cCOVID-19

During the COVID-19 pandemic, the Centre of Biomedical Ethics and Culture (CBEC), SIUT contributed to discussions about the ethical challenges created by the pandemic. Its work included developing ethical guidance for healthcare decision-making in Pakistan, publishing on emerging ethical issues, organizing educational webinars, and sharing public narratives about people’s experiences during the pandemic.

The main areas of CBEC’s COVID-19 work were:

• Guidelines for ethical decision-making
• Faculty publications
• #CBEContheweb webinars
• #HumansOfCovid public narratives

Guidelines for Ethical Decision-Making

One of CBEC’s key contributions during the pandemic was the development of a guidance document for ethical decision-making in the context of Pakistan.

The guidelines were developed as COVID-19 began unfolding in Pakistan. They were then circulated among stakeholders in private and public medical institutions and members of civil society. The CBEC page states that the National Bioethics Committee of Pakistan subsequently ratified the guidelines.

The guidelines were intended to address ethical decision-making within the realities and circumstances of Pakistan during the pandemic.

Faculty Publications

CBEC faculty members also wrote about the ethical issues that emerged during COVID-19. Their work appeared in both academic publications and the lay press, covering subjects such as clinical ethics, vaccines, plasma therapy, healthcare workers, public health, and the experiences of people affected by lockdowns.

Academic Publications

The CBEC COVID-19 page lists publications including:

• Farhat Moazam and Aamir Jafarey, “Realigning Pakistan’s Bioethics Center during Covid-19,” Hastings Center Report, 2020.
• Aamir Jafarey, “Ethical dilemmas in clinical care during Covid-19 pandemic,” Journal of Pakistan Medical Association, 2020.

Publications in the Lay Press

CBEC faculty and contributors also wrote for publications including The News on Sunday, Dawn Prism, Dawn, and The Hindu.

Topics included:

• COVID-19 vaccines and antibodies
• Plasma therapy
• Ethical issues affecting healthcare workers
• The experiences of daily wage workers during the Karachi lockdown
• Ethical issues surrounding COVID-19
• Healthcare worker responsibilities and reciprocity
• Decisions about access to treatment during the pandemic

#CBEContheweb

CBEC-SIUT launched the #CBEContheweb webinar series to discuss ethical questions emerging during the COVID-19 pandemic. The series covered research ethics, pandemic response, emergency use of interventions, data privacy, public health, and vaccination.

1. The COVID-19 Research Quagmire: Perspectives from the Subcontinent

The first webinar was held on May 14, 2020.

It examined research opportunities that emerged in the contexts of Pakistan and India and explored how COVID-19 was shaping research in the subcontinent.

The speakers included:

• Dr. Mariam Hasan — Shaukat Khanum Memorial Cancer Hospital and Research Centre, Pakistan
• Dr. Saima P. Iqbal — Research Ethics Committee, National Bioethics Committee, Pakistan
• Dr. Anant Bhan — Yenepaya University, India
• Dr. Natasha Anwar — Aga Khan University, Pakistan

2. Taming of a Pandemic: Evidence, Context and Realities of LMICs

The second webinar was held on June 10, 2020.

The session examined the pandemic through the evidence, context, and realities of low- and middle-income countries (LMICs).

The speakers included:

• Prof. Keymanthri Moodley — Stellenbosch University, South Africa
• Prof. Richard Cash — Harvard University, United States
• Ms. Amber Mehmood — Johns Hopkins University, United States

3. Balancing Research with Therapy during COVID-19: MEURI and Beyond

The third webinar was held on August 5, 2020.

It examined the historical background of the MEURI framework — Monitored Emergency Use of Unregistered and Investigational Interventions — and discussed its use during the COVID-19 pandemic.

The CBEC page explains that the framework emerged after the 2014 Ebola epidemic. It allowed the use of unregistered interventions when effective treatments were unavailable for seriously ill patients, while also aiming to generate generalizable knowledge from the experience.

The speakers included:

• Prof. Andreas Reis — World Health Organization, Switzerland
• Prof. Aasim Ahmad — The Kidney Centre, Pakistan

4. Data Privacy and Public Health: All Is Fair in Love and War?

The fourth #CBEContheweb webinar was held on September 16, 2020.

The session examined ethical questions surrounding the use and sharing of private health data during public health emergencies, with particular attention to Pakistan.

The discussion considered the growing use of digital technologies for public health surveillance and concerns about awareness and understanding of what private health information could be shared during emergencies.

The speakers included:

• Dr. Joseph Ali — Johns Hopkins University, United States
• Dr. Haroon Jehangir — Punjab Health Services, Pakistan
• Ms. Nighat Dad — Digital Rights Foundation, Pakistan
• Ms. Shmyla Khan — Digital Rights Foundation, Pakistan

5. COVID-19 Vaccination: Obligation versus Choice

Another CBEC webinar examined the ethical debate surrounding mandatory COVID-19 vaccination, particularly for healthcare workers.

The session first discussed the science of the COVID-19 vaccines available at that time and then considered ethical arguments for and against mandatory vaccination.

The webinar provided an in-depth discussion of the vaccination debate as it stood during the pandemic.

#HumansOfCovid

CBEC also launched #HumansOfCovid on its Facebook page as a public outreach initiative.

The series shared different narratives about people’s lived experiences during the COVID-19 pandemic. These included experiences of:

• Working from home
• Daily wage workers affected by lockdowns
• People dealing with worries and concerns related to the pandemic

The initiative provided a way to document and share personal experiences alongside CBEC’s academic and educational work on COVID-19.

CBEC’s COVID-19 Work in Context

CBEC’s COVID-19 activities brought together several aspects of its work in bioethics: ethical guidance, academic research, public education, professional discussion, and public outreach.

Rather than focusing only on the medical aspects of the pandemic, the Centre’s activities examined ethical questions arising in healthcare, research, public health, data privacy, vaccination, and people’s lived experiences.

This page serves as a record of CBEC-SIUT’s work and educational activities during the COVID-19 pandemic.

 

CBEC and COVID-19

During the COVID-19 pandemic, faculty members from the Centre of Biomedical Ethics and Culture (CBEC), SIUT wrote about a range of ethical issues that emerged during the pandemic. Their work appeared in both academic publications and the lay press, helping bring bioethics discussions to researchers, healthcare professionals, and the wider public.

Academic Publications

CBEC faculty contributed to academic discussions on how COVID-19 affected bioethics and clinical care.

• Farhat Moazam and Aamir Jafarey — “Realigning Pakistan’s Bioethics Center during Covid-19,” Hastings Center Report, Vol. 50, No. 3, May–June 2020.
• Aamir Jafarey — “Ethical dilemmas in clinical care during Covid-19 pandemic,” Journal of Pakistan Medical Association, Vol. 70, No. 5, May 2020.

Publications in the Lay Press

CBEC faculty and colleagues also wrote for newspapers and public-facing publications. These articles addressed topics such as COVID-19 vaccination, plasma therapy, healthcare workers, lockdown experiences, and ethical challenges in clinical care.

• Aamir Jafarey and Natasha Anwar — “A Never Ending Vaccine Story,” The News on Sunday, July 12, 2020.
• Sualeha Shekhani, Natasha Anwar, and Mariam Hassan — “Plasma Therapy for Covid-19: The Hopes and the Hype,” Dawn Prism, June 25, 2020.
• Aamir Jafarey and Natasha Anwar — “What Are Covid-19 Anti-bodies? Does It Help to Test for Them? Here’s What Is Known So Far,” Dawn Prism, June 25, 2020.
• Aamir Jafarey and Nida Wahid Bashir — “From Bouquets to Brickbat: Healthcare Workers in the Time of Covid-19,” Dawn Prism, June 22, 2020.
• Ghazal Shahid and Sualeha Shekhani — “Voices of the Unheard: Living Through the Karachi Lockdown as a Daily Wager,” Dawn Prism, May 12, 2020.
• Farhat Moazam — “Ethics and COVID,” Dawn Op-ed, May 3, 2020.
• Sanjay Nagral and Aamir Jafarey — “A Task for South Asia,” The Hindu, April 29, 2020.
• Aamir Jafarey and Nida Wahid Bashir — “To Fight Covid-19, Healthcare Workers Need Responsible Citizenry, Capacity Building, and Reciprocity,” Dawn Prism, April 10, 2020.
• Sualeha Shekhani, Natasha Anwar, and Mariam Hassan — “Does Plasma Therapy Treat COVID? Is It Safe? Here’s All You Need to Know About the Approach,” Dawn Prism, April 6, 2020.
• Aamir Jafarey and Sualeha Shekhani — “With COVID-19, Healthcare Workers Are Having to Choose Who Gets a Chance to Live, and Who Will Be Left to Die,” Dawn Prism, March 25, 2020.

CBEC-SIUT COVID-19 Webinars

CBEC also organized a series of webinars during 2020 under its #CBEContheweb series. The sessions examined ethical questions raised by COVID-19, including research, public health, data privacy, emergency treatment, and vaccination.

The COVID-19 Research Quagmire: Perspectives from the Subcontinent

The first webinar in the #CBEContheweb series was held on May 14, 2020.

The session explored research opportunities that emerged in Pakistan and India during the pandemic. It also examined how COVID-19 shaped research in the subcontinent.

Speakers included:

• Dr. Mariam Hasan, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Pakistan
• Dr. Saima P. Iqbal, Research Ethics Committee of the National Bioethics Committee, Pakistan
• Dr. Anant Bhan, Yenepaya University, India
• Dr. Natasha Anwar, Aga Khan University, Pakistan

Taming of a Pandemic: Evidence, Context and Realities of LMICs

The second webinar was held on June 10, 2020.

It focused on the evidence, context, and realities of managing a pandemic in low- and middle-income countries (LMICs).

The speakers included:

• Prof. Keymanthri Moodley, Stellenbosch University, South Africa
• Prof. Richard Cash, Harvard University, United States
• Ms. Amber Mehmood, Johns Hopkins University, United States

Balancing Research with Therapy during COVID-19: MEURI and Beyond

The third webinar was held on August 5, 2020.

The session examined the MEURI framework, including its historical roots and its use during the COVID-19 pandemic.

MEURI stands for Monitored Emergency Use of Unregistered and Investigational Interventions. The framework developed after the Ebola epidemic in 2014 and allowed the use of unregistered interventions when effective treatments were not available for seriously ill patients. The session also discussed the importance of learning from such use and generating knowledge that could be applied more broadly.

The speakers included:

• Prof. Andreas Reis, World Health Organization, Switzerland
• Prof. Aasim Ahmad, The Kidney Centre, Pakistan

Data Privacy and Public Health — All Is Fair in Love and War?

The fourth webinar in the #CBEContheweb series was held on September 16, 2020.

The session examined ethical questions surrounding the use of private health data during public health emergencies. It also considered concerns about public health surveillance, particularly in the context of Pakistan.

The discussion highlighted the growing use of digital technologies for public health surveillance and questions about how private health information may be collected and shared during health emergencies.

The speakers included:

• Dr. Joseph Ali, Johns Hopkins University, United States
• Dr. Haroon Jehangir, Punjab Health Services, Pakistan
• Ms. Nighat Dad, Digital Rights Foundation, Pakistan
• Ms. Shmyla Khan, Digital Rights Foundation, Pakistan

COVID-19 Vaccination: Obligation versus Choice

Another CBEC webinar examined the ethical debate surrounding mandatory COVID-19 vaccination, particularly for healthcare workers.

The panel discussed the science of the COVID-19 vaccines available at the time and then considered ethical arguments surrounding mandatory vaccination. The session focused on the tension between vaccination as an obligation and vaccination as a personal choice.

The webinar provided participants with an opportunity to examine different ethical arguments involved in the debate.

Key Areas Covered by CBEC During COVID-19

Taken together, these publications and webinars show the range of ethical questions CBEC addressed during the COVID-19 pandemic. These included:

• Ethics in clinical care
• COVID-19 research
• Research ethics
• Emergency use of unregistered interventions
• Plasma therapy
• Vaccine policy and choice
• Healthcare workers’ responsibilities and rights
• Public health surveillance
• Health data privacy
• The experiences of vulnerable communities during lockdowns

The material provides a record of how bioethics questions were discussed in Pakistan and the wider South Asian context during the COVID-19 pandemic.