Projects on Public Health in the Research Group Schicktanz



Since 2021: Study Group for inter-generational Health Ethics

Carried out by:
Prof. Dr. Silke Schicktanz silke.schicktanz(at)medizin.uni-goettingen.de
Dr. Shingo Segawa shingo.segawa(at)med.uni-goettingen.de

Prof. Dr. Mark Schweda mark.schweda(at)uni-oldenburg.de
Nils Groppe-Ellrich (Oldenburg)
Prof. Dr. Christoph Rehmann-Sutter christoph.rehmannsutter(at)uni-luebeck.de
Prof. Dr. Claudia Bozarro claudia.bozzaro(at)iem.uni-kiel.de
Dr. Anke Erdmann erdmann(at)iem.uni-kiel.de
Dominik Koesling dominik.koesling(at)iem.uni-kiel.de

The study group for inter-generational Health Ethics is a research network dedicated bioethical issues concerning the relationship between generations and, more generally, questions of the future. These include health-related issues of sustainability, climate justice, genetics, and prevention. It addresses medicine as a dynamic field of inter-professional social practices that evolve and change in social and political contexts. Our ethical reflection is grounded in an analysis of relations, is sensitive to issues of injustice, and also incorporates social and cultural science approaches. Furthermore, methods of medium- to long-term normative evaluation, anticipation, and models of the future are the subject of our ethical inquiry.
 


2020 - 2021: Research Project: "COMPASS – Coordination on Mobile Pandemic Apps Best Practice and Solution Sharing"
Subproject "Ethical and social challenges and requirements"

Carried out by:
Lorina Buhr, M.A. lorina.buhr(at)med.uni-goettingen.de

Contact:
Prof. Dr. Silke Schicktanz  sschick(at)gwdg.de
Fuding: German Ministry of Education and Research (BMBF)
Duration: Sept. 2020 – March 2021

External Project Website COMPASS

External Website NUM (Netzerk Universitätsmedizin; in German)

The aim of the COMPASS project (Coordination on mobile pandemic apps best practice and solution sharing) is to establish a platform for the sustainable coordination of pandemic apps and to provide concrete methods and tools for their implementation according to the current state of science, technology and legislation.

The nationwide approach of partners from science and industry is intended to contribute to sustainably anchor the development and use of digital solutions in pandemic management through coordinated construction, processing and evaluation of pandemic apps as well as the creation of recommendations for design.

The question of the ethical legitimacy of pandemic-related apps is currently being raised primarily with a focus on contact-tracing apps, since privacy concerns and the possibilities for abuse are evident here. A central aspect of contact tracing apps is that only a large distribution of the app can make an effective contribution to pandemic management, so that the ethical evaluation of the app depends on the actual degree of distribution. This leads to the balancing of two goods - privacy and collective health protection. In the case of the Corona warning app issued by the German government, for example, privacy protection had to be taken into account to such an extent that this could not be solved by simply referring to corresponding data protection clauses and terms of use.

However, there are also apps and digital applications that are not developed for contact tracing but for other purposes in the context of infectious disease management, e.g. to support infectious disease research. So far, however, there are only a few empirical studies that have surveyed the population’s attitude towards, and acceptance of, such research-focused, and often data-intensive digital applications. By conducting a representative survey, the general population’s attitudes towards, and acceptance of, various digital solutions with regard to the management and research of pandemic and epidemic infectious diseases will be explored. The survey will feed into the development of ethically and socially reflective recommendations for the development and design of mobile apps. Additionally, a scoping review on existing ethical guidelines and governance frameworks is conducted.


2020 – 2022: Research Project: "Medicine and Ethics Go Viral: The Ethics of Covid-19-health-care – A Global Mapping of Bioethical Perspectives"

Carried out by:
Prof. Dr. Silke Schicktanz sschick(at)gwdg.de
Prof. Dr. Sabine Wöhlke Sabine.Woehlke(at)haw-hamburg.de
Jane Mailin Vonderschmitt j.vonderschmitt(at)stud.uni-goettingen.de

Contact:
Prof. Dr. Silke Schicktanz sschick(at)gwdg.de
Funding: VolkswagenStiftung
Duration: Sept. 2020 – July 2022

Since the start of its pandemic spread at the end of 2019, the Covid-19 virus has caused dramatic consequences worldwide and posed new medical, political, economic, cultural and ethical challenges. Our study examines in a contemporary snapshot, how resulting bioethical conflicts in different countries may appear similar or, upon closer examination, indicate differences across countries, systems, and cultures.

In order to illustrate commonalities and differences, we are conducting a qualitative interview study with about 30-40 experts worldwide. The empirical-ethical approach focuses on the presentation of the main areas with bioethical conflict potential in public health, health literacy, medical-clinical contexts and professional care. This method describes a combination of empirical research and ethical analysis and is thus more context-sensitive than purely normative ethics. The aim of the study is not a systematic, all-encompassing survey, but rather the reflection of contextualization and the mapping of bioethical conflicts.

In a second stage, we want to produce 20-30 short podcasts, which will illustrate the results in both a virtual and in-person exhibition at Forum Wissen.

The project addresses an audience of bioethicists and other people in medicine, public health, and nursing. Its aim is to shed light on bioethical conflicts that have been caused by the pandemic. It thus represents an approach to broaden the ethical, cultural, and social understanding of the Covid-19-crisis and pandemics in general. It also might provide new approaches for ethical reflection on cultural issues. Furthermore, we plan to provide teaching material for bioethics.


2020 – 2022: PhD Project: "Ethical Aspects of Fair Resource Allocation in Hospitals during the Covid-19-crisis – A Qualitative Assessment"

Carried out by:
Clemens Friedrich Schmidt, cand.med c.schmidt01(at)stud.uni-goettingen.de

Contact:
Prof. Dr. Silke Schicktanz sschick(at)gwdg.de
Duration: Sept. 2020 – May 2022

The Covid-19 pandemic has posed profound challenges to the healthcare system, especially where the allocation of health resources is concerned. The pandemic has led to an immediate scarcity of personal protective equipment which had to be rapidly obtained, stocked and distributed. Staff and treatment time shortages had to be accounted for as well. The topic of Triage, the allocation of intensive care treatment on an individual level, immediately dominated the discussion, soon to be followed by a debate on the allocation of vaccines on a much higher, macroscopic level. However, in between these levels, for example in hospitals and care facilities, allocation decisions were and continued to be critical as well.

The aim of this study is to examine what kind of ethical problems and intersubjective conflicts were prevalent with respect to resource allocation on the so-called meso-level of hospitals as institutions of the healthcare system. For this purpose, we will conduct a qualitative survey via the means of expert interviews with employees and employers of medium-sized hospitals in the region of Göttingen to analyse how allocation decisions were communicated and implemented during the crisis situation in Spring 2020. Which ethical problems became visible in the allocation process in the view of healthcare workers in hospitals? The project thus aims at contributing to the ethical discussion on fair resource allocation in crisis situations and is set to close a gap in research on the perspective of hospital staff on this topic.


2020 – TBD: Research Project: "Lives and Livelihoods: Understanding Public Preferences and Trade-offs for Government Responses During a Pandemic"

Carried out by:
Dr. Mesfin Genie (Health Economics Research Unit Aberdeen)
Dr. Luis Loría-Rebolledo (Health Economics Research Unit Aberdeen)
Dr. Shantini Paranjothy (University of Aberdeen)
Dr. Daniel Powell (University of Aberdeen)
Prof. Dr. Mandy Ryan (Health Economics Research Unit Aberdeen)
Dr. Ruben Sakowsky (Department of Medical Ethics and History of Medicine, Göttingen)
Dr. Verity Watson (Health Economics Research Unit Aberdeen)

Contact:
Dr. Ruben Andreas Sakowsky rubenandreas.sakowsky(at)med.uni-goettingen.de
Funding: Health Economics Research Unit of the University of Aberdeen
Duration: May 2020 – TBD

External Project Website

The Covid-19 pandemic has forced governments worldwide to implement lockdown measures. These policies have differed considerably across different countries in terms of scope, length, and in the severity of restrictions.

While necessary to save lives, lockdown measures had a profound negative impact on many people’s lives and livelihoods. Many employees saw their hours reduced, were furloughed, or lost their jobs entirely. Patients had limited access to non-pandemic related health services, and parents were unable to make use of childcare services.

In this project, which is coordinated by the Health Economics Research Unit in Aberdeen, we focus on citizen preferences with respect to lockdown policies. In particular, we are evaluating what restrictions people are willing to endure in order to save lives.

We evaluate how these preferences differ across age, sex, and income levels. In addition, we employ an innovative methodology (a combination of the Moral Foundations Questionnaire-20 with Discrete Choice Experiment methodology) to evaluate the effect of people’s moral attitudes on their lockdown policy preferences. We also measure people’s willingness to comply with different restrictions.

Our research aims at understanding which lockdown measures have the greatest impact on different people and which restrictions are most likely to be followed. This knowledge can help political decision makers implement lockdown policies in a way that minimizes negative impact and increases compliance. Our investigation of the effect of moral attitudes on lockdown preferences can lead to more effective ways to promote trust in pandemic prevention strategies.

Genie, M. G., Loría-Rebolledo, L. E., Paranjothy, S., Powell, D., Ryan, M., Sakowsky, R. A. and Watson, V. (2020) 'Understanding public preferences and trade-offs for government responses during a pandemic: a protocol for a discrete choice experiment in the UK', BMJ Open, 10(11), e043477. dx.doi.org/10.1136/bmjopen-2020-043477


2021 – 2023: Research Project “Infection and Injustice. Narrative Responses to Pandemics”

Carried out by:
Prof. Dr. Silke Schicktanz (Department of Medical Ethics and History of Medicine, Göttingen) sschick[at]gwdg.de
Prof. Dr. Moritz Ege (ISEK Zürich) mege[at]uni-goettingen.de
Prof. Dr. Andrew Gross (University of Göttingen) Andrew.gross[at]phil.uni-goettingen.de
Prof. Dr. Franziska Meier (University of Göttingen) Franziska.Meier[at]phil.uni-goettingen.de
PD Dr. Richard Hölzl (University of Göttingen) Richard.hoelz[at]phil.uni-goettingen.de
Dr. Carna Brkovic (University of Göttingen) carna.brkovic[at]uni-goettingen.de

Contact:
Prof. Dr. Silke Schicktanz (Department of Medical Ethics and History of Medicine, Göttingen)
Victoria Morick, M.Ed. (Department of Medical Ethics and History of Medicine, Göttingen) victoria.morick[at]med.uni-goettingen.de
Funding: University of Göttingen
Duration: 2021 – 2023

The Covid-19 pandemic is not the first (and might not be the last) instance of infectious disease triggering social panic. Pandemics are public health crisis because they threaten not only individuals or communities, but the way communities organize themselves into publics. For a better understanding of the current crisis, we propose focusing on how people narrate the experience of infection in terms of injustice.

The term injustice is not meant to invoke a particular conception of justice in legal studies, moral philosophy, or existing law. People do not need legal training to feel they are being treated unfairly. However, the sense of being treated unfairly does imply certain feelings about equity, fairness, social recognition, in short the public sphere. We are interested in how people channel these feelings into narratives: what is understood to be unjust? who is the narrator? How is injustice articulated? How is it communicated and where?

To study narrative components of injustice, our interdisciplinary research group will combine approaches from literary and cultural studies, history and bioethics. We outline six topics to examine narrative responses to pandemics (ranging from Benjamin Franklin’s position on vaccines, to role of pandemics in Camus’ literary work, the formation of international health organizations, to current anti-vaccination protests and Southeastern European refugee camps). These case studies illustrate how different actors, at different places and times, connect infection and injustice. By focusing on the narrative aspects of injustice we seek to develop a typology that will allow us to compare responses and collaborate over disciplinary boundaries.

Workshop I: “Infection and Injustice. Narrative Responses to Pandemics – Interdisciplinary Perspectives (November 5-7, 2021, Fulda)