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A new collection of commentaries, developed by Epidemic Ethics, provides insight into the practical ethical challenges associated with research undertaken during epidemics and pandemics.

Drawing on learning from the COVID-19 pandemic, Research Ethics in Epidemics and Pandemics: A Casebook, brings together expert commentaries and 44 contextually-rich real-world case studies from around the world to illustrate ethical issues encountered by researchers, ethics reviewers and regulators. It provides unique insight into the breadth of practical ethical challenges posed by the exceptional pace and breadth of pandemic health research.

As the first resource focusing on the complexity of conducting research in challenging and rapidly evolving pandemic contexts, the Casebook is relevant to academic and professional audiences with an interest in global health, research ethics, outbreaks and epidemics, including researchers, ethical and regulatory reviewers, policymakers and health systems staff.

The Casebook takes a broad approach to research ethics. It addresses a range of values, obligations and priorities that inform complex interactions between researchers, reviewers, policymakers, health providers, and research participants and publics during pandemic research. Ethical issues arising during the prioritisation, design, and adaption of research, within accelerated processes for reviewing research, reporting findings, sharing data, and translating findings into practice are explored.

Susan Bull, Associate Professor of Bioethics at Oxford Population Health’s Ethox Centre and lead editor of the Casebook, said ‘We have been honoured to bring together contributions from over 100 authors and editors from around the world for this Casebook. The Casebook provides important, novel and diverse insights into ethical challenges encountered in practice during health research in emergencies.

‘The commentaries and case studies can be drawn on to strengthen capacities to conduct ethical research in challenging research environments, including by promoting a deep understanding of relevant ethical issues, differing perspectives and competing considerations, and evaluations of their implications for practice.’

One of the case studies included in the Casebook is the Randomised Evaluation of COVID-19 Therapy (RECOVERY) trial. The case study assesses the ethical issues associated with adaptive trial designs, where elements of the trial can change and treatment arms can be added or removed if there is sufficient evidence that a treatment may or may not be of benefit to patients.

The case study considers how the trial was conducted within the NHS without disrupting care, the need for fair and inclusive approaches to the selection of research participants, the ability of patients and their families to consent to participating in the trial, how the study treatments were selected, and how the results from each of the treatment arms were reported.

The Casebook is part of the first book series dedicated to the topic of public health ethics. The series aims to fill a gap in the existing literature by providing thorough, book-length treatment of the most important topics in public health ethics.

In 2020, the World Health Organization’s Health Ethics and Governance Unit put out a call for proposals to better understand the breadth of ethical issues associated with the COVID-19 pandemic. As a global and inclusive response to this call for proposals, the Casebook aims to inform the work of the Health Ethics and Governance Unit and those working to ensure that ethics is a key component of pandemic responses and future preparedness.  

Research Ethics in Epidemics and Pandemics: A Casebook is an open access resource that can be downloaded in PDF or EPUB format, and is also available to buy in softcover or hardcover.