COVID-19, multiple emergencies, and moral entanglements: extraordinary and transcendental moral worlds as a new analytical framework

Abstract The COVID-19 pandemic resulted in a multitude of complex emergencies, extending beyond the realm of health and healthcare. The situation presented a significant challenge to human security . The content analysis and literature review provide evidence of varied choices and decision-making processes at individual, local, national, and global levels in response to the COVID-19 pandemic. These decisions were influenced by various factors such as time constraints, limited resources, unfamiliar situations, unpredictable outcomes, and the uncertainty surrounding the end of the pandemic. The necessity to make exceptional moral decisions posed a challenge to existing conceptual and analytical frameworks, including Arthur Kleinman’s concept of “local moral worlds.” An examination of emergency medicine, particularly in the context of a critical global event, revealed the presence of numerous ethical decisions that, I suggest, may better be termed extraordinary local moral worlds and transcendental moral worlds . Following the development of an effective vaccine and the official declaration of the end of the pandemic, a thorough assessment of these impacts has commenced at various levels. We have observed a growing sense of regret regarding numerous decisions made amidst this exceptional circumstance. Not only can individuals regret over their choices, but governments and stakeholders, including the World Health Organization (WHO), may also find themselves regretting decisions that were initially seen as pragmatic in containing the virus and flattening the curve. Individuals can also experience regret over their choices. To illustrate the exceptional impacts of the pandemic on “ordinary people”, I specifically draw upon the case of thalassemia patients from Pakistan as these patients required blood to survive, thus, they serve as a significant example of making certain choices. Lastly, I contend that it is crucial to reexamine these choices in order to gain valuable insights that can inform more moral and practical choices in the future.