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Marta Spranzi1, Nicolas Foureur2, Virginie Faidherbe3

  • 1Maîtresse de conférences en éthique médicale, UFR Simone Veil - santé, UVSQ Consultante d'éthique, Centre d'éthique clinique (AP-HP).

Sante Publique (Vandoeuvre-Les-Nancy, France)
|February 13, 2026
PubMed
Summary

Patients and proxies valued basic care over technical treatments during COVID-19. Despite accepted liberty limits for public health, trust in authorities eroded, necessitating a reevaluation of public health ethics principles like transparency and proportionality.

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Area of Science:

  • Bioethics
  • Public Health Policy
  • Patient-Centered Care

Background:

  • The COVID-19 crisis necessitated unprecedented individual medical and public health decisions.
  • Ethical considerations surrounding these decisions, particularly patient and proxy perceptions, require thorough investigation.

Purpose of the Study:

  • To explore patient and proxy perceptions of ethical considerations in medical and public health decision-making during the COVID-19 pandemic.
  • To identify key themes influencing trust and acceptance of public health measures.

Main Methods:

  • A qualitative, multi-center study employing semi-directive interviews.
  • Interviews were conducted by an interdisciplinary team and analyzed using thematic analysis and an ethical framework.
Keywords:
Clinical decision makingEthical issuesInformation sharingPandemicPublic healthRisk/benefit assessmentTransparency

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Main Results:

  • Patients prioritized "basic care" over a technical treatment approach, unlike proxies.
  • A significant "crisis of trust" emerged between citizens and public authorities, despite information transparency.
  • While accepting liberty limitations for public health, participants stressed the need for boundaries, especially concerning human relationships.

Conclusions:

  • There is a critical need to redefine public health ethics, emphasizing transparency and proportionality.
  • Patient and proxy perspectives highlight the importance of human connection and trust in public health governance.
  • Ethical frameworks must balance individual liberties with collective well-being, respecting fundamental human relationships.