Ethics for pandemics beyond influenza: Ebola, drug-resistant tuberculosis, and anticipating future ethical challenges in pandemic preparedness and response
Identifieur interne : 001B02 ( Ncbi/Checkpoint ); précédent : 001B01; suivant : 001B03Ethics for pandemics beyond influenza: Ebola, drug-resistant tuberculosis, and anticipating future ethical challenges in pandemic preparedness and response
Auteurs : Maxwell J. Smith ; Diego S. SilvaSource :
- Monash Bioethics Review [ 1321-2753 ] ; 2015.
Descripteurs français
- KwdFr :
- Adhésion aux directives (tendances), Adhésion aux directives (éthique), Contrôle des maladies contagieuses (organisation et administration), Coopération internationale, Ebolavirus, Fièvre hémorragique à virus Ebola (), Fièvre hémorragique à virus Ebola (transmission), Humains, Mise en oeuvre des programmes de santé (organisation et administration), Mise en oeuvre des programmes de santé (éthique), Organisation mondiale de la santé, Pandémies (), Pandémies (éthique), Protection civile (tendances), Protection civile (éthique), Prévision, Tuberculose multirésistante (), Tuberculose multirésistante (transmission), Éthique médicale.
- MESH :
- organisation et administration : Contrôle des maladies contagieuses, Mise en oeuvre des programmes de santé.
- tendances : Adhésion aux directives, Protection civile.
- éthique : Adhésion aux directives, Fièvre hémorragique à virus Ebola, Mise en oeuvre des programmes de santé, Pandémies, Protection civile, Tuberculose multirésistante.
- Coopération internationale, Ebolavirus, Fièvre hémorragique à virus Ebola, Humains, Organisation mondiale de la santé, Pandémies, Prévision, Tuberculose multirésistante, Éthique médicale.
English descriptors
- KwdEn :
- Civil Defense (ethics), Civil Defense (trends), Communicable Disease Control (organization & administration), Ebolavirus, Ethics, Medical, Forecasting, Guideline Adherence (ethics), Guideline Adherence (trends), Health Plan Implementation (ethics), Health Plan Implementation (organization & administration), Hemorrhagic Fever, Ebola (prevention & control), Hemorrhagic Fever, Ebola (transmission), Humans, International Cooperation, Pandemics (ethics), Pandemics (prevention & control), Tuberculosis, Multidrug-Resistant (prevention & control), Tuberculosis, Multidrug-Resistant (transmission), World Health Organization.
- MESH :
- ethics : Civil Defense, Guideline Adherence, Health Plan Implementation, Pandemics.
- organization & administration : Communicable Disease Control, Health Plan Implementation.
- prevention & control : Hemorrhagic Fever, Ebola, Pandemics, Tuberculosis, Multidrug-Resistant.
- transmission : Hemorrhagic Fever, Ebola, Tuberculosis, Multidrug-Resistant.
- trends : Civil Defense, Guideline Adherence.
- Ebolavirus, Ethics, Medical, Forecasting, Humans, International Cooperation, World Health Organization.
Abstract
The unprecedented outbreak of Ebola virus disease (EVD) in West Africa has raised several novel ethical issues for global outbreak preparedness. It has also illustrated that familiar ethical issues in infectious disease management endure despite considerable efforts to understand and mitigate such issues in the wake of past outbreaks. To improve future global outbreak preparedness and response, we must examine these shortcomings and reflect upon the current state of ethical preparedness. To this end, we focus our efforts in this article on the examination of one substantial area: ethical guidance in pandemic plans. We argue that, due in part to their focus on considerations arising specifically in relation to pandemics of influenza origin, pandemic plans and their existing ethical guidance are ill-equipped to anticipate and facilitate the navigation of unique ethical challenges that may arise in other infectious disease pandemics. We proceed by outlining three reasons why this is so, and situate our analysis in the context of the EVD outbreak and the threat posed by drug-resistant tuberculosis: (1) different infectious diseases have distinct characteristics that challenge anticipated or existing modes of pandemic prevention, preparedness, response, and recovery, (2) clear, transparent, context-specific ethical reasoning and justification within current influenza pandemic plans are lacking, and (3) current plans neglect the context of how other significant pandemics may manifest. We conclude the article with several options for reflecting upon and ultimately addressing ethical issues that may emerge with different infectious disease pandemics.
Url:
DOI: 10.1007/s40592-015-0038-7
PubMed: 26507138
PubMed Central: 7100556
Affiliations:
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Silva</name><affiliation><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.61971.38</institution-id><institution-id institution-id-type="ISNI">0000000419367494</institution-id><institution>Faculty of Health Sciences,</institution><institution>Simon Fraser University,</institution></institution-wrap>8888 University Drive, Bulsson Hall, Room 11008, Burnaby, BC V5A 1S6 Canada</nlm:aff><wicri:noCountry code="subfield">BC V5A 1S6 Canada</wicri:noCountry></affiliation></author></analytic><series><title level="j">Monash Bioethics Review</title><idno type="ISSN">1321-2753</idno><idno type="eISSN">1836-6716</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Civil Defense (ethics)</term><term>Civil Defense (trends)</term><term>Communicable Disease Control (organization & administration)</term><term>Ebolavirus</term><term>Ethics, Medical</term><term>Forecasting</term><term>Guideline Adherence (ethics)</term><term>Guideline Adherence (trends)</term><term>Health Plan Implementation (ethics)</term><term>Health Plan Implementation (organization & administration)</term><term>Hemorrhagic Fever, Ebola (prevention & control)</term><term>Hemorrhagic Fever, Ebola (transmission)</term><term>Humans</term><term>International Cooperation</term><term>Pandemics (ethics)</term><term>Pandemics (prevention & control)</term><term>Tuberculosis, Multidrug-Resistant (prevention & control)</term><term>Tuberculosis, Multidrug-Resistant (transmission)</term><term>World Health Organization</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adhésion aux directives (tendances)</term><term>Adhésion aux directives (éthique)</term><term>Contrôle des maladies contagieuses (organisation et administration)</term><term>Coopération internationale</term><term>Ebolavirus</term><term>Fièvre hémorragique à virus Ebola ()</term><term>Fièvre hémorragique à virus Ebola (transmission)</term><term>Humains</term><term>Mise en oeuvre des programmes de santé (organisation et administration)</term><term>Mise en oeuvre des programmes de santé (éthique)</term><term>Organisation mondiale de la santé</term><term>Pandémies ()</term><term>Pandémies (éthique)</term><term>Protection civile (tendances)</term><term>Protection civile (éthique)</term><term>Prévision</term><term>Tuberculose multirésistante ()</term><term>Tuberculose multirésistante (transmission)</term><term>Éthique médicale</term></keywords><keywords scheme="MESH" qualifier="ethics" xml:lang="en"><term>Civil Defense</term><term>Guideline Adherence</term><term>Health Plan Implementation</term><term>Pandemics</term></keywords><keywords scheme="MESH" qualifier="organisation et administration" xml:lang="fr"><term>Contrôle des maladies contagieuses</term><term>Mise en oeuvre des programmes de santé</term></keywords><keywords scheme="MESH" qualifier="organization & administration" xml:lang="en"><term>Communicable Disease Control</term><term>Health Plan Implementation</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Hemorrhagic Fever, Ebola</term><term>Pandemics</term><term>Tuberculosis, Multidrug-Resistant</term></keywords><keywords scheme="MESH" qualifier="tendances" xml:lang="fr"><term>Adhésion aux directives</term><term>Protection civile</term></keywords><keywords scheme="MESH" qualifier="transmission" xml:lang="en"><term>Hemorrhagic Fever, Ebola</term><term>Tuberculosis, Multidrug-Resistant</term></keywords><keywords scheme="MESH" qualifier="trends" xml:lang="en"><term>Civil Defense</term><term>Guideline Adherence</term></keywords><keywords scheme="MESH" qualifier="éthique" xml:lang="fr"><term>Adhésion aux directives</term><term>Fièvre hémorragique à virus Ebola</term><term>Mise en oeuvre des programmes de santé</term><term>Pandémies</term><term>Protection civile</term><term>Tuberculose multirésistante</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Ebolavirus</term><term>Ethics, Medical</term><term>Forecasting</term><term>Humans</term><term>International Cooperation</term><term>World Health Organization</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Coopération internationale</term><term>Ebolavirus</term><term>Fièvre hémorragique à virus Ebola</term><term>Humains</term><term>Organisation mondiale de la santé</term><term>Pandémies</term><term>Prévision</term><term>Tuberculose multirésistante</term><term>Éthique médicale</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p id="Par1">The unprecedented outbreak of Ebola virus disease (EVD) in West Africa has raised several novel ethical issues for global outbreak preparedness. It has also illustrated that familiar ethical issues in infectious disease management endure despite considerable efforts to understand and mitigate such issues in the wake of past outbreaks. To improve future global outbreak preparedness and response, we must examine these shortcomings and reflect upon the current state of ethical preparedness. To this end, we focus our efforts in this article on the examination of one substantial area: ethical guidance in pandemic plans. We argue that, due in part to their focus on considerations arising specifically in relation to pandemics of influenza origin, pandemic plans and their existing ethical guidance are ill-equipped to anticipate and facilitate the navigation of unique ethical challenges that may arise in other infectious disease pandemics. We proceed by outlining three reasons why this is so, and situate our analysis in the context of the EVD outbreak and the threat posed by drug-resistant tuberculosis: (1) different infectious diseases have distinct characteristics that challenge anticipated or existing modes of pandemic prevention, preparedness, response, and recovery, (2) clear, transparent, context-specific ethical reasoning and justification within current influenza pandemic plans are lacking, and (3) current plans neglect the context of how other significant pandemics may manifest. We conclude the article with several options for reflecting upon and ultimately addressing ethical issues that may emerge with different infectious disease pandemics.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Adebamowo, C" uniqKey="Adebamowo C">C Adebamowo</name></author><author><name sortKey="Bah Sow, O" uniqKey="Bah Sow O">O Bah-Sow</name></author><author><name sortKey="Binka, F" uniqKey="Binka F">F Binka</name></author><author><name sortKey="Bruzzone, R" uniqKey="Bruzzone R">R Bruzzone</name></author><author><name sortKey="Caplan, A" uniqKey="Caplan A">A Caplan</name></author><author><name sortKey="Delfraissy, J" uniqKey="Delfraissy J">J Delfraissy</name></author><author><name sortKey="Heymann, D" uniqKey="Heymann D">D Heymann</name></author><author><name sortKey="Horby, P" uniqKey="Horby P">P Horby</name></author><author><name sortKey="Kaleebu, P" uniqKey="Kaleebu P">P Kaleebu</name></author><author><name 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Brown</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list></list><tree><noCountry><name sortKey="Silva, Diego S" sort="Silva, Diego S" uniqKey="Silva D" first="Diego S." last="Silva">Diego S. 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