Moral and Ethical Orientations and Responses to Nonpharmaceutical Public Health Recommendations in the Early COVID-19 Pandemic

During the early COVID-19 pandemic, citizens of the United States were asked to comply with strict nonpharmaceutical public health recommendations to stop the spread of the virus. As the response evolved, resistance to these recommendations began to emerge along moral and ethical lines. While a growing body of post-pandemic research examines moral associations with public health compliance, no studies have examined the ethical orientations that existed prior to large-scale politicization of the pandemic response. This study is a cross-sectional secondary analysis of a convenience sample (N=110) collected in March 2020, before mask mandates and widespread political polarization of the public health response. Participants completed Forsyth's (1980) Ethics Position Questionnaire and indicated agreement or disagreement with six nonpharmaceutical public health recommendations. Analysis was triangulated using Pearson's correlation, independent samples ttest, and one-way ANOVA. Findings reveal a "Golden Hour" of broad consensus with collective public health recommendations during the early pandemic, with no statistically significant differences across Forsyth's (1980) four ethical taxonomies. Exploratory trends that did not survive Bonferroni correction suggest an association between idealism and disagreement with the recommendation that senior citizens stay home, and between relativism and agreement that those with serious underlying health conditions should stay home. These findings suggest that collective public health recommendations can achieve high levels of compliance through uniform messaging; however, targeted, individualized recommendations require ethically segmented communication strategies. The Ethical Activation Messaging Model (EAMM) is proposed as a theoretical framework to guide future research and public health communication practice.