Rapid Ethics Assessment and Learning (REAL) method in policy decision-making: Evidence report

The Rapid Ethics Assessment and Learning (REAL) method is intended to be a pragmatic decision-support which policy professionals and institutions can use to identify and address ethical challenges in a highly time-constrained situation, such as during a crisis.

While there are long-established and institutionalised processes that encourage scrutiny of scientific evidence, the same cannot be said about analysis of ethical tensions. Ethical implications are not always well integrated into the decision-making process, and they can become de-prioritised, particularly in time-pressured and crisis contexts. When uncertainty is high and evidence is incomplete, dealing with fairness, proportionality or trade-offs can be inconsistent. This can lead to inequalities and unintended harms. Examining ethical issues early on and throughout decision-making processes can enhance rigour and support openness and transparency. Development of the REAL method, which seeks to respond to this problem, is presented in this report. It is the result of a collaboration between the Ethics & Expertise (E&E) research project led by a team at the University of Birmingham, the Nuffield Council on Bioethics (NCOB), and the Faculty of Public Health (FPH).

The consultation, co-design and testing activities through which we have developed the REAL method involved engagement with more than 170 unique participants, including Australian civil servants, representatives of international organisations and participants from over 30 UK policy or public sector organisations, through six consultations and four testing events.

This report sets out the research that has informed the REAL method and the lessons we have learnt thus far from the co-design process. It provides an evaluation of the strengths of the method including its openness, generalisability, flexibility and support for learning, as well as reflecting on potential limitations in relation to resolving power relations, fulfilling public participation requirements, risks of tokenism, and adhering to a singular ethical framework. The Appendices contain further details on who was involved in consultation and testing. In the accompanying step-by-step guide to using the method, we also provide a glossary of technical terms, and visualisations of how the REAL method could fit into the policy design cycle.

We are now seeking public sector partners to create case studies of how the REAL method can be used within live projects and to encourage embedding the method across different areas of public sector decision-making practices