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Ethics-driven policy framework for implementation of movement restrictions in pandemics

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Siddhesh Zadey, Surabhi Dharmadhikari, Pradeeksha Mukuntharaj

Summary box

  • In recent years, autonomy and liberty-restrictive public health interventions have generated ethical debates and necessitated guidelines, and the COVID-19 movement restrictions such as lockdowns reinvigorated this ethical dilemma.

  • An applied ethics framework for policymakers to make quick evaluations of the ethical soundness of movement-restrictive policy decisions is urgently needed in view of the COVID-19 pandemic to be better prepared for future pandemics but is missing.

  • We present a novel integrated ethical principles–pragmatic considerations–measurable policy indicators framework based on an amalgamation of unique ethical principles drawn from a rigorous review of the existing literature on the ethics of movement restrictions with each ethical principle mapped to answerable questions or pragmatic considerations to subsequently generate 34 policy indicators.

  • We also depict ethical lapses in proportionality, utility efficiency and accountability for the largest such restriction in the COVID-19 pandemic, that is, India’s lockdown.

  • Our framework bridges the gap between public health ethics and policymaking in the context of movement restrictions through an easy-to-use tool that can be applied across countries to assess the ethical implications of policies in the face of ongoing and future pandemics.