Ethics, knowledge vital to policy
It is a time of risk and uncertainty as we cope with the Covid19 pandemic. Dr Royden Somerville explains.
THE language of risk is the dominant discourse during the horrendous Covid19 pandemic. We all understand the three stages that are involved when we address a risk. We identify a risk (perceived or actual), we try to evaluate the likelihood or probability of the risk being realised, and we manage the risk by endeavouring to mitigate its impacts.
An everyday example of this process is when we wish to cross the road when there is limited visibility. We identify the risk of being struck by a vehicle, we evaluate the likelihood or probability of crossing safely, and we may manage the risk by moving to a spot where there is a less impeded view.
However, risk identification, assessment and management are major challenges when addressing what is sometimes called a phantomrisk. The characteristics of a phantomrisk, such as the Covid19 pandemic, involve uncertainty and an absence of reliable information to inform an effective evaluation of the likelihood and probability of significant and irreversible consequences.
When developing policies and laws for urgently implementing risk management responses to a pandemic or other phantomrisks, a strong precautionary risk management approach should be adopted. This will often involve utilising adaptive management to address uncertainty and complex issues surrounding the risk. Central to this method is the incorporation of monitoring, review and adjustment processes to address changing and new information. These processes should be flexible and should not foreclose on considering innovative options. The importance of involving scholars and experts across the many disciplines required to develop and evaluate these options, cannot be overstated.
In the case of a pandemic, a rigorous testing and tracing regime is required to inform decision makers so they can then consider the public health, social, economic, and cultural implications of a proposed policy or regulatory response. When addressing public health issues, as with any public interest matter, the ethics of kaitiakitanga and stewardship should be at the forefront, in order to honour the moral obligation to ensure that there are no significant or irreversible adverse consequences, not only for existing, but also for future generations. Steps taken to achieve shortterm gains or benefits at the expense of public health often result from pressure to move quickly to promote quantifiable social and economic benefits, and discount the unquantifiable risks that may have longlasting adverse impacts.
A regulatory response should be developed and implemented by central government when a strong precautionary approach is considered essential to protect the national interest. Such a response is also necessary when economic instruments are being utilised. When judging the extent of a proposed legislative response, regulatory impact statements are required. These involve costbenefit and riskbenefit evaluations. However, when there is a need to act urgently, without sufficiently reliable evaluative information and the opportunity to engage in a comprehensive programme of public consultation about possible risk management options, it will inevitably mean a less than robust assessment of the regulatory impacts. Therefore, in such circumstances, when judging what is an acceptable level of risk for the community, the focus on the valueladen considerations of equity, justice, and compassion will be crucial.
In conclusion, with a pandemic the inability to predict reliably and usefully what the future might bring can be mitigated by developing policies and laws that provide for a precautionary risk management framework, that incorporates effective processes to allow for the development and implementation of fair and wellreasoned adaptive and reflexive responses.
During these uncertain times we need to acknowledge and extend our grateful thanks to our politicians, and the experts in public health, epidemiology, ethics, science, matauranga Maori, economics and law, who are striving to assist with the development of an effective and just policy and regulatory regime to combat the multiple Covid19 risks confronting our shared humanity.