passive social listening, in order to conduct an empirical mixed methods study aimed at understanding the magnitude and the meaning of digital conversations of no-green- pass groups. Chapter 7 presents the protocol for a state-of-the-art approach for collecting and analysing patient narratives, through which many novel and unforeseen issues can be pinpointed, especially those connected to fairness in healthcare and communication. Finally, Chapter 8 offers a systematic ethical framework for risk and crisis communication, based on the findings of this research, that can be used to guide the design, governing and evaluation of communication actions in current and future crises.