Coming out of confinement: will we give up democratic mobilisation?

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On Tuesday, the Prime Minister will present the framework for the government's plan to break out of containment.
It would be neither understandable nor admissible that the field expertise acquired in the Covid-19 test should not be considered as an indispensable resource in the argumentation of post-confinement political decisions. However, there are no tangible signs, beyond a few vague resolutions, that this practical intelligence is being taken into account to its rightful extent. Similarly, no initiative suggests that civil society is involved in arbitrations taken in haste with regard to deadlines set according to political imperatives of which no one is unaware of what is at stake.

Jumping into the void

Since the announcement of the first cases of Covid-19 reported by China on 7 January 2020, the public authorities have been developing a communication and prescription strategy adapted to the circumstances in an uncertain and evolving context. The language takes into account factors that are difficult to control, drawn from scientific expertise or the means available to "arm" the hospital system, but also each of us in order to prevent an avoidable risk of contamination. The ambiguity relating to the optional or necessary wearing of masks, the maintenance of the confinement of our elderly, the conditions for returning children to school have demonstrated, if necessary, the difficulty of the exercise from the point of view of the requirement for transparency, loyalty and accountability so often invoked by the government.
The same applies to the definition of what would be an exit from confinement, which obviously does not mean the end of a long process whose consequences we need to discover and integrate, which are as yet unpredictable. This test of jumping into the void will require not only equipment and devices proportionate to the risks, but also a human and social environment that reinforces the spirit of trust and the desire to make democracy. The general interest must take precedence over individualistic withdrawal, national cohesion over "saving who can", collective intelligence over admonitions and administrative procedures systematized without any real consultation or impact study.

It is together, at the heart and at the very heart of what is most precious in our democracy, that we took up the first weeks of the pandemic challenge. It is together, respectful of this strength of commitment, dedication, expertise and agility in the field, of solidarity at the grassroots level, that we must invent the path of a society living with Covid-19.
Not subject to Covid-19 and the approximate management of a health crisis whose imperatives in terms of public health and constrained choices everyone has understood. The risk is that political trade-offs will be made without relying on experience and hard-won knowledge in the face of a virus that has invaded the public arena and already our ways of thinking.

No decision will be acceptable and sustainable after containment if it does not take into account the fact that its implementation will depend on individual adherence and collective validation. It is no wiser to consider justified, not to say imperative, measures whose implementation is subject to personal assessment than a transitional plan for exiting containment whose principles and guidelines would be imposed without public consultation.

Our national representation will be led to vote in the urgency of the measures that will determine our social life in the coming months, while the lid of the containment is opening on misery and trauma that no public authority could anticipate.

An unprecedented democratic mobilization

More than ever before, ethics was called upon during these long days of confinement, to provide understanding and discernment in a moment of fear and urgency punctuated by the dramatic litany of the daily quantification of deaths caused by the Covid.19 What meaning should be given to the choices, according to what criteria should we decide to resuscitate or renounce, is it more justified to be concerned about the survival of our elders, and the most vulnerable among us, than about the continuity of economic life? Does any experimental drug protocol justify a marketing authorization even without recourse to the international standards of biomedical research? Ethical reflection has made it possible, where it was necessary to decide in a "degraded" and restrictive context, to argue the "preferable" choices with reference to the principles of respect for the person, dignity, justice and proportionality. Ethical concern has also been expressed in the interests of the public and the public at large, in the interests of the environment.

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If the government had wished to consult civil society, it had the "State Platform for Citizen Participation" at its disposal and had the benefit of proven experience in this respect. Since 17 March 2020, we have not only had time but also the desire to contribute to the anticipation of the possibilities of social life, and even the invention of other ways of life, after confinement.
We did not concede intellectual or moral confinement to the temporary acceptance of certain obstacles! This imperative of democratic life was not contradictory with other emergencies of public health or organizational discipline. On the contrary, because the accountability of each individual will determine the acceptance of choices that the government will find difficult to impose by relying on the legitimization of experts while the Covid-19 contaminates to the principle of authority.

We may be told that a body, a council or a "citizen committee" will be set up to mediate between the government and civil society, as our country knows how to invent and combine them without always taking their analyses and recommendations seriously.
In a context of mistrust, deep-seated concerns, and already of growing disapproval of public decisions, it is risky to think that such a short-term measure will be likely to restore confidence, which it is essential to regain.

The exit from confinement will not be without ethics, because if we do not share unconditional values when they are put to the test of the total and formidable circumstances of our social vulnerabilities, Covid-19 will begin, as it could have already done, the very meaning of making society.

We have understood that, if our doctors and researchers have the mission to mitigate the risks of a "second pandemic wave" and to allow us to hope for a therapeutic response in the long term, it is now time to enter this time of "the with Covid-19" by investing the public space with an unprecedented democratic creativity. The conditions are there. Inspired by what we have discovered in this field innovation which has imposed its expertise and its rules on administrative decision-makers without contesting their legitimacy, let us decide together on a democratic mobilization of which we are capable together, each with his experience, expertise, competence and talent. A "great debate" is possible and necessary, right now, in a form taking into account the current constraints, associating in particular the actors in the field, the cultural environment, universities and other knowledge institutions, associative networks, the

National and regional political leaders will, I hope, be able to integrate this requirement, in accordance with procedures to be specified, into their post-confinement perspectives. It is as democrats that we must "live with Covid-19" and invent it together.

Emmanuel Hirsch, Professor of Medical Ethics, Faculty of Medicine
President of the Council for Research Ethics and Scientific Integrity of the University of Paris-Saclay
Director of the Ethics Area of the Île-de-France Region

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