Objective The political costs associated with healthcare priority-setting give decision-makers an incentive to shield from the consequences of unpopular decisions. This fact, together with the factual and normative complexity of priority-setting decisions, give politicians reason to delegate decision-making through arrangements such as consultative procedures and to seek the advice of moral and political philosophers. Not surprisingly, many countries made use of ethics expert panels to advice on priority setting of COVID-19 vaccines in the first phase of the pandemic. However, the authority of a distinctive expertise in ethical guidance was being questioned in the public debate on vaccine prioritisation. This sceptical stance regarding the role and expertise of the ethics expert is not new. If we are all equal as autonomous beings and autonomy is the source of normativity, then we all have equal capacity for moral decision-making. The aim of this paper is to examine if and how ethics expertise can contribute to policy making regarding the development and implementation of COVID-19 immunisation programmes: What kind of expertise can ethicists offer?
Methods Theoretical discussion based on an illustrative case: Domestically prioritisation of COVID-19 vaccines.
Results and Discussion We argue that ethicists have an epistemic authority in the sense of being in a privileged position to give ethical advice if a set of meta-principles for regulation of the ethical debate is followed. By using a methodology of ‘engaged philosophy’, the ethics experts should seek to identify relevant values in the context of a specific problem and work through a series of steps so that broad agreement can be made in a given case. While we may not necessarily converge on the deepest foundations for our normative beliefs, we may reach agreement particular outcomes and mid-level principles.
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