History repeats itself: an ethic for two pandemics

ABSTRACT

The emergence of the human immunodeficiency virus (HIV) in the 1980s brought ethical conflicts that meant a bioethics challenge. Among others, issues of confidentiality, stigmatization, justice, duty of care and investigation arose. Bioethical reflection had been focused on conflicts involving respect for individual autonomy, nevertheless HIV highlighted the needs of the community. Almost four decades later, the COVID-19 pandemic has brought the ethical conflicts typical of public health back to the bioethical scene. Quarantines, various restrictions on mobility, the obligation of masks, poorly protected health care, rationing of scarce resources, rushed research, the vaccines allocation, stigmatization and discrimination, the immune passport, or the moralization of infectious disease have highlighted the need for an ethical framework that helps to reflect and justify public health decisions. In this article we review and analyze the ethical conflicts that arose with HIV and how they have reappeared and been reinterpreted with the COVID-19 pandemic.