The duty to care in an influenza pandemic: A qualitative study of Canadian public perspectives
Identifieur interne : 001C37 ( Main/Exploration ); précédent : 001C36; suivant : 001C38The duty to care in an influenza pandemic: A qualitative study of Canadian public perspectives
Auteurs : Cécile M. Bensimon [Canada] ; Maxwell J. Smith [Canada] ; Dmitri Pisartchik [Canada] ; Sachin Sahni ; Ross E. G. Upshur [Canada]Source :
- Social Science & Medicine (1982) [ 0277-9536 ] ; 2012.
Abstract
Ever since the emergence of SARS, when we were reminded that the nature of health care practitioners' duty to care is greatly contested, it has remained a polarizing issue. Discussions on the nature and limits of health care practitioners' duty to care during disasters and public health emergencies abounds the literature, ripe with arguments seeking to ground its foundations. However, to date there has been little public engagement on this issue. This study involved three Townhall meetings held between February 2008 and May 2010 in three urban settings in Canada in order to probe lay citizens' views about ethical issues related to pandemic influenza, including issues surrounding the duty to care. Participants included Canadian residents aged 18 and over who were fluent in English. Data were collected through day-long facilitated group discussions using case scenarios and focus group guides. Participant's views were organized according to several themes, including the following main themes (and respective sub-themes): 1. Legitimate limits; a) competing obligations; and b) appeal to personal choice; and 2. Legitimate expectations; a) reciprocity; and b) enforcement and planning. Our findings show that participants moved away from categorical notions of the duty to care towards more equivocal and often normative views throughout deliberations. Our analysis contributes a better understanding of the constitutive nature of the duty to care, defined in part by taking account of public views. This broadened understanding can further inform the articulation of acceptable norms of duty to care and policy development efforts. What is more, it illustrates the urgent need for policy-makers and regulators to get clarity on obligations, responsibilities, and accountability in the execution of HCPs' duty to care during times of universal vulnerability.
Url:
DOI: 10.1016/j.socscimed.2012.09.021
PubMed: 23089615
PubMed Central: 7126096
Affiliations:
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Bensimon</name><affiliation wicri:level="4"><nlm:aff id="aff1">University of Toronto, Joint Centre for Bioethics, 155 College Street, Suite 754, Toronto, ON M5T 1P8, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Toronto, Joint Centre for Bioethics, 155 College Street, Suite 754, Toronto, ON M5T 1P8</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Smith, Maxwell J" sort="Smith, Maxwell J" uniqKey="Smith M" first="Maxwell J." last="Smith">Maxwell J. Smith</name><affiliation wicri:level="4"><nlm:aff id="aff1">University of Toronto, Joint Centre for Bioethics, 155 College Street, Suite 754, Toronto, ON M5T 1P8, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Toronto, Joint Centre for Bioethics, 155 College Street, Suite 754, Toronto, ON M5T 1P8</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Pisartchik, Dmitri" sort="Pisartchik, Dmitri" uniqKey="Pisartchik D" first="Dmitri" last="Pisartchik">Dmitri Pisartchik</name><affiliation wicri:level="1"><nlm:aff id="aff2">University of Western Ontario, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Western Ontario</wicri:regionArea></affiliation></author><author><name sortKey="Sahni, Sachin" sort="Sahni, Sachin" uniqKey="Sahni S" first="Sachin" last="Sahni">Sachin Sahni</name><affiliation><nlm:aff id="aff3">School of Medicine, St. George's University, Grenada</nlm:aff><wicri:noCountry code="subfield">Grenada</wicri:noCountry></affiliation></author><author><name sortKey="Upshur, Ross E G" sort="Upshur, Ross E G" uniqKey="Upshur R" first="Ross E. 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Upshur</name><affiliation wicri:level="4"><nlm:aff id="aff4">Department of Family and Community Medicine, Dalla Lana School of Public Health, University of Toronto, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Family and Community Medicine, Dalla Lana School of Public Health, University of Toronto</wicri:regionArea><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation></author></analytic><series><title level="j">Social Science & Medicine (1982)</title><idno type="ISSN">0277-9536</idno><idno type="eISSN">1873-5347</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Ever since the emergence of SARS, when we were reminded that the nature of health care practitioners' duty to care is greatly contested, it has remained a polarizing issue. Discussions on the nature and limits of health care practitioners' duty to care during disasters and public health emergencies abounds the literature, ripe with arguments seeking to ground its foundations. However, to date there has been little public engagement on this issue. This study involved three Townhall meetings held between February 2008 and May 2010 in three urban settings in Canada in order to probe lay citizens' views about ethical issues related to pandemic influenza, including issues surrounding the duty to care. Participants included Canadian residents aged 18 and over who were fluent in English. Data were collected through day-long facilitated group discussions using case scenarios and focus group guides. Participant's views were organized according to several themes, including the following main themes (and respective sub-themes): 1. Legitimate limits; a) competing obligations; and b) appeal to personal choice; and 2. Legitimate expectations; a) reciprocity; and b) enforcement and planning. Our findings show that participants moved away from categorical notions of the duty to care towards more equivocal and often normative views throughout deliberations. Our analysis contributes a better understanding of the constitutive nature of the duty to care, defined in part by taking account of public views. This broadened understanding can further inform the articulation of acceptable norms of duty to care and policy development efforts. What is more, it illustrates the urgent need for policy-makers and regulators to get clarity on obligations, responsibilities, and accountability in the execution of HCPs' duty to care during times of universal vulnerability.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Agency For Healthcare Research And Quality" uniqKey="Agency For Healthcare Research And Quality">Agency for Healthcare Research and Quality</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="American Bar Association" uniqKey="American Bar Association">American Bar Association</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Angoff, N R" uniqKey="Angoff N">N.R. Angoff</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Arras, J D" uniqKey="Arras J">J.D. 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