Philosophers assist Swedish government with guidelines for intensive care

Researchers in practical philosophy at the University of Gothenburg assist the National Board of Health and Welfare in formulating new guidelines for prioritization and rationing of healthcare resources, to prepare for the possible consequences of the ongoing Covid-19 pandemic. Christian Munthe and Erik Malmqvist contribute in several ways with expertise on public health ethics and healthcare ethics.


The disease caused by the new corona virus has led to intense activity within many branches of society and research, and is estimated to lead to exceptional strain on the healthcare system, especially intensive care units.

During the week, the philosophers Christian Munthe and Erik Malmqvist have contributed to the design of new guidelines for priority setting and rationing of healthcare resources in exceptional circumstances.

It is the National Board of health and Welfare, one of Sweden’s main agencies for handling the pandemic, that has commissioned the new guidelines, and the work is led by Lars Sandman, director of the Centre for Healthcare Priority Setting at Linköping University. Since before, both Malmqvist and Munthe contribute to the regular priority setting of new drugs in Region Västra Götaland.

– The guidelines are, of course, based primarily on the Swedish Parliament’s ethical platform for health care priorities, and in particular stress the need for less urgent care to be rationed so that resources can be released for life-saving intensive care. But there are also difficult decisions about how to do when you have to choose between patients with equal needs and equal benefits, Associate Professor of Medical Ethics Erik Malmqvist says.

Ethical expertise

– We are several practical philosophy researchers in the Department of Philosophy, Linguistics and Theory of Science, and several who have done their PhD studies with us, who have an internationally recognised expertise in these areas, which now can be made useful, Christian Munthe, Professor of practical philosophy, says.

Munthe has also been rapidly recruited to assist with ethical expertise in a brand new EU-funded project at Karolinska institutet that aims to develop treatments for Covid-19 based on immunotherapy. Several years ago, he participated in the development of the national pandemic plans in preparation for the so-called swine flu.

Help in public health work

Another Professor of Practical Philosophy at the department, Bengt Brülde, has edited the only existing Swedish textbook in public health ethics. The book has contributions from a number of world-leading public health ethicists, and is used in several university programs for training of public health specialists.

– Since a growing number of countries take extraordinary measures to mitigate the pandemic, difficult ethical questions arise, besides those about effectiveness, Bengt Brülde explains.

Examples of such questions are what actions are morally justified to stop the spread of the disease, and how that aim should be balanced against competing ones.

– This actualize basic issues about the goals of public health, Bengt Brülde says.

The potential of philosophy

– We can now contribute with expertise since we for a long time have had both the opportunity to conduct extensive basic research, and practice in collaboration with community actors and other research areas. It is a reminder of the great potential of practical philosophy and humanistic research – how it can make tangible benefits on the basis of strong basic research, Christian Munthe says.

Contacts at the Department of Philosophy, Linguistics and Theory of Science,:

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