Thursday, December 12, 2019
Ethical Issues in Influenza Pandemic Planning
Question: Discuss about the Case Study for Ethical Issues in Influenza Pandemic Planning. Answer: Introduction Influenza pandemic is one of the pandemics whose occurrence cannot be prevented whatsoever. Although it might not be accurately predicted, its occurrence can cause a serious burden on health and disruption to the socio-economic stability of the country. It is therefore incumbent upon the local, state and national governments to adequately prepare for it (Davis, Chen, Pappas, Stevens, Tumpey, Gubareva, Cox, 2014). The implementation of public health measures before, during and after the outbreak of influenza pandemic often bring lots of controversies. Although the measures are aimed at addressing the pandemic, it is quite challenging because the measures affect people in different ways. This results into numerous ethical issues that if properly handled, can greatly contribute to the mitigation of the pandemic. Accessibility to Health Care during Pandemic One of the major issues of ethical concern during an influenza pandemic is accessibility to health care services. When there is an outbreak of influenza pandemic, a large number of people can be affected. In fact, the situation can worsen if it is a serious disaster that affects a large geographical area. In case this happens, the affected populations need to have access to health care facilities such as vaccines, medications, beds, antivirals, and Intensive Care Unit services (Dewar, Barr Robinson, 2014). These are important resources that can be of great contribution if availed to the affected population. Influenza is a very serious pandemic that requires an urgent contribution of medical care no matter how unpredictable it may erupt. However, there still remains a challenge because the distribution of the medical resources might not be evenly done. The first reason why the resources cannot be accessed by all the victims is because of the inadequacy in supply. Naturally, it might not be possible to provide enough resources to satisfy everyone. Besides, the distribution process might be skewed (Biggerstaff, Reed, Swerdlow, Gambhir, Graitcer, Finelli Bridges, 2015). Meaning, the resources might only be availed to a certain section of the affected persons at the expense of the entire community. This makes the accessibility to health care to become a major challenge when addressing the eruption of influenza pandemic. It is morally right to evenly distribute health care facilities to the affected communities depending on the level of need and risk posed by the pandemic. Solution To effectively address this issue, the authority should ask important questions regarding the distribution strategy to adopt during influenza pandemic. After the acknowledgement of the inadequacy of health care resources, the authority should take all the necessary measures to ensure that the available resources are evenly distributed. Since it is unethical to discriminate any victim, the available resources should be availed to all the victims who urgently need it. However, to do so, a proper plan should be made to analyze the needs of each and every segment of the community (Cox, Trock Burke, 2014). Priority should be given to the victims whose level of need is higher than the rest. After serving this group, the resources should be availed to other victims who did not suffer as much as the first group, but are still in need of medical intervention. The distribution process should be guided by the principle of utility. According to this principle, an action should be regarded as mortally right if it yields benefits to a great number of people (Fineberg, 2014). The principle of utility is appropriate in the distribution of health care services because it emphasizes the need for common good. Since the major aim of the intervention is to help the victims, efforts should be made to ensure that everyone who deserves medical attention is served whenever necessary (Vayena, Salath, Madoff Brownstein, 2015). The provision of health care services is a wise idea that if properly implemented, can help in saving the lives of the victims from imminent danger from the pandemic. It is an important contribution that can help in dealing with influenza pandemic no matter how serious it might be. The other principle that should be applied when addressing the issue of resource allocation during the outbreak of influenza pandemic is fairness. Here, the decision-makers should take all the necessary measures to ensure that the available resources are made accessible to all the victims based on the magnitude of their needs (Thompson, Smith, McDougall, Bensimon, Perez, 2015). When the principle of fairness is applied during the pandemic, the distribution of health care services can be availed to all the victims of the pandemic. It is unethical to discriminate any section of the community because they all deserve to be served whenever faced with such emergencies. All healthcare providers should be guided by fairness because it is a very important ethical that should be applied when handling patients. Balancing Rights, Values and Interests As part of its mitigation measures, the government has a mandate to take measures aimed at protecting the lives of the affected populations. This is actually what the local, state and federal government has to do in response to an outbreak of influenza pandemic. In order to curb the spread of influenza infections, various public health measures have to be taken (Smith, Bensimon, Perez, Sahni Upshur, 2012). According to the World Health Organization (WHO), influenza pandemic requires the following measures: isolation of the infected, quarantine of the exposed, social distancing, personal hygiene, border control, and surveillance of animal-human transmission of the influenza virus (Lurie, Manolio, Patterson, Collins Frieden, 2013). Even if these measures are necessary, their introduction into the society always results into conflicts. Many people have raised questions regarding the morality of these measures. Critiques have faulted the authority for implementing these measures becaus e they arguably limit and infringe on individual and communal liberties, interests and freedoms guaranteed by the constitution. Solution The ethical challenges facing these restrictive regulations can be resolved if measures are taken to sensitize the affected populations on the necessity, utility, morality, and legitimacy of such measures. One way of achieving this is to promote an effective timely communication between the authorities and the local populations (Prematunge, Corace, McCarthy, Nair, Roth, Suh Garber, 2014). Unnecessary resistance can be attained if the general public is informed about the essence of the regulations. The authorities should take time to involve the participation of the local communities in the major decision-making processes. This can help in eliminating resistance and winning the confidence of the public by convincing them to know why it is necessary to give up their individual rights for the sake of the larger community. Advance planning can be helpful because it helps in psychologically-preparing the community before the actual occurrence of the pandemic, should it occur. To address the ethical challenges that arise from communicable resistance to the restrictions, the authorities should apply the ethical principle of justice. The constitution of the USA guarantees individuals rights that should be enjoyed without unnecessary interference from any other party. It is for this reason that it is anticipated that the introduction of restrictive policies can result into resistances (Riley, Ben-Nun, Armenta, Linker, Eick, Sanchez Riley, 2013). Many people can resort to rebellion because they believe that they have freedom of assembly, movement and choice, that no one has a legal right to interfere with. However, by applying the principle of justice, individuals can be made to acknowledge that they deserve the restrictions for the benefit of the community. The principle of justice should be applied alongside the principle of liberty. Even if the government has a mandate to decide on behalf of the community, it can be much better if the decision-making process is made inclusive of all the involved parties (Simonsen, Spreeuwenberg, Lustig, Taylor, Fleming, Kroneman Paget, 2013). At the same time, through the principle of liberty, the government can help the government to pt for beneficial restrictive policies against its people. A strict compliance with the principle of justice can compel the authorities to acknowledge that the citizens have rights that need to be respected. Therefore, when the situation necessitates the imposition of restrictions, only the least restrictive alternative can be adopted. This can be a better way of balancing individual rights and eliminating unnecessary conflicts of interest that might arise when dealing with influenza pandemic. The Obligation of Health Workers during Pandemic Whenever any pandemic occurs, many people get infected with the disease. And if no immediate measures are taken, the disease can spread so fast to other people. This is why an influenza pandemic requires an urgent deployment of health workers. Although the health workers are required to salvage the situation, a lot of questions have been raised regarding the ethical obligation of these specialists (Viboud, Eisenstein, Reid, Janczewski, Morens Taubenberger, 2013). A hot debate has ensued regarding the safety of the health workers. As much as the health workers are responsible for monitoring the situation and treating the victims, they are in a risky position because of possible infection by the disease. This justifies why it is necessary to know whether the health workers should protect their own lives of sacrifice for the benefit of the larger society. Solution To address this challenge, the health workers should acknowledge that, as specialists, they should be guided by the ethical codes of conduct of the profession. It is incumbent upon health care providers to always prioritize the interests of the patients. At no one time should health care providers put their own interests primary to their patients. The health workers should therefore take the initiative to sacrifice and deliver best services to the patients especially during such difficult times. Pandemics are disasters that cannot be prevented by human beings (Hedge, Lycett Rambaut, 2013). The life of the patients should not be sacrificed for the sake of protecting ones profession or life. It can be unethical if health workers fail to actively participate in the mitigation of influenza pandemic because it might spread and become more disastrous than it would have been should efforts be made to mitigate it. The other way through which this challenge can be addressed is by reciprocating to the health workers. After appealing to the health workers to sacrifice and serve the community, they also deserve to be offered the necessary support. The community should support the health workers in discharging their duties by cooperating with them at all times (Kunin, Engelhard, Thomas, Ashworth, Piterman, 2013). At the same time, the government should participate by providing enough protection equipments, medicine, and all the other resources that might be necessary during this challenging time. It is therefore evident that this controversy can be resolved if the health workers, government and the general community work as a team. The mitigation of influenza pandemic can be effectively done if each of these parties plays its role well. The ethical principle of utility is the most appropriate to apply when addressing this challenge. Since this principle advocates for a common good, it can help in encouraging the health workers to participate in the mitigation of an influenza pandemic. Once a heath worker is concerned about the welfare of the general society, they will serve the victims of the pandemic without any fear or favor. A health worker who is concerned about the welfare of the community can readily sacrifice his life no matter how risky it might be (Iskander, Strikas, Gensheimer, Cox Redd, 2013). After all, such self-driven workers cannot allow any conflict of interest between profession and personal life. The same principle should also be applied by the government and community in offering continued support to the health workers who are treating influenza victims and monitoring the course of the pandemic. Obligations of the Governmental and Intergovernmental Organizations The responsibility of planning for, mitigation and responding to pandemics is not a one-man show, but a serious menace handled by the local, state, national, and the international entities. Each of these bodies has a mandate to play a significant role in dealing with any pandemic that might occur at any given time. As much as it might be argued that these pandemics do not announce their occurrence, the government, at all levels, should make the necessary measures to tackle it (Cauchemez, Van Kerkhove, Archer, Cetron, Cowling, Grove Oshitani, 2014). However, conflicts often arise as what responsibilities should each level of government play. Ethical questions have been asked regarding the level of support or attention that a country should offer the other in case of disaster. Should a foreign government abandon or support another country in case of a pandemic? To what magnitude should such interventions be offered? This ethical challenge can be resolved if each government plays its role well. Although it is morally-justified for a country to intervene in case a neighbor is hit with a pandemic, it is right to limit the kind of support given. Each and every government should be concerned about its own welfare. Only when necessary, should foreign nations should be supported. Nonetheless, such support should be restricted. The government should not use all its resources to support a foreign country that has been hit by a pandemic (Gog, Ballesteros, Viboud, Simonsen, Bjornstad, Shaman Grenfell, 2014). The government of USA should not use all the money to support a foreign country in case of influenza outbreak. It is international bodies such as World Health Organization that should be actively involved in such interventions. It is such organizations that have funds exclusively reserved for such disasters in any of its member states. This implies that governmental support should be limited to a cert ain level lest the government exhausts all the resources that would otherwise be used to support its citizens. Solution The controversy surrounding the obligation of the government and intergovernmental bodies can be resolved if the ethical principle of efficiency is applied. According to the principle of efficiency, a right action is the one in which minimal resources are used to produce optimal yield (He, Dushoff, Day, Ma Earn, 2013). So, the government, in mitigating influenza pandemic, should not use a lot of funds. Instead, limited resources should be allocated and appropriately used for the same. The principle of efficiency poses a challenge to the government to budget well for the available resources that can be used in handling the influenza pandemic. Only if necessary should money be allocated for the management and influenza pandemic out of the country. Since priority should always be given to the matters of domestic importance, only limited support should be given to foreign countries. Apart from efficiency, the governmental bodies should allude to the principles of transparency and review. By applying these principles, the government ensures that all decisions are made as per the expected standard. This means that accepted procedures are followed while making important decisions regarding influenza pandemic (Kerkhove, Hirve, Koukounari Mounts, 2013). At the same time, the government should incorporate the input of all the concerned stakeholders by giving them an opportunity to express their opinion and review the agreements before its eventual implementation. Pandemic decisions should be inclusive because they directly and indirectly affect many people when implemented. Therefore, the local community, local government, state government, national and international governments should ensure that there is transparency in whatever decision made. Once this is done, no controversy will arise whenever because everyone is involved. Conclusion: As a nation, the USA is not exempt from the Influenza pandemic. It can be hit at any time. However, should this happen, the situation can be swiftly handled by the national, state and local governments which always have a mandate to mobilize health care professionals, social workers, and volunteers to respond to such emergencies. However, it should be upon the government to address all the issues of ethics that might be of concern during such a time. The ethical challenges of accessibility to health care; balancing of rights and interests; obligations of the health workers, government and the community during the pandemic period should be amicably handled by applying the most appropriate principles and strategies. References: Biggerstaff, M., Reed, C., Swerdlow, D. L., Gambhir, M., Graitcer, S., Finelli, L. Bridges, C. (2015). Estimating the potential effects of a vaccine program against an emerging influenza pandemicUnited States. Clinical Infectious Diseases, 60(suppl 1), S20-S29. Cauchemez, S., Van Kerkhove, M. D., Archer, B. N., Cetron, M., Cowling, B. J., Grove, P. 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