In order to identify appropriate responses to a pandemic, governments should adopt a consequentialist approach with the aim of reducing the disease burden to an acceptable level of harm.
Cameron JAM, Williams BM, Ragonnet R, Marais BJ, Trauer JM, Savulescu J.


Liberty-restricting measures have been implemented for centuries to limit the spread of infectious diseases. This article considers if and when it may be ethically acceptable to impose selective liberty-restricting measures in order to reduce the negative impacts of a pandemic by preventing particularly vulnerable groups of the community from contracting the disease.


We argue that the commonly accepted explanation-that liberty restrictions may be justified to prevent harm to others when this is the least restrictive option-fails to adequately accommodate the complexity of the issue or the difficult choices that must be made, as illustrated by the COVID-19 pandemic. We introduce a dualist consequentialist approach, weighing utility at both a population and individual level, which may provide a better framework for considering the justification for liberty restrictions. While liberty-restricting measures may be justified on the basis of significant benefits to the population and small costs for overall utility to individuals, the question of whether it is acceptable to discriminate should be considered separately. This is because the consequentialist approach does not adequately account for the value of equality. This value may be protected through the application of an additional proportionality test. An algorithm for making decisions is proposed. Ultimately whether selective liberty-restricting measures are imposed will depend on a range of factors, including how widespread infection is in the community, the level of risk and harm a society is willing to accept, and the efficacy and cost of other mitigation options.

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First published: May 31, 2021
Department of Epidemiology and Preventive Medicine
The Monash University's Department of Epidemiology and Preventive Medicine in the School of Public Health and Preventive Medicine has initially focused on TB epidemiology and control, but recently shifted its focus to include a strong interest in the COVID-19 pandemic. The focus comprises the use of methodological approaches in the areas of deterministic and stochastic modelling, agent-based simulations, applied mathematics, Bayesian inference, statistics, epidemiology, health economics, computer science and data visualisation.