Is Deliberative Democracy Possible During a Pandemic? Reflections of a Bioethicist

Abstract

In 1985, Governor Mario Cuomo established the New York State Task Force on Life and the Law to provide guidance on issues at the interface of medicine, ethics and the law.During its tenure, the Task Force has been the leading state-based commission in this space producing landmark reports on end-of-life care, physician-assisted suicide, genetic testing, newborn care, brain death, surrogate decision making, assisted reproduction, and ventilator allocation in pandemic flu. These documents have informed state policy, both regulatory and statutory, and had an outsized influence on policy deliberation nationwide. Despite this notable provenance, the Task Force was missing in action during the coronavirus disease 2019 (COVID-19) pandemic. Although individual members were sought for consultation, the Task Force as a whole did not meet during the entirety of the pandemic. This article will explore the consequences of this omission and argue that as a deliberative body, the Task Force should have been an essential component of statewide debate on questions of crisis standards of care, health equity, and vaccine allocation. The COVID-19 experience exposed weaknesses in New York’s process of deliberative democracy in response to the pandemic. A state with a distinguished history in this interdisciplinary space was left behind with the views of important constituencies left unheard and communities unserved. Better apprehending how this abdication of responsibility occurred