Response to comments on: Surgical ethics during a pandemic: moving into the unknown?

Dear Editor We welcome the letter from Dr Sheah, which raises important points, including that the COVID-19 pandemic is more than just a medical crisis which has exposed 'massive inequalities in wealth, income and power' Dr Sheah also correctly notes that a health service borne from solidarity with the most vulnerable in society 'requires a sense of unity beyond what we have historically displayed' Dr Sheah further observes that 'it is science and not mere ideology , which will give us hope as we face uncertainties around the pandemic' Some ideologies may indeed be problematic, but we would nevertheless emphasize that science alone will not provide the solutions Science itself is a tool that can be used for good or for ill, and how we use science matters as much as the science itself Questions about how we should use it are external to science itself As we noted in a BMJ editorial 1 , the UK government may insist it is 'following the science' but 'this implies that the science alone will tell us what to do Not only does this rhetoric shift the responsibility for difficult decisions on to 'the science', it is also wrong Science may provide evidence on which to base decisions, but our values will determine what we do with that evidence and how we select the evidence to use It is disingenuous and misleading to imply that value-free science leads the way' What we need is close interaction between science and ethics-not the dominance of one The problems we collectively face and the solutions we must collectively craft are not just about science;they require just science