A (care) ethical analysis of COVID-19 policymaking

The measures that the Dutch government took in the first half of 2020 to curb the COVID-19 pandemic successfully slowed down the rate of contaminations and hospitalisations. However, the social and economic costs were high. From an ethical perspective, it is problematic that the far-reaching governmental decisions during those months often lacked a sound ethical argument, or were only accompanied with one-sided utilitarian justifications. This is also troublesome, since the measures especially impacted groups that already found themselves at the margins of public and political attention before the crisis started. Their voices and experiences were not, or barely, included in processes of decision making. At the same time, in the context of stories about exhausted hospital workers and the devastating impact of lockdown measures on vulnerable groups, there was a growing public awareness that care and being cared for are crucial for human flourishing and sustaining a just society. The importance of care and voice, especially for people in the margins, has long been emphasised by care ethicists like Tronto, Sevenhuysen, and Robinson. Therefore, their work seems to be a helpful lens to look back at, and evaluate, the COVID-19 crisis response in order to learn lessons for the future. This project aims to do exactly that, by analysing the drastic policy decisions of the first months from a care ethical perspective, as well as by mapping their impact on vulnerable groups through empirical research. Combined with the reflections of policy makers, these are the building blocks for a new framework for policy making that is ethically coherent and that contributes to a caring democracy, which is resilient enough to respond to future crises in a more inclusive way. This research project consists of four elements. The first is an analysis of the Dutch governmental COVID-19 policies and how these were translated into protocols and measures in the care sector. The focus will be especially on the underlying ethical assumptions and arguments. The second element is a qualitative study that consists of semi-structured interviews and focus groups with people in a vulnerable position, their relatives, professional care workers, and managers. To cover a wide range of care arrangements, four groups will be included: People receiving palliative care, people with mental illness receiving residential care, the elderly living at home who are dependent on informal care, and refugees who have no stable residency. On the one hand, the aim of the empirical research is to understand how the crisis measures impacted the already vulnerable position, the experienced quality of life, and possibilities for hearing the voices of the different groups. On the other hand, the study seeks to explore what creative solutions people found to cope with the impact of the pandemic and the emergency policies. The third element of this project is the drafting of a policy framework based on a care ethical reflection that combines the findings of the policy analysis and the empirical research. This framework will be developed together with policy makers and discussed during round tables with Dutch and international (care) ethicists, as well as policy makers from several sectors, especially education and culture. After these consultations, the framework will be finalised. The fourth element is dissemination: the framework will be presented during a conference with relevant national policymakers. Smaller events will be organised with and for the four vulnerable groups that are at the centre of this project. Through online and offline publications of the policy framework, academic papers, and the network resulting from this project, the dissemination of the lessons learned will be ensured.