The ethical dilemmas of risky decisions.

Even in a pandemic there seem to be inherent conflicts of interest between the individual and societal consequences of remedial actions and strategies. Actions taken in the sole interests of patients, as required by the Hippocratic oath, can have broadly inconvenient economic implications for the State. ("Average" benefits for a population can impose individual inconveniences for the vulnerable.). Understandably these decisions are not normally made explicitly and transparently by governments. This leads to seemingly illogical and inhumane strategies which are not understood and hence mistrusted and often ignored by the public. Vaccination sentiments on social media are often an unwanted symptom of this dilemma. This article outlines and discusses a number of examples of such situations with a focus on ethical aspects. It concludes that each case must be considered individually as to the issues that need to be weighed in these difficult decisions; and that there are no clear and universally acceptable ethical solutions. What can be learned from the COVID-19 crisis is that short term utilitarianism has consequences that in the eyes of the population are unacceptable. This lesson seems equally valid for cost benefit evaluations regarding other risks, such as from hazardous industries, flood defenses, and air transport. Decisionmakers and politicians can learn that persuasion only goes so far. In the end the people appear to prioritize in terms of deontology.

Optimising the Performance of Complex Sociotechnical Systems in High-Stress, High-Speed Environments: The Formula 1 Pit Stop Test Case

Featured ApplicationA development of the FRAM visualisation software to enable quantitative prediction of system performance.In analysing the performance of complex sociotechnical systems, of particular interest is the inevitable and inherent variability that these systems exhibit, but can normally tolerate, in successfully operating in the real world. Knowing how that variability propagates and impacts the total function mix then allows an understanding of emergent behaviours. This interdependence, however, is not readily apparent from normal linear business process flow diagrams. An alternative approach to exploring the operability of complex systems, that addresses these limitations, is the functional resonance analysis method (FRAM). This is a way of visualising a system’s behaviour, by defining it as an array of functions, with all the interactions and interdependencies that are needed for it to work successfully. Until now this methodology has mainly been employed as a qualitative mind map. This paper describes a new development of the FRAM visualisation software that allows the quantification of the extent and effects of this functional variability. It then sets out to demonstrate its application in a practical, familiar test case. The example chosen is the complex sociotechnical system involved in a Formula 1 pit stop. This has shown the potential of the application and provided some interesting insights into the observed performances.

A systems analysis of the UK COVID 19 pandemic response: Part 2 - work as imagined vs work as done.

Modelling complex sociotechnical systems to try to understand how observed behaviours emerge from a network of interacting, interdependent and interrelated functions is a major challenge. Woods et al (Branlat, 2010), have pointed out that it is difficult to find a satisfactory current methodology. They suggested that perhaps the Functional Resonance Analysis Methodology developed by Hollnagel (Hollnagel, 2012) could be an appropriate approach to try. In Part 1 this approach was employed to build an overall model of the UK's COVID 19 response management system, which was constructed as a framework against which, a series of more detailed analyses of specific health care responses could be examined. This meant being conscious of the bigger picture of simultaneous activities and the dynamic emergence of unexpected developments. At that stage, it was of necessity a model of "work as imagined" from careful official and speculative media sources. Although, a full rigorous application will require a more authenticated, official (peer reviewed?), set of data, reports and evidence statements, which doubtless will be available eventually from the inevitable Public Inquiry, it seems a pity to delay gaining and applying any insights and adaptations from "work as (actually) done", that have been observed to date. The recent select committee evidence from people at the heart of the system, (Committee, 2021), which may, or may not be corroborated later, nevertheless now provides a provisional database, which can be utilised to test whether the FRAM model can produce such insights from the actual performance of this highly complex system. This paper has thus attempted a trial run and has found that it can produce a plausible set of insights, which can explain how the system behaved in practice. With such a serious challenge to Government systems worldwide, in all their advisory, operation and decision-making functions, such insights although provisional, could usefully be incorporated and formalised in the current systems rather than waiting for inquiry endorsed recommendations to be formally considered perhaps some years into the future. The paper thus sets out a set of conclusions and recommendations, caveated by emphasising the lack of fully authenticated public domain data on which it is based. The main conclusion however is that the current system appears not to have included any of the functions which could have provided the adaptability and resilience required by fast moving emergencies, such as pandemics. The exception noted was the establishment of a parallel, independent vaccine development and delivery function and it is hoped that at least this lesson from the work as done could be recognised as providing the type of adaptability required and incorporated without delay.

A systems analysis of the COVID-19 pandemic response in the United Kingdom - Part 1 - The overall context.

The most common reaction to suggesting that we could learn valuable lessons from the way the current pandemic has been/ is being handled, is to discourage the attempt; as it is suggested that it can all be done more accurately and authoritatively after the inevitable Public Inquiry (Slater, 2019). On the other hand, a more constructive approach, is to capture and understand the work that was actually done.This would include normal activities, as well as positive adaptations to challenges and failures that may have occurred. Such an approach aimed at improving what worked, rather than blaming people for what went wrong, has the potential to contribute more successfully to controlling the consequences of the current crisis. Such an approach should thus be aimed at detecting and feeding back lessons from emerging and probably unexpected behaviours and helping to design the system to adapt better to counter the effects. The science and discipline of Human Factors (HF) promotes system resilience. This can be defined as an organisation's ability to adjust its functioning before, during or after significant disturbances (such as a pandemic), enabling adaptation and operation under both anticipated and unanticipated circumstances. A "functional" approach methodology enables the identification of where the system and its various interdependent functions (an activity or set of activities that are required to give a certain output), could be improved and strengthened; if not immediately, at least for the future. Along these lines, suggestions for adding key resilience functions are additionally identified and outlined. The application and insights gained from this functional approach to the 2015 MERS-Cov pandemic in South Korea has been seen as contributing substantially to the effective response to the current crisis in that country (Min, submitted for publication). In this paper, we present an overarching framework for a series of projects that are planned to carry out focussed systems-based analysis to generate learning from key aspects of the COVID-19 pandemic response in the United Kingdom.

Social Distancing from the Problem of Japanese Homelessness under Covid-19

Of the many populations at risk in these corona times, the homeless are among the most vulnerable. Without shelter, having to do without personal protective equipment, often without health insurance and unable to limit contact with strangers, the risk of infection is very high. The emergency measures taken by the Tokyo Metropolitan Government included the closure of many public spaces, indoors and out, depriving them of access to the few spaces of survival. This ethnographic article outlines how an older group of homeless men responded to the risk of infection and inconsistent government efforts to address this issue. Finally, we examine the response of civil society organizations to compensate for weakness of the government's response.

The Whole Block Goes Down: Refugees in Japan's detention centers during the pandemic

In the context of the global increase in displaced people, spiking to nearly 80 million in these corona times, Japan has also seen a dramatic increase in the number of applications for refugee asylum since 2010. Despite increasing numbers of applications, Japan has not increased its refugee recognition rate. Unable to return home to sure persecution when rejected, many refugees end up in Japanese detention centers once their visa expires. Like jails, hospitals and detention centers everywhere, detention centers in Japan are crowded and dangerous and unable to protect the detainees inside. Japan has been slower than many other countries to take precautions, including temporary release. This paper outlines some of the policy shifts that have led to this dangerous situation, the conditions of anxiety inside the detention centers themselves in Tokyo and Ibaraki and the problematic situation of "provisional release" of some detainees into a corona-infested Japan without any safety net or protection. We hope to not only point out the immediate danger of infection under COVID-19, but also the larger dynamic of using detention to manage a refugee asylum system that has proven to be ineffective and unjust.

Vulnerable Populations Under COVID-19 in Japan: A Lull in the Storm?

This is a collection of original articles on diverse vulnerable populations in Japan in the wake of the new coronavirus pandemic. The effects of COVID-19 are felt differently, with some among us at much greater risk of infection due to preexisting health and welfare conditions. For others, perhaps more than the risk of infection, it is the precautions taken to mitigate the risk for the whole population, such as lockdowns and business closures, that have pulled away the already fragile safety net of state and civil society organization (CSO) support, leading to increased marginalization and social exclusion. The goal of this set of papers is to document the conditions of those that have been most directly affected by the virus and to provide background on the conditions that made them vulnerable in the first place, notably chronic conditions that are brought into more obvious relief in light of emergency measures. Each of the authors had a pre-established relationship with those affected populations and employed various ethnographic approaches, some face to face, others digitally via Zoom interviews and SNS exchanges. In this moment of what appears to be relative calm, we hope that our collection, quickly compiled in an attempt to capture the ever-changing situation, will give some insight into how those most vulnerable are faring in this time of crisis and provide information that will allow us to prepare better before the next wave comes our way.