Children, acceptable health risks and COVID-19: Ethical guidance for a fair policy response

To respond to the pandemic the NHS deployed strategies (e.g. usual service restriction, changes in care delivery, redeployment of staff and clinic space) which had an immediate effect on children's usual care. To date, the direct impact of Covid-19 infection on children's physical health has been recorded as being far milder than for other groups. By contrast the indirect impact on children has been profound, with substantial reductions in urgent activity in hospitals (von Dadelszen, Khalil, Wolfe et al. 2020 BMJ). There are no known studies which assess the extent to which health service restrictions and changes in care delivery are fair for children. This project, undertaken in collaboration with NHS child healthcare specialists, aims to address the omission of a children-related ethical dimension in Covid-19 related research and policy. It will achieve this by exploring which risks on children's physical and mental health can be morally justified in health systems' response to the pandemic. This project will provide accessible ethical guidance to medical authorities and government departments on how the needs of children with long-term conditions should feature in the prioritisation process required in the pandemic context. This guidance will be assessed, in context, in conjunction with a range of decision-makers who are responsible for making decisions about the allocation to resources and by working closely with the clinical-academic Children and Young People's Health Partnership (CYPHP) in South East London.