Trung Nguyen Trong Quoc¹, Nitzan Rimon-Zarfaty¹, Silke Schicktanz¹

¹ Institut für Ethik und Geschichte der Medizin, Universitätsmedizin Göttingen

Background: The COVID-19 pandemic placed political decision-makers under intense pressure and brought scientific policy advice to the center of public and ethical debate. German public health measures restricted fundamental rights, raising questions of legitimacy, responsibility and ethical decision-making. While prior research focused on institutional and governance aspects of COVID-19 policymaking, this study empirically and ethically examines the science–policy interface through the experiences of experts who served as scientific advisors in policymaking with specific regards to decision-making processes, related tensions and ethical challenges involved in providing pandemic policy advice.

Method: 15 semi-structured interviews with German scientific advisors in infection prevention, public health, virology, and epidemiological modeling were conducted and analyzed using content analysis.

Results: Scientific policy advice involved formal and informal interactions with political actors under uncertainty. Advisors reported challenges related to unclear political objectives, inconsistent alignment with their scientific recommendations, selective prioritization of expertise, limited opportunities for systematic evaluation of measures and increasing divergence between scientific advice and political decisions. These confronted advisors with ethical conflicts between their professional commitment to evidence-based advice and political actions involving restrictions of fundamental rights that were not always transparently or scientifically justified.

Conclusion: The findings show ethical tensions at the intersection of science and politics, raising questions of professional integrity, accountability, and the legitimacy of public health decision-making. We discuss these findings against the normative ideal of Evidence-Based Policy Making — which aims to align political decisions with the best available scientific evidence. By revealing evidence hierarchies and political motives, the study highlights tensions between ideals of scientific objectivity and political responsibility. These tensions challenge the legitimacy of scientific policy advice and the ethical foundations of democratic public health governance, calling for critical reflection on professional integrity, the limits of value-neutral evidence transmission and political accountability in future public health crises.