Background: The emergency context of the Covid-19 pandemic necessitated the use of national and international public health measures of unprecedented scale to minimize mortality and morbidity, often in conflict with other principles and rights, such as the autonomy of individuals. Concerns have been voiced that for populations facing precarity, such as migrants, a disproportionate and unfair application of restrictive measures, deficient application of protective measures, and even enforcement of restrictive migration policies under the pretext of the pandemic has occurred.
Methods: Various principles have been proposed as moral foundations of public health interventions. The author used two public health ethics frameworks to examine the ethical acceptability of movement restrictions on asylum seekers residing in refugee camps in Greece from March 2020 to October 2020.
Results: Most of the principles described in the frameworks for the ethical application of movement restrictions were not adhered to. Main concerns include that, measures were prolonged despite lack of evidence about their effectiveness to reduce morbidity and mortality, while posing severe and disproportionate burdens for this population.
Conclusions: An ethically acceptable public health response to Covid-19 is incompatible with certain living conditions of refugees, asylum seekers, and migrants. The question of whether and if so the extent to which the discipline of public health inherently has the role of rectifying existing injustices and social inequalities when these can be convincingly related to health outcomes, is central to the design of public health interventions for these populations. The answer can exemplify the need to address moral and political determinants of health. It is essential for public health professionals to be aware of the moral theorizations that underpin their work, so as to ensure that their policies are aligned with those and to contribute to the debate that shapes these determinants.
Keywords: Public health; ethics; infectious diseases; migration; movement restrictions.
In recent years, thousands of individuals have sought asylum in Greece. They are initially geographically restricted and accommodated in reception centers. These centers, or camps, have attracted international criticism due to undignified and harmful living conditions. In 2020, in the beginning of the CoViD-19 pandemic, the Greek government, imposed strict movement restrictions for camp residents in the name of public health. In this study, the author attempts to examine if the public health measures imposed on asylum seekers residing in reception centers in Greece in 2020 were ethically sound, drawing information from scientific articles, legislative acts and reports from a range of institutions. Public health measures imposed during the pandemic have challenged individual liberties with the aim to protect human lives. However, for vulnerable populations, such as asylum seekers, it is uncertain if certain measures did more good than harm and if they were used to their best interest. Public health interventions are based on trust and should adhere to ethical principles. Analysis of available evidence using ethics tools seems to be unable to justify the implemented CoViD-19 response policy for asylum seekers in reception centers. Further research, as well as political will, are needed to determine if and how ethical public health policies for migrants are feasible on a national and international level.
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