John Beverley

View Original

Fair Allocation of Philosophers in the Age of COVID-19

We philosophers are often trained to identify, refine, and illuminate difficult issues with a range of techniques. I would like to direct attention towards opportunities where philosophical skills might contribute to healthcare efforts during the present pandemic.

The first involves contributing to important ethics discussions held not in philosophy journals, but in journals like The Lancet and the New England Journal of Medicine. For example, on March 23rd the latter published an article advocating guidelines for allocating scarce resources, prioritizing predicted quality of life and mortality of patients in allocating resources for patients infected with SARS-CoV-2. The article has already been cited 230 times in peer-reviewed journals such as The Lancet, Nature, has been viewed nearly half a million times, and ranks in the 99th percentile of articles mentioned in social media across all medical articles. Notably, this journal has also published four “Letters to the Editor” each objecting to the advocated guidelines. One letter worried such guidelines would sharply disadvantage members of marginalized communities. Authors of the original article responded to each, in this case suggesting discrimination could be avoided by “guidelines and triage committees to preclude the arbitrariness and bias endemic to improvised, bedside rationing.” As of today, that is the end of this discussion in this widely-read, highly influential, medical journal. There was no follow-up discussion of, say, how guidelines not designed to preclude discrimination have a tendency to lead to discriminatory practices when implemented. I suspect readers of this blog already recognized this as an issue worth discussing. Many of us spend our time reflecting on, teaching about, and arguing over such ethical issues. The authors of the above article and associated letters, however, specialize elsewhere. The first opportunity I see then is just this: Direct our philosophical training towards widely-read medical journals via letters to the editor, commentaries, or even articles, in the interest of helping medical researchers think through touch ethical issues.

The second involves contributing to research at the intersection of philosophy, computer science, and medicine focused on making existing medical data more accessible to researchers who need it. Data collected, say, in hospitals is often annotated in ways that make it only locally accessible. Researchers in the growing field of Applied Ontology have been developing ontologies, functioning as dictionaries which allow translations among such datasets. Because medical research generates so much data, these ontologies must be computer-readable; because researchers in the same domain working at different institutions may carve up their domain differently, ontologists are needed to ensure the coherence of translations. And these needs are why philosophers have been a staple in the creation and development of the most widely-used ontologies. To be computer-readable, ontologies are built on a decidable fragment of first-order logic; to ensure coherence, ontologists work with domain experts, e.g. immunologists, virologists, etc., using conceptual analysis. This is expertise in the toolkit of most philosophers, and can be used to contribute to the current development of ontologies being designed to unify data concerning the Covid-19 pandemic, e.g. Virus Infectious Disease Ontology (VIDO), the Coronavirus Infectious Disease Ontology (CIDO). Even under development, these ontologies have already been used to facilitate re-purposing of drugs likely useful in treating Covid-19. Philosophers have been working alongside immunologists, microbiologists, and other relevant researchers in development of these ontologies, and given the state of development, there is plenty of space for those interested in helping researchers explore datasets as they work to address the pandemic. In short, the second opportunity I see is this: Direct philosophers trained as described above towards developing coherent, consistent, structure vocabularies for medical research. For more information about the details of this opportunity, feel free to contact me directly, or explore the National Center for Ontological Research.

In the midst of the present crisis, it may not be clear how our expertise can be useful. I hope the above opportunities illustrates how useful we can be, and I encourage readers to seek out and share other opportunities where our specific skillsets might be useful during these dire times.