Loneliness and Public Health: An Empirical and Ethical Inquiry into the Covid-I9 Pandemic and Beyond (FAG)

Loneliness has emerged as a pressing public‑health concern, especially highlighted by the COVID‑19 pandemic. Its association with adverse health outcomes and its impact on a fulfilled, flourishing life render it an ethically relevant issue. The unprecedented social impact of pandemic measures during Covid-19 raises ethical questions about the role of loneliness in public health measures in future health emergencies. This doctoral thesis investigates loneliness from both empirical and normative perspectives, focusing on adolescents and young adults worldwide, Swiss residents who experienced loneliness during the pandemic, and the stakeholders who provided social support to them. It further inquires into the ethical implications of loneliness in the clinical setting beyond pandemic crises.

The empirical component comprises three parts: (1) a systematic review of qualitative research on pandemic‑related loneliness among youths, employing JBI meta‑aggregation to synthesize findings; (2) focus groups with Swiss professionals from the German and French-speaking parts of the country providing formal social support, exploring their experiences and views on mitigating loneliness; and (3) semi‑structured interviews with individuals who lived through the pandemic in Switzerland, capturing personal narratives of loneliness and isolation.

Building on Martha Nussbaum’s ‘Capabilities approach’—particularly her notion of affiliation—the first part of the normative analysis interrogates the ethical justification for incorporating the capability of affiliation into pandemic public‑health deliberations. The second normative part addresses loneliness in the clinical setting. It examines possible moral approaches for health care professionals regarding this issue, building on the capabilities approach and extending it to the concrete clinical encounter.

The dissertation aims to integrate empirical findings into normative analysis to build ethical recommendations for future pandemics suitable for the Swiss context and beyond. Qualitative data on Swiss residents’ loneliness experiences during Covid-19 are missing, and there is a lack of ethical analysis on the relevance of affiliation in public health planning. Embedded in the ‘National Research Program 80: Covid-19 in Society’ from the Swiss National Science Foundation, this dissertation intends to make a unique contribution to the current scientific discussion on pandemic planning, highlighting gaps in existing pandemic preparedness frameworks, which largely overlook affiliation, and providing high-quality first-hand insights from the Swiss context.