COVID-19, black swans and the anticipation of health disasters: future problems and the future as a problem in Public Health ethics

Abstract

The COVID-19 pandemic has recalled the importance of prevention and preparedness for highly disastrous events in community health. Several emerging phenomena pose prospective threats to public health. However, the largely future-oriented character of problems, for instance, such as antibiotic resistance, the impact of climate change on health, or the bioengineering of pathogens generates difficulties of analysis. What are the ethical and epistemological challenges raised by future public health problems? How should the moral problems of potentially catastrophic future scenarios be addressed? This article argues in favour of adopting anticipatory ethical approaches from public health ethics. First, it will be argued that addressing these future problems requires reflection on the future as an ethical and epistemic problem. Second, the characteristics of the emerging anticipatory ethics in the fields of ethics of technology and bioethics will be clarified. Third, the application of foresight and anticipatory methodologies in public health ethics debates will be defended. Finally, some reflections will be offered to strengthen anticipatory normative analyses to prevent and address in advance the adverse effects of future health crises.