Shalansky Rebecca, Upshur Ross
Dalla Lana School of Public Health, The University of Toronto, 155 College St, Toronto, ON, M5T 3M7, Canada.
Philos Ethics Humanit Med. 2025 Mar 12;20(1):4. doi: 10.1186/s13010-025-00166-2.
The coronavirus disease 2019 (COVID-19) pandemic has left a devastating global toll. As such, there is a strong impetus to prevent future global pandemics. Ethical considerations are an integral element of pandemic preparedness and response plans and should be incorporated into any pandemic prevention plan to explicitly examine the incorporated values from various stakeholders. Our study aims to determine the ethical considerations of primordial pandemic prevention from a One Health perspective.
This was a prospective Delphi consensus seeking-study. We aimed to recruit a purposive, globally representative sample of experts in the fields of public health ethics, One Health ethics, pandemic ethics and pandemic prevention. Two rounds were completed between November 2021, and January 2022. The first round consisted of open-ended questions to establish ethical considerations for primordial pandemic prevention. Thematic analysis was used to uncover themes. The second-round presented the ethical consideration results of the first round, and asked participants to rate the importance of each of them.
The first-round had 27 participants, and the second-round had 25 participants. Both rounds had global representation from all intended fields of expertise. There were five ethical considerations for which consensus was achieved: Promoting equity, global collective effort, distributive justice, evidence-based efficiency and the interconnectedness of humans, animals and the environment.
Our study identified five ethical considerations for primordial pandemic prevention from a globally representative sample. The findings will contribute to current and future pandemic prevention policy, and expand ethics research in the fields of One Health, pandemic prevention and zoonotic disease control.
2019年冠状病毒病（COVID-19）大流行给全球带来了毁灭性损失。因此，有强大的动力来预防未来的全球大流行。伦理考量是大流行防范和应对计划的一个组成部分，应纳入任何大流行预防计划，以明确审视来自不同利益相关者的内在价值观。我们的研究旨在从“同一健康”视角确定原始大流行预防的伦理考量。
这是一项前瞻性德尔菲共识研究。我们旨在招募公共卫生伦理、“同一健康”伦理、大流行伦理和大流行预防领域有目的的、具有全球代表性的专家样本。在2021年11月至2022年1月期间完成了两轮调查。第一轮包括开放式问题，以确定原始大流行预防的伦理考量。采用主题分析来揭示主题。第二轮展示了第一轮的伦理考量结果，并要求参与者对每个结果的重要性进行评分。
第一轮有27名参与者，第二轮有25名参与者。两轮调查都有来自所有预期专业领域的全球代表性样本。达成共识的伦理考量有五项：促进公平、全球集体努力、分配正义、基于证据的效率以及人类、动物和环境的相互联系。
我们的研究从具有全球代表性的样本中确定了原始大流行预防的五项伦理考量。这些发现将有助于当前和未来的大流行预防政策，并扩展“同一健康”、大流行预防和人畜共患病控制领域的伦理研究。
