The COVID-19 pandemic has adversely affected every person in Ireland, with people making sacrifices at both an individual and societal level, according to the Department of Health's chief bioethics officer.

Dr Siobhan O'Sullivan said that people nationwide have had to make "many difficult personal choices", but she believes that solidarity "has been, and must remain, the hallmark of the Irish response to COVID-19".

Dr O' Sullivan explained that Ireland's response has been anchored in seven key ethical principles - solidarity fairness, minimising harm, proportionality, reciprocity, privacy and a duty to provide care.

These principles, which were published as part of the department's Ethical Framework for Decision-Making in a Pandemic in March 2020, "have guided our collective response to this unprecedented public health emergency".

Dr O'Sullivan noted that the pandemic has brought into sharp focus questions around "what we owe to each other and what values we wish to prioritise as a society".

She said that the emphasis on solidarity during the pandemic has been welcome and has been important for "societal cohesiveness".

"Solidarity is about standing beside and up for others, in facing a common threat and in achieving our shared common goal of containing this virus. It is a recognition of our shared humanity and interconnectedness and is characterised by people acting in mutual support of each other.

"COVID-19 has exposed, as well as exacerbated, pre-existing health and social inequities, with a disproportionate burden falling on vulnerable and disadvantaged populations. We need to take care that the decisions we make during this pandemic do not deepen these inequalities," Dr O'Sullivan commented.

She also pointed out that difficult decisions have had to be made by clinicians and policymakers when it comes to issues such as vaccination, however the core principles of the ethical framework have "laid the foundation for Ireland's approach to rolling out a vaccination programme to protect us all against COVID-19".

She emphasised that getting vaccinated is one of the most important things we can do to protect ourselves and others and the starting point for deciding which groups should receive the earliest allocations of vaccines, especially during this period of constrained supply, "is to recognise that every person deserves equal respect and consideration".

"The vaccine allocation strategy seeks to balance the requirement to produce the most good while ensuring the equitable treatment of people. The latter involves giving special consideration to those who are most vulnerable. Those who have an increased risk of dying or developing severe disease have been prioritised, as have frontline healthcare workers," she noted.

However, Dr O'Sullivan acknowledged that no-one is protected until everyone is protected, and solidarity "becomes a very thin concept if we only apply it to those who are very much like us and if it comes with terms and conditions".

She also noted that efforts to control the pandemic at the national level will only succeed "if we play our part in the global effort".

"Human dignity and respect is due to everyone, not just those who live within our borders. While we in Ireland and the rest of Europe have already commenced vaccinating our priority groups, it is a sobering thought that nearly a quarter of the world's population, mostly in low- and middle-income countries, will not have access to a vaccine before 2022," she said.

The director general of the World Health Organization, Tedros Adhanom Ghebreyesus, has already described this as a "catastrophic moral failure".

"Equitable, global distribution of COVID vaccines is not only the right thing to do, but in protecting the most vulnerable, we are protecting ourselves.

"In 2020, we saw how we can collectively make a difference at a population level by abiding by public health measures. It has never been more clear that our own actions impact on other people, both at a national as well as a global level. Solidarity remains a relevant ethical lens through which to view our pandemic response," Dr O'Sullivan added.

Dr O'Sullivan is a member of the National Public Health Emergency Team (NPHET) and was recently elected vice-chair of the Committee on Bioethics in the Council of Europe.

The Government's Ethical Framework for Decision-Making in a Pandemic can be viewed here.