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Current controversy
Hydroxychloroquine and COVID-19: critiquing the impact of disease public profile on policy and clinical decision-making
  1. Yves S J Aquino1,
  2. Nicolo Cabrera2
  1. 1 Department of Philosophy, Macquarie University, Sydney, New South Wales, Australia
  2. 2 Division of Infectious Diseases, Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, Texas, USA
  1. Correspondence to Dr Yves S J Aquino, Philosophy, Macquarie University, Sydney, NSW 2109, Australia; ysjames{at}gmail.com

Abstract

The controversy surrounding the use of hydroxychloroquine (HCQ), an antimalarial drug, for COVID-19 has raised numerous ethical and policy problems. Since the suggestion that HCQ has potential for COVID-19, there have been varying responses from clinicians and healthcare institutions, ranging from adoption of protocols using HCQ for routine care to the conduct of randomised controlled trials to an effective system-wide prohibition on its use for COVID-19. In this article, we argue that the concept of ‘disease public profile’ has become a prominent, if not the sole, determinant in decision-making across various healthcare responses to the pandemic. In the case of COVID-19, the disease’s public profile is based on clinical and non-clinical factors that include contagiousness, clinical presentation and media coverage. In particular, we briefly examine the dangers of a heightened public profile in magnifying the inequality of diseases and undermining three key ethical concepts, namely (1) evidence-based practice, (2) sustainable allocation and (3) meaningful consent.

  • history of health ethics/bioethics
  • distributive justice
  • informed consent
  • public health ethics
  • clinical ethics

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/medethics-2020-106306

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    Footnotes

    • Contributors Both authors have substantial contributions to the conception of the manuscript, drafted and revised the manuscript, approved the version to be published and agreed to be accountable for all aspects of the work ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. YSJA designed the structure and identified the key claims during the development stage; responsible for the ethical discussion raising specific ethical concepts in the manuscript. NC is responsible for the technical details of the drugs and the diseases discussed.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement There are no data in this work.

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