Abstract
This critical essay evaluates the potential integration of distinct kinds of expertise in policymaking, especially during situations of critical emergencies, such as the COVID-19 pandemic. This article relies on two case studies: (i) herd immunity (UK) and (ii) restricted access to ventilators for disabled people (USA). These case studies are discussed as examples of experts’ recommendations that have not been widely accepted, though they were made within the boundaries of expert epistemic authority. While the fundamental contribution of biomedical experts in devising public health policies during the COVID-19 pandemic is fully recognized, this paper intends to discuss potential issues and limitations that may arise when adopting a strict expert-based approach. By drawing attention to the interests of minorities (disenfranchized and underrepresented groups), the paper also claims a broader notion of “relevant expertise.” This critical essay thus calls for the necessity of wider inclusiveness and representativeness in the process underlying public health policymaking.
Highlights
When severe emergency health situations arise, biomedical and public health experts are consulted and their recommendations are closely followed
We examine the role that experts played in guiding public health debates during the COVID-19 pandemic
We believe that in times of emergency, we should be drawing on every type of potentially relevant expertise across the humanities, social and natural sciences, and on insights from the wider society as well
Summary
When severe emergency health situations arise, biomedical and public health experts are consulted and their recommendations are closely followed. Vaccine roll-out is dramatically uneven (Farina and Lavazza 2021a); the emergence of new variants is likely to modify any predictions about herd immunity; immunity may not last forever; and, no less important, vaccination may induce an unjustified sense of safety and lead people to adopt more relaxed behaviours, abandoning those preventive measures that should still be maintained until the virus has been completely eradicated (Aschwanden 2021) Another example of disagreement among biomedical experts concerns the adoption of criteria for accessing life-saving ventilators in some U.S states, when the available devices became fewer than the patients needing them. White and Lo (2020, E1) argued that those criteria of exclusion (namely, severe cognitive impairments) “are not explicitly justified and they are ethically flawed” because they “are selectively applied to only some types of patients.” In addition, “such exclusions violate a fundamental principle of public health ethics: use the means that are the least restrictive to individual liberty to accomplish the public health goal.”
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