Bioethics and COVID-19: Considering the Social Determinants of Health

Abstract

In this paper, we focus on a novel bioethical approach concerning the ethical implications of the Social Determinants of Health (SDs) in the time of COVID-19, offering a fresh interpretation of our agency and responsibility in the current pandemic era. Our interpretation is grounded on the idea that our health basically depends on factors that go beyond our organism. In this sense, we stress the radical importance of circumstances to ethically assess an action, in the current pandemic context. Moreover, due the centrality of the SDs in our bioethical assessments—that implies that our health does not exclusively depend on our choices, behaviors, and lifestyle—we can affirm that we are not entirely responsible for our wellness or diseases. As health depends on economic, social, cultural, and environmental factors, we argue that the analysis of personal responsibility facing personal health status should receive further consideration. In this sense, following the “social connection model,” we stress the importance of the concept of “shared responsibility” in collective decisions: if we make many decisions collectively, we are also collectively responsible of these decisions. Furthermore, to responsibly tackle the social inequalities that are the underlying cause of disparities in health outcomes, we propose two main strategies based on the Capability Approach: 1. empowering the individuals, especially the most vulnerable ones; and 2. designing preventive policies and interventions that provides an opportunity to address the disparities moving forward. This will help us going beyond the “individualistic medical ethics paradigm” and integrating our concept of health with social factors (e.g., the SDs), based on a more relational and interdependent anthropological thought.

“What Other Information Is There?”: Identifying Information Gaps, Perceptions and Misconceptions on COVID-19 Among Minority Ethnic Groups in the Netherlands

“…As our data showed the impact of the COVID-19 pandemic on public health requires a global bioethical reflections and responses as discussed in the recently published special issue on "Ethics and COVID-19: The Bioethics of a 'Job Well Done' in Public Health" by the Frontiers Health services journal. People's information choices go beyond the individual and incorporate ideas of health with social factors, based on a more relational approach (49). Our findings highlight how the COVID-19 pandemic has revealed the reality of policy gaps and information gaps that people from minority ethnic groups are confronted with and its effect on their well-being.…”

Contributions of Hippocratic medicine and Plato to today’s debate over health, social determinants and the authority of biomedicine

“…What is required is a change in template for addressing health, which will entail, among other things, major institutional adjustments and dramatic shifts in resource allocation 4. By casting into stark relief the fact that healthcare is but one factor bearing on persons’ health, and how deeply entwined health and well-being are (Kobayashi et al 2021; Valera and López Barreda 2022), COVID-19 and responses to it have pushed this necessity to the fore.…”