Faculty Scholars Tackle Ethical Issues in COVID-19 Pandemic

The unprecedented public health crisis caused by the COVID-19 pandemic raises many complex ethical issues – from putting in place public health restrictions on individual liberty, to allocating protective equipment and critical care beds when the need far exceeds supply, to carrying out timely clinical trials during a pandemic to identify effective treatments and vaccines.  

Many Greenwall Faculty Scholars and Alumni/ae are on the front lines caring for those affected by the novel coronavirus and working to develop policies to provide practical recommendations on ethical issues. Here we provide links to their work related to the pandemic, which we will continue to update. 

• Holly Fernandez Lynch, Emily A. Largent, and Andrew Peterson, Alzheimer’s patients are desperate for treatment. But the FDA can’t throw out its standards., USA Today, July 28, 2021.
  
• Govind Persad and Holly Fernandez Lynch, Millions of vaccines are about to expire. The U.S. might just let them go to waste., The Washington Post, July 27 2021.
• Michelle M. Mello, My husband had a stroke after his COVID vaccine. We gave our kid his shot anyway, San Francisco Chronicle, July 6, 2021. 
• Govind Persad, and Ezekiel J. Emanuel, Ethical Considerations of Offering Benefits to COVID-19 Vaccine Recipients, JAMA, July 1, 2021.
  
• Nicholas G. Evans et al., Covid-19, Equity, and Inclusiveness, June 29, 2021. 
• I. Glenn Cohen (interviewed by Nora Young), Post-Pandemic Travel and Tourism, CBC Radio, June 18, 2021.
• Clayton Jones and Andrew Peterson, COVID-19 Proved That Americans With Disabilities Need Biden’s Infrastructure Plan. Lawmakers Must Not Negotiate it Away., The American Journal of Bioethics Blog, June 16, 2021.
• Emily A. Largent, Govind Persad, Michelle M. Mello, Danielle M. Wenner, Daniel B. Kramer, Brownsyne Tucker Edmonds, and Monica Peek, Incorporating Health Equity Into COVID-19 Reopening Plans: Policy Experimentation in California, American Journal of Public Health, June 10, 2021.
• Julia S. C. Chelen, Douglas B. White, et al.,US Ventilator Allocation and Patient Triage Policies in Anticipation of the COVID-19 Surge, Health Security, June 9, 2021.
• Erin S. DeMartino and Jon Tilburt, Pandemic Allocation, Cultural Difference, and Imperfect Methods Separating the “Is” From the “Ought,” Chest Journal, June 1, 2021.
• Ezekiel J. Emanuel and Govind Persad, This Is the Wrong Way to Distribute Badly Needed Vaccines, The New York Times, May 24, 2021.
• Holly Fernandez Lynch and Emily Largent, Is it OK to offer a shot at lottery money to get people vaccinated? As bioethicists we say yes., The Philadelphia Inquirer, May 24, 2021.
  
• Steven Joffe et al., Data and Safety Monitoring of COVID-19 Vaccine Clinical Trials, The Journal of Infectious Diseases, May 19, 2021. 
  
• Elana F. Jaffe, Anne Drapkin Lyerly, and Ilona T. Goldfarb, Advancing research in pregnancy during COVID-19: Missed opportunities and momentum in the US, Cell Press, May 14, 2021.
  
• Holly Fernandez Lynch and Govind Persad, Yes, it’s legal for businesses and schools to require you to get a coronavirus vaccine, The Washington Post, May 4, 2021.
  
• Nicholas G. Evans and Mark Eccleston-Turner, COVID-19 Vaccine Nationalism Will Cost Lives Worldwide, Slate, May 3, 2021.
• Douglas B. White et al. (including Govind Persad), Developing and Implementing a Weighted Lottery to Equitably Allocate Scarce COVID-19 Medications, American Journal of Respiratory and Critical Care Medicine, May 2021.         
  
• Reed F Beall, Aaron S Kesselheim, and Aidan Hollis, Pre-market development times for innovative vaccines – to what extent are the COVID-19 vaccines outliers?, Clinical Infectious Diseases, April 29, 2021.       
  
• Govind Persad and William F. Parker, Opinion: Extending the Johnson & Johnson vaccine pause for a week was a deadly mistake, The Washington Post, April 17, 2021. 
• Govind Persad, Prioritizing the Prevention of Early Deaths during COVID‐19, The Hastings Center Report, April 11, 2021.
• Govind Persad et al. (including Emily A. Largent), Public Perspectives on COVID-19 Vaccine Prioritization, JAMA Open Network, April 9, 2021.
• Govind Persad, William F. Parker, and Ezekiel J. Emanuel, Taming the 4th COVID surge: Delay second shots and get first vaccine doses into arms ASAP., USA Today, April 8, 2021.
• Dorit R. Reiss, I. Glenn Cohen, and Carmel Shachar, ‘Authorization’ status is a red herring when it comes to mandating Covid-19 vaccination, Stat News, April 5, 2021.
• William F. Parker, Govind Persad, and Monica Peek, Fair allocation at COVID-19 mass vaccination sites, JAMA Health Forum, April 2, 2021.
  
• Govind Persad (interviewed by Christiane Wisehart), Vaccine equity with Govind Persad, Examining Ethics Podcast, March 31, 2021. 
• Ezekiel J. Emanuel and Govind Persad, US should share vaccines it’s not using with the rest of the world, Boston Globe, March 30, 2021.
• Shannon Elizabeth Fyfe and Andrew Peterson, Opinion: End the coronavirus lockdown in the D.C. Jail, The Washington Post, March 29, 2021.
• Govind Persad and Steven Joffe, Allocating scarce life-saving resources: the proper role of age., Journal of Medical Ethics, March 22, 2021.
• Govind Persad, Emily A. Largent, and Ezekiel J. Emanuel, Opinion: Age-based vaccine distribution is not only unethical. It’s also bad health policy., Washington Post, March 9, 2021.
• Daniel B. Kramer, Douglas J. Opel, Efthimios Parasidis, and Michelle Mello, Choices in a crisis—Individual preferences among SARS-CoV-2 vaccines, New England Journal of Medicine, March 3, 2021.
• B.E. Berkman, A. C. Mastroianni, et al., The ethics of repurposing previously collected research biospecimens in an infections disease pandemic, Ethics & Human Research, Feb 22, 2021.
• Andrew Peterson, Jason Karlawish, and Emily Largent, A monument to our monumental suffering can help America heal from this pandemic, Stat News, Feb 14, 2021.
• William Parker, Govind Persad, and Monica Peek, Four recommendations to efficiently and equitably accelerate the COVID-19 vaccine rollout, Health Affairs Blog, Feb 10, 2021.
• Douglas J Opel, Bernard Lo, and Monica Peek, Addressing mistrust about COVID-19 vaccines among patients of color, Annals of Internal Medicine, Feb 9, 2021.
• Philip Pizzo, David Spiegel, and Michelle Mello, When physicians engage in practices that threaten the nation’s health, JAMA, Feb 4, 2021.
• Daniel Salmon, Douglas J Opel, et al., Reflections on governance, communication, and equity: challenges and opportunities in COVID-19 vaccination, Health Affairs, Feb 4, 2021.
• Holly Fernandez Lynch et al. (including Emily A. Largent), Promoting ethical payment in human pandemic challenge studies, AJOB, Feb 4, 2021.
• Mariana Socal, Joshua Sharfstein, and Jeremy Greene, The pandemic and the supply chain: gaps in pharmaceutical production and distribution, AJPH, Jan 28, 2021.
• Monica E. Peek, COVID equity and vaccinations, Society of General Internal Medicine Forum, Jan 25, 2021.
• Elana Jaffe, Ilona Telefus Goldfarb, and Anne Drapkin Lyerly, The costs of contradictory messages about live vaccines in pregnancy, AJPH, Jan 21, 2021.
• Emily Largent and Franklin Miller, Problems with paying people to be vaccinated against COVID-19, JAMA, Jan 6, 2021.
• Jennifer Prah Ruger (interviewed by Marie Bellevue), UC Berkeley alumna discusses COVID-19 impact on health equity, The Daily Californian, Dec 29, 2020.
• Monica Peek, Russell Simons, William Parker, David Ansell, Selwyn Rogers, and Brownsyne Tucker Edmonds, COVID-19 among African Americans: An action plan for mitigating disparities, AJPH, Dec 22, 2020.
• Holly Fernandez Lynch, Vaccination priority? Government officials should wait their turn, Newsweek, Dec 18, 2020.
• Emily Largent and Govind Persad, US public attitudes toward COVID-19 vaccination, JAMA Network Open, Dec 18, 2020.
• Emily Largent, Scott Halpern and Holly Fernandez Lynch, Waivers and alterations of research informed consent during the COVID-19 pandemic, Annals of Internal Medicine, Dec 15, 2020.
• Holly Fernandez Lynch (interviewed by Katherine Unger Baillie-Penn), 5 Things to know about the FDA’s COVID-19 vaccine authorization, Futurity, Dec 14, 2020.
• Andrew Peterson, Charles Weijer and Emily A. Largent, COVID-19 vaccines are worthless if people aren’t vaccinated, The Hill, Dec 12, 2020.
• Douglas B. White and Bernard Lo, Mitigating inequities and saving lives with ICU triage during the COVID-19 pandemic, American Journal of Respiratory and Critical Care Medicine, Dec 2, 2020.
• Aaron Kesselheim et al, An overview of vaccine development, approval, and regulation, with implications for COVID-19, Health Affairs, Nov 19, 2020.
• Andrew Peterson and Wesley Buckwalter, Rising Covid cases means Americans may face health care rationing. Here’s how they view that, Think NBC, Nov 9, 2020.
  
• Govind Persad (interviewed by Maiken Scott), The quest for a coronavirus vaccine, The Pulse Podcast, Nov 6, 2020.
• Wesley Buckwalter and Andrew Peterson, Public attitudes toward allocating scarce resources in the COVID-19 pandemic, PLOS One, Nov 4, 2020.
  
• Jeffrey Kahn et al. (including Anna C. Mastroianni), Opinion: For now, it’s unethical to use human challenge studies for SARS-CoV-2 vaccine development, PNAS, Oct 29, 2020.
• Jeremy Goldhaber-Fiebert, David Studdert, and Michelle Mello, School reopenings and the community during the COVID-10 pandemic, JAMA Health Forum, Oct 28, 2020.
• Jennifer Prah Ruger, Social justice as a foundation for democracy and health, BMJ, Oct 23, 2020.
• Yasmin Rafiei and Michelle Mello, The missing piece — SARS-CoV-2 testing and school reopening, NEJM, Oct 21, 2020.
• Holly Fernandez Lynch (interviewed by Jenn White), The FDA’s Role in a COVID-19 Vaccine, 1A Podcast, Oct 21, 2020.
• Govind Persad (interviewed by Lorne Fultonberg, Alyssa Hurst, and Nicole Militello), COVID-19 Vaccine: The Race for Relief, RadioED Podcast, Oct 13, 2020.
• Holly Fernandez Lynch (interviewed by James D. Walsh), A Bioethicist on Trump’s COVID-19 Treatment Plan, Intelligencer, Oct 6, 2020.
• Liam Bendicksen, Joshua M. Sharfstein, and Aaron S. Kesselheim, Increase transparency at the FDA: we need sunlight to fight the pandemic, Stat News, Sept 29, 2020. 
• Jennifer Prah Ruger, A healthy constitution, The Royal Society of Arts, Sept 25, 2020.
• Jerry Avorn and Aaron S. Kesselheim, Up is down — pharmaceutical industry caution vs. federal acceleration of COVID-19 vaccine approval, NEJM, Sept 15, 2020.
• Douglas J. Opel, Douglas S. Diekema, and Lainie Friedman Ross, Should we mandate a COVID-19 vaccine for children?, JAMA Pediatrics, Sept 14, 2020. 
• Efthimios Parasidis, Big pharma’s safety pledge isn’t enough to build public confidence in COVID-19 vaccine – here’s what will, The Conversation, Sept 14, 2020.    
• Govind Persad, Monica E. Peek, and Ezekiel J. Emanuel, Fairly Prioritizing Groups for Access to COVID-19 Vaccines, JAMA, Sept 10, 2020.
• Ezekiel J. Emanuel, Govind Persad, et al., An ethical framework for global vaccine allocation, Science, Sept 3, 2020. 
• Jamie Webb, Lesha Sha, and Holly Fernandez Lynch, No easy answers in allocating unapproved COVID-19 drugs outside clinical trials, AJOB, Aug 25, 2020.
• Steven Joffe, It’s time to start testing potential COVID-19 vaccines on children, Washington Post, Aug 25, 2020.
• Emily Largent, Sabrina Assoumou, and Paul Offit, Global Hangout: Ask the experts: voting & vaccines, NBC News, Aug 21, 2020.
• Jennifer Prah Ruger, The future of global health governance, Penn On the World After Covid-19, Aug 20, 2020.
• Michelle Mello (interviewed by Tanzina Vega), Public health officials are increasingly facing threats, The Takeaway Podcast, Aug 11, 2020. 
  
• Courtney B. Sherman et al. (including Peter P. Reese), In-person outreach and telemedicine in liver and intestinal transplant: a survey of national practices, impact of COVID-19 and areas of opportunity, Liver Transplantation, Aug 9, 2020. 
• Michelle M. Mello, Jeremy A. Greene, and Joshua M. Sharfstein, Attacks on public health officials during COVID-19, JAMA, Aug 5, 2020.
• Patricia Zettler, Micah Berman, and Efthimios Parasidis, Drug and vaccine development and access in Assessing Legal Responses to Covid-19, Public Health Law Watch, Aug 2020.
• Barbara J. Evans and Ellen Wright Clayton, Deadly delay: the FDA’s role in America’s COVID-19 testing debacle, The Yale Law Journal Forum, July 29, 2020.
• Govind C. Persad, A conceptual framework for clearer ethical discussions about Covid-19 Response, The American Journal of Bioethics, July 27, 2020.
• Cynda H. Rushton et al. (including Jeremy Greene), Dramatic interventions in the tragedy of the COVID-19 pandemic, The Lancet, July 23, 2020.
• Catherine L. Auriemma, Scott D. Halpern, and Jeremy M. Asch, Completion of advance directives and documented care preferences during the Coronavirus disease 2019 (COVID-19) pandemic, JAMA Network Open, July 20, 2020.
• Jason Karlawish, David C. Grabowski, and Allison K. Hoffman, For residents’ good, nursing homes should consider re-allowing visitors, The Washington Post, July 13, 2020.
• Andrew Peterson, How to decide who gets the COVID-19 vaccine first, CNN, July 10, 2020.
• Holly Fernandez Lynch, Neal W. Dickert, Patricia J. Zettler, Steven Joffe, and Emily A. Largent, Regulatory Flexibility for COVID-19 Research, Journal of Law and Biosciences,  July 7, 2020.
• Jennifer Prah Ruger, The injustice of COVID-19: we need a moral constitution for our planet’s health, The Lancet, July, 2020.
• Ryan M. Antiel et al. (including Farr A. Curlin, Govind Persad, and Douglas B. White), Should pediatric patients be prioritized when rationing life-saving treatments during the COVID-19 pandemic?, Pediatrics, July 1, 2020.
• Nicholas G. Evans, Human infection challenge studies: a test for the social value criterion of research ethics, mSphere, July, 2020.
• Michelle M. Mello, Ross D. Silverman, and Saad B. Omer, Ensuring uptake of vaccines against SARS-CoV-2, NEJM, June 26, 2020.
• Douglas B. White and Derek C. Angus, A proposed lottery system to allocate scarce COVID-19 medications, JAMA, June 24, 2020.
• Ameet Sarpatwari, Anna Kaltenboeck, and Aaron Kesselheim, Missed opportunities on emergency remdesivir use, JAMA, June 24, 2020.
• Lance Gable, Natalie Ram, and Jeffrey L Ram, Legal and ethical implications of wastewater monitoring of SARS-CoV-2 for COVID-19 surveillance, Journal of Law and the Biosciences, June 24, 2020.
• Micah Berman, Patricia Zettler, and Efthimios Parasidis, Law and Ethics During a Public Health Crisis, Ohio Journal of Public Health, June 16, 2020.
• Steven Woloshin, Neeraj Patel, and Aaron S. Kesselheim, False negative tests for SARS-CoV-2 Infection — challenges and implications, NEJM, June 5, 2020.
• Monica Peek and Alicia Fernandez (interviewed by Eric Widera and Alex Smith), Outsized impact of COVID-19 on minority communities, GeriPal Podcast, June 3, 2020.
• Mark A. Hall, Michelle M. Mello, and David M. Studdert, The legal authority for states’ stay-at-home orders, NEJM, June 3, 2020.
• Steven Joffe and Holly Fernandez Lynch, The FDA should not rush a covid-19 vaccine, Washington Post, June 2, 2020.
• Jennifer Prah Ruger, Positive public health ethics: Toward flourishing and resilient communities and individuals, AJOB, June 2, 2020.
• Emily A. Largent and Holly Fernandez Lynch, Paying participants in COVID-19 trials, The Journal of Infectious Diseases, May 29, 2020.
• I. Glenn Cohen, Lawrence O. Gostin, and Daniel J. Weitzner, Digital smartphone tracking for COVID-19: public health and civil liberties in tension, JAMA, May 27, 2020.
• William D. Miller, Monica E. Peek, and William F. Parker, Scarce resource allocation scores threaten to exacerbate racial disparities in healthcare, CHEST, forthcoming.
• Michelle M. Mello, Govind Persad, and Douglas B. White, Respecting disability rights — toward improved crisis standards of care, NEJM, May 19, 2020.
• Catherine L. Auriemma, Ashli M. Molinero, Amy J. Houtrow, Govind Persad, Douglas B. White, and Scott D. Halpern, Eliminating categorical exclusion criteria in crisis standards of care frameworks, The American Journal of Bioethics, May 18, 2020.
• Nicholas G. Evans, The ethics of social distancing, The Philosophers’ Magazine, May 18, 2020.
• Jason Karlawish, A pandemic plan was in place. Trump abandoned it — and science — in the face of COVID-19, STAT, May 17, 2020.
• Jennifer Prah Ruger, The CDC is a national treasure. Why is it being sidelined?, CNN, May 15, 2020.
• Govind Persad and David Wasserman, Diversity and solidarity in response to Covid-19, Hastings Bioethics Forum, May 13, 2020.
• Andrew Peterson, Emily A. Largent, and Jason Karlawish, Ethics of reallocating ventilators in the COVID-19 pandemic, BMJ, May 12, 2020.
• Michello Mello and David Relman (Interviewed by Michael McFaul), COVID-19 and the importance of immunity, World Class Podcast, May 12, 2020.
• Michelle M. Mello and C. Jason Wang, Ethics and governance for digital disease surveillance, Science, May 11, 2020.
• Govind Persad and Ezekiel J. Emanuel, What are the ethics behind COVID-19 ‘immunity passports’?, Washington Post, May 10, 2020.
• Natalie Ram, Mass surveillance in the age of COVID-19, Journal of Law and the Biosciences, May 8, 2020.
• Seema K. Shah et al. (including Holly Fernandez Lynch), Ethics of controlled human infection to study COVID-19, Science, May 7, 2020.
• Scott D. Halpern and Franklin G. Miller, The urge to build more intensive care unit beds and ventilators: intuitive but errant, Annals of Internal Medicine, May 7, 2020.
  
• Daniel B. Kramer, Bernard Lo, and Neal W. Dickert, CPR in the COVID-19 era — an ethical framework, NEJM, May 6, 2020.
• Govind Persad and Ezekiel J. Emanuel, The ethics of COVID-19 immunity-based licenses (“immunity passports”), JAMA, May 6, 2020.
• Jennifer Prah Ruger, The World Health Organization can be reformed, Financial Times, May 6, 2020.
• Sara Manning Peskin, Allison K. Hoffman, and Jason Karlawish, As coronavirus shut down support systems, the struggles of dementia patients and caregivers only get worse, The Philadelphia Inquirer, April 29, 2020.
• Andrew Peterson, Adrian M. Owen, and Charles Weijer, Is it ethical to forcibly withdraw ventilators from nursing home patients for reallocation to COVID-19 patients?, Journal of Medical Ethics Blog, April 27, 2020.
  
• Govind Persad, Why disability law permits evidence-based triage in a pandemic, Yale Law Journal Forum, forthcoming.
• Michelle Mello (Interviewed by Pam Karlan and Joe Bankman), Regulating in a pandemic: COVID-19 legal issues, Stanford Legal, April 25, 2020.
• Monica Peek (interviewed by Paul Rand), How Coronavirus is exposing our racial disparities, Big Brains Podcast, April 21, 2020.
• Jason Karlawish (interviewed by Deborah Kan), Hospital delirium and dementia in the time of COVID-19, Being Patient, April 14, 2020.
• Jennifer Prah Ruger, Interview: Jennifer Prah Ruger on pandemic preparation, KSRO, April 13, 2020.
• Jennifer Prah Ruger, How prepping for pandemics can lead to big economic returns, CNN, April 11, 2020.
• Thomas H. Gallagher and Anneliese M. Schleyer, “We signed up for this!” — Student and trainee responses to the COVID-19 pandemic, NEJM, April 8, 2020.
• Gary E. Weissman et al. (including Scott D. Halpern), Locally informed simulation to predict hospital capacity needs during the COVID-19 pandemic, Annals of Internal Medicine, April 7, 2020.
• Monica Peek, Commentary: Food insecurity adds to COVID-19 vulnerability for too many, Chicago Tribune, April 6, 2020.
• Rebecca L. Haffajee and Michelle M. Mello, Thinking globally, acting locally — the U.S. response to COVID-19, NEJM, April 2, 2020.
• I. Glenn Cohen, Andrew M. Crespo, and Douglas B. White, Potential legal liability for withdrawing or withholding ventilators during COVID-19: assessing the risks and identifying needed reforms, JAMA, April 1, 2020.
• I. Glenn Cohen, Andrew M. Crespo, and Douglas B. White, Protect the doctors and nurses who are protecting us, NY Times, April 1, 2020.
• Jason Karlawish, Benefit-risk analysis, Webinar: The science of social distancing, Part 2, NAM-APHA COVID-19 Conversation Series, April 1, 2020.
• Holly Fernandez Lynch, Alison Bateman-House, and Arthur L. Caplan, ‘Panic prescribing’ untested coronavirus treatments: A danger to patients today and tomorrow, Health Affairs Blog, March 31, 2020.
• Isaac Chotiner, Imagining a justice-based health system (interviewing Jennifer Prah Ruger), The New Yorker, Mar 31, 2020.
• Douglas B. White (audio interview), Coronavirus (COVID-19) Update: fairly rationing ICU care, JAMA, March 30, 2020.
• Jason Karlawish, Hospitalized adults need their caregivers — they aren’t visitors, STAT, March 29, 2020.
• Douglas B. White and Bernard Lo, A framework for rationing ventilators and critical care beds during the COVID-19 pandemic, JAMA, March 27, 2020.
• Kristina Garcia, Health equity in a time of global crisis (interviewing Jennifer Prah Ruger), Penn Today, March 25, 2020.
  
• Leah R. Fowler, Jessica L. Roberts, and Nicolas P. Terry, COVID-19 Policy Playbook II: Improving Data Collection and Management, Public Health Law Watch, March 23, 2021.
• Douglas B. White and Scott D. Halpern, A model hospital policy for allocating scarce critical care resources, March 23, 2020.
• Ezekiel J. Emanuel, Govind Persad, et al., Fair allocation of scarce medical resources in the time of COVID-19, NEJM, Mar 23, 2020.
• Zackary D. Berger, Nicholas G. Evans, et al., COVID-19: control measures must be equitable and inclusive, BMJ, March 20, 2020.
• Douglas B. White and James Frank (interviewed by Alex Smith and Eric Widera), Rationing life saving treatments in the setting of COVID pandemics, GeriPal Podcast, March 19, 2020.
• Ezekiel J. Emanuel, James Phillips, and Govind Persad, How the coronavirus may force doctors to decide who can live and who dies, NY Times, March 12, 2020.
• Steven Joffe, Doctors working while sick is bad enough in ordinary times. During the COVID-19 outbreak it could be catastrophic, STAT, March 9, 2020.
• Joshua M. Sharfstein, Scott J. Becker, and Michelle M. Mello, Diagnostic testing for the novel coronavirus, JAMA, March 9, 2020.
• Lori Frank, Thomas W. Concannon, and Karishma Patel, Health care resource allocation decisionmaking during a pandemic, RAND Research Reports, 2020 (Panel consulted includes Jason Karlawish, Andrew H. Peterson, and Douglas B. White).

Updated: July 28, 2021