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To examine these issues, we conducted a qualitative study based on twenty-three semi-structured interviews with pandemic decision-makers and representatives of marginalized populations in Germany and Israel, focusing on decisions made in 2020 before vaccines were available. Key ethical themes emerged, including decision-making with ethical relevance under intense time pressure, the dominance of biomedical framings often at the expense of social considerations, inadequate attention to populations in bio-psycho-socially vulnerable positions, and the exclusion of stakeholders from decision-making processes. These findings have critical normative significance, highlighting issues of justice in the distribution of burdens and benefits, underscoring the importance of epistemic humility in acknowledging uncertainty and diverse forms of expertise, and affirming the moral obligation to integrate considerations of psycho-social vulnerabilities into public health. To inform future policy, we recommend establishing equitable governance structures to ensure broader stakeholder representation, implementing inclusive communication strategies to reach marginalized groups, and strengthening ethically informed crisis preparedness. Such measures can better align urgent public health decision-making with principles of justice, protection from harm,\u00a0inclusion, and moral responsibility.<\/jats:p>","DOI":"10.1007\/s11673-026-10573-5","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T09:01:10Z","timestamp":1786093270000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ethics and Inequities in the Context of Urgency"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3012-7662","authenticated-orcid":false,"given":"Verina","family":"Wild","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvia","family":"Agbih","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keren","family":"Landsman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quintus","family":"Sleumer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angus","family":"Dawson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan-Christoph","family":"Heilinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"10573_CR1","unstructured":"Aithal, L., H. 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During the pandemic, VW served as external advisor for the federal vaccination committee (STIKO\/RKI). AD served on several advisory committees in Australia and in the World Health Organization (WHO) COVID-19 Ethics Working Group. KL worked in the Ministry of Health in Israel during 2020.","order":2,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The information and views set out in this article are those of the author and do not necessarily reflect the official opinion of the European Commission.","order":3,"name":"Ethics","label":"Disclaimer for Keren Landsman","group":{"name":"EthicsHeading","label":"Declarations"}}]}}