In Review: Coursework

Ethical issues in epidemics are a standard part of philosopher Richard Dees’s course, Public Health Ethics. It’s a course he teaches regularly, and he typically devotes three class sessions to questions about epidemics.

But in 2020–21, three class meetings didn’t seem remotely commensurate with world events. Last summer he asked students if they’d like to devote the seminar to the ethics of pandemics. They unanimously said yes. And so this spring, Dees offered an entirely new course: Pandemic Ethics.

Dees, a professor of philosophy and bioethics, directs the University’s program in bioethics. Bioethics majors are required to take a capstone course, a seminar that takes an in-depth look at ethical issues and ties together themes of the major.

Pandemic Ethics fulfills that charge by focusing on ethical issues arising out of the coronavirus pandemic, from disease surveillance and contact tracing to resource allocation to quarantine and lockdowns to vaccine developments. Dees sets current dilemmas within the context of other epidemics, too.

“Government responses to cholera, for example, caused considerable social unrest in Italy in the 19th century, so I tied it to the week on social justice issues. AIDS containment has a lot of contact tracing; the Black Death was all about quarantine,” he says.

Diverse diseases require bioethicists to consider varied factors and inhabit a range of perspectives. And so, as the students are examining issues surrounding COVID-19, they’re also learning that its lessons aren’t transcendent.

“Different diseases create different issues in transmissibility, they create different problems in treatment, they affect different marginalized communities in different ways,” says Dees. “So I want the students to think about coronavirus but also about the distinct issues that arise in other diseases.”

He and his students are considering the current pandemic, and its historical forerunners, from a wide range of angles. They’re investigating broad principles of bioethics, such as justice, the right to autonomy, and beneficence and nonmaleficence. But they’re also plunging into the thorny questions of managing the current crisis: the duty to treat; resource allocation; triage and equality; quarantine and isolation; social distancing, lockdowns, and masks; reopening; vaccine development and distribution; and social justice in both US and global contexts.

“The goal of the course is to help students understand how to apply broad ethical principles to particular bioethical issues,” says Dees. “I want them to learn how to think through a difficult ethical problem, how to make sure that they are considering all the factors that might be ethically relevant, and how to make sure they are listening to all the points of view that might be relevant. But then they must learn to make an ethical judgment about the best course of action and defend it.

“In the pandemic context, the most difficult issues concern the allocation of resources, and that issue arises in a number of contexts. There are limits to ventilators, to new drug therapies, to health care workers, and (to a lesser extent) to relief money. And now we are seeing the limits of vaccines. The task is then to find a fair way to distribute those resources.”

Among the students’ assigned readings, which include optional background selections on polio, tuberculosis, and HIV/AIDS, is one golden oldie of philosophy and other humanities courses: Albert Camus’s 1947 novel, The Plague. “The book is often seen as a metaphor for the response to fascism, but it’s hard to see it as a metaphor anymore,” says Dees.

It was clear how much more relevant the book was to students now.

“They were able to understand the moral and psychological situation in which the characters found themselves, and so they were much more sympathetic to the problems,” he says. “Students talked a lot about their own experiences and those of their family, some of whom were gravely affected by COVID-19.”