Ethics-sensitivity of the Ghana national integrated strategic response plan for pandemic influenza
Identifieur interne : 000569 ( Main/Exploration ); précédent : 000568; suivant : 000570Ethics-sensitivity of the Ghana national integrated strategic response plan for pandemic influenza
Auteurs : Amos Laar [Ghana] ; Debra Debruin [États-Unis]Source :
- BMC Medical Ethics [ 1472-6939 ] ; 2015.
Abstract
Many commentators call for a more ethical approach to planning for influenza pandemics. In the developed world, some pandemic preparedness plans have already been examined from an ethical viewpoint. This paper assesses the attention given to ethics issues by the Ghana National Integrated Strategic Plan for Pandemic Influenza (NISPPI).
We critically analyzed the Ghana NISPPI’s sensitivity to ethics issues to determine how well it reflects ethical commitments and principles identified in our review of global pandemic preparedness literature, existing pandemic plans, and relevant ethics frameworks.
This paper reveals that important ethical issues have not been addressed in the Ghana NISPPI. Several important ethical issues are unanticipated, unacknowledged, and unplanned for. These include guidelines on allocation of scarce resources, the duties of healthcare workers, ethics-sensitive operational guidelines/protocols, and compensation programs. The NISPPI also pays scant attention to use of vaccines and antivirals, border issues and cooperation with neighboring countries, justification for delineated actions, and outbreak simulations. Feedback and communication plans are nebulous, while leadership, coordination, and budgeting are quite detailed. With respect to presentation, the NISPPI’s text is organized around five thematic areas. While each area implicates ethical issues, NISPPI treatment of these areas consistently fails to address them.
Our analysis reveals a lack of consideration of ethics by the NISPPI. We contend that, while the plan’s content and fundamental assumptions provide support for implementation of the delineated public health actions, its consideration of ethical issues is poor. Deficiencies include a failure to incorporate guidelines that ensure fair distribution of scarce resources and a lack of justification for delineated procedures. Until these deficiencies are recognized and addressed, Ghana runs the risk of rolling out unjust and ethically indefensible actions with real negative effects in the event of a pandemic. Soliciting inputs from the public and consultation with ethicists during the next revision of the NISPPI will be useful in addressing these issues.
Url:
DOI: 10.1186/s12910-015-0025-9
PubMed: 25947354
PubMed Central: 4427965
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Ethics-sensitivity of the Ghana national integrated strategic response plan for pandemic influenza</title><author><name sortKey="Laar, Amos" sort="Laar, Amos" uniqKey="Laar A" first="Amos" last="Laar">Amos Laar</name><affiliation wicri:level="3"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.8652.9</institution-id><institution-id institution-id-type="ISNI">0000000419371485</institution-id><institution>Department of Population, Family and Reproductive Health, School of Public Health, College of Health Sciences,</institution><institution>University of Ghana,</institution></institution-wrap>Box LG 13, Legon, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Box LG 13, Legon, Accra</wicri:regionArea><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName></affiliation></author><author><name sortKey="Debruin, Debra" sort="Debruin, Debra" uniqKey="Debruin D" first="Debra" last="Debruin">Debra Debruin</name><affiliation wicri:level="1"><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.17635.36</institution-id><institution-id institution-id-type="ISNI">0000000419368657</institution-id><institution>Center for Bioethics,</institution><institution>University of Minnesota,</institution></institution-wrap>410 Church Street S.E MN, 55455-0346 Minneapolis, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>410 Church Street S.E MN, 55455-0346 Minneapolis</wicri:regionArea><wicri:noRegion>55455-0346 Minneapolis</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25947354</idno><idno type="pmc">4427965</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4427965</idno><idno type="RBID">PMC:4427965</idno><idno type="doi">10.1186/s12910-015-0025-9</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">000166</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000166</idno><idno type="wicri:Area/Pmc/Curation">000166</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000166</idno><idno type="wicri:Area/Pmc/Checkpoint">000402</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000402</idno><idno type="wicri:Area/Ncbi/Merge">000B62</idno><idno type="wicri:Area/Ncbi/Curation">000B62</idno><idno type="wicri:Area/Ncbi/Checkpoint">000B62</idno><idno type="wicri:Area/Main/Merge">000570</idno><idno type="wicri:Area/Main/Curation">000569</idno><idno type="wicri:Area/Main/Exploration">000569</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Ethics-sensitivity of the Ghana national integrated strategic response plan for pandemic influenza</title><author><name sortKey="Laar, Amos" sort="Laar, Amos" uniqKey="Laar A" first="Amos" last="Laar">Amos Laar</name><affiliation wicri:level="3"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.8652.9</institution-id><institution-id institution-id-type="ISNI">0000000419371485</institution-id><institution>Department of Population, Family and Reproductive Health, School of Public Health, College of Health Sciences,</institution><institution>University of Ghana,</institution></institution-wrap>Box LG 13, Legon, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Box LG 13, Legon, Accra</wicri:regionArea><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName></affiliation></author><author><name sortKey="Debruin, Debra" sort="Debruin, Debra" uniqKey="Debruin D" first="Debra" last="Debruin">Debra Debruin</name><affiliation wicri:level="1"><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.17635.36</institution-id><institution-id institution-id-type="ISNI">0000000419368657</institution-id><institution>Center for Bioethics,</institution><institution>University of Minnesota,</institution></institution-wrap>410 Church Street S.E MN, 55455-0346 Minneapolis, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>410 Church Street S.E MN, 55455-0346 Minneapolis</wicri:regionArea><wicri:noRegion>55455-0346 Minneapolis</wicri:noRegion></affiliation></author></analytic><series><title level="j">BMC Medical Ethics</title><idno type="eISSN">1472-6939</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Many commentators call for a more ethical approach to planning for influenza pandemics. In the developed world, some pandemic preparedness plans have already been examined from an ethical viewpoint. This paper assesses the attention given to ethics issues by the Ghana National Integrated Strategic Plan for Pandemic Influenza (NISPPI).</p></sec><sec><title>Methods</title><p>We critically analyzed the Ghana NISPPI’s sensitivity to ethics issues to determine how well it reflects ethical commitments and principles identified in our review of global pandemic preparedness literature, existing pandemic plans, and relevant ethics frameworks.</p></sec><sec><title>Results</title><p>This paper reveals that important ethical issues have not been addressed in the Ghana NISPPI. Several important ethical issues are unanticipated, unacknowledged, and unplanned for. These include guidelines on allocation of scarce resources, the duties of healthcare workers, ethics-sensitive operational guidelines/protocols, and compensation programs. The NISPPI also pays scant attention to use of vaccines and antivirals, border issues and cooperation with neighboring countries, justification for delineated actions, and outbreak simulations. Feedback and communication plans are nebulous, while leadership, coordination, and budgeting are quite detailed. With respect to presentation, the NISPPI’s text is organized around five thematic areas. While each area implicates ethical issues, NISPPI treatment of these areas consistently fails to address them.</p></sec><sec><title>Conclusions</title><p>Our analysis reveals a lack of consideration of ethics by the NISPPI. We contend that, while the plan’s content and fundamental assumptions provide support for implementation of the delineated public health actions, its consideration of ethical issues is poor. Deficiencies include a failure to incorporate guidelines that ensure fair distribution of scarce resources and a lack of justification for delineated procedures. Until these deficiencies are recognized and addressed, Ghana runs the risk of rolling out unjust and ethically indefensible actions with real negative effects in the event of a pandemic. Soliciting inputs from the public and consultation with ethicists during the next revision of the NISPPI will be useful in addressing these issues.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Hsieh, Yc" uniqKey="Hsieh Y">YC Hsieh</name></author><author><name sortKey="Wu, Tz" uniqKey="Wu T">TZ Wu</name></author><author><name sortKey="Liu, Dp" uniqKey="Liu D">DP Liu</name></author><author><name sortKey="Shao, Pl" uniqKey="Shao P">PL Shao</name></author><author><name sortKey="Chang, Ly" uniqKey="Chang L">LY Chang</name></author><author><name sortKey="Lu, Cy" uniqKey="Lu C">CY Lu</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Osterholm, Mt" uniqKey="Osterholm M">MT 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