Ebola – blog.Bioethics.gov https://bioethicsarchive.georgetown.edu/pcsbi/blog The blog of the 2009 - 2017 Presidential Commission for the Study of Bioethical Issues Mon, 09 Jan 2017 23:23:29 +0000 en-US hourly 1 Ethically Sound Episode 10: Charting a Path Forward https://bioethicsarchive.georgetown.edu/pcsbi/blog/2016/11/21/ethically-sound-episode-10-charting-a-path-forward/ https://bioethicsarchive.georgetown.edu/pcsbi/blog/2016/11/21/ethically-sound-episode-10-charting-a-path-forward/#respond Mon, 21 Nov 2016 16:00:01 +0000 https://bioethicsarchive.georgetown.edu/pcsbi/blog/?p=2052 The tenth and final episode of the Bioethics Commission’s podcast series, Ethically Sound, is now available. Today’s episode, “Charting a Path previewscreensnapz001Forward,” focuses on the Bioethics Commission’s two most recent public meetings, during which the Bioethics Commission reflected on the impact of past, present, and future of national bioethics advisory bodies.

Since the 1970s, the U.S. has had a succession of national advisory bodies to provide Congress or the President with expert advice on topics related to bioethics. Other countries also benefit from advisory bodies that provide advice about bioethi
cal issues. During its twenty-fifth and twenty-sixth public meetings, the Bioethics Commission heard
from members of past bioethics advisory bodies, representatives of international bioethics bodies, as well as officials who have been advised by such bodies.

The podcast opens with a narrative from Alex Capron, Professor of Law and Medicine at the University of Southern California. Mr. Capron chaired the Biomedical Ethics Advisory Committee from 1987 to 1990, and served on President William J. Clinton’s National Bioethics Advisory Body from 1996 to 2001. Mr. Capron presented before the commission during Meeting 26, and reflected on his experiences with both of these advisory bodies. In the podcast, Mr. Capron recounts a challenging experience he faced while describing the disciplinary backgrounds of bioethics advisory body staff to policymakers unfamiliar with the interdisciplinary nature of bioethics.

The podcast also includes an interview with Bioethics Commission member Dr. Daniel Sulmasy, Kilbride-Clinton Chair in Medicine and Ethics at the University of Chicago. The interview was conducted by Hillary Wicai Viers, a former Communications Director with the Bioethics Commission staff. Dr. Sulmasy discussed the importance of looking to past commissions, the legacy of the current Bioethics Commission, and the pressing ethical issues that we could face in the future. Regarding the importance of looking to past bioethics commissions, Dr. Sulmasy said “The past is applicable because many of the most basic ethical questions are perennial. We may encounter new problems, but the most fundamental questions about human finitude, the meaning of human progress, the role of balancing relief of suffering versus other ethical principles, questions of cost, and justice are always with us.”

Episode 10, and all of the other Ethically Sound episodes, is now available on our website, as well as on our SoundCloud, YouTube and iTunes pages. Listeners can follow the podcast using #EthicallySound or by following us on Twitter @bioethicsgov. Stay tuned for our upcoming educational resource, a set of discussion questions to accompany the Ethically Sound series that can be used in a classroom or seminar setting. We welcome comments and feedback at info@bioethics.gov.

]]>
https://bioethicsarchive.georgetown.edu/pcsbi/blog/2016/11/21/ethically-sound-episode-10-charting-a-path-forward/feed/ 0
Ethically Sound Episode 2: Ethics and Ebola https://bioethicsarchive.georgetown.edu/pcsbi/blog/2016/09/19/ethically-sound-episode-2-ethics-and-ebola/ Mon, 19 Sep 2016 14:00:33 +0000 https://bioethicsarchive.georgetown.edu/pcsbi/blog/?p=1932

Since the Bioethics Commission was established through Executive Order in 2009 by President Barack Obama, it has released 10 reports on a variety of ethically challenging topics, including synthetic biology, neuroscience, and whole genome sequencing, among others. The Bioethics Commission is excited to release a new podcast series, Ethically Sound. Each episode features one of the Commission’s reports.  Today’s episode, the second in the series, focuses on the Commission’s report Ethics and Ebola: Public Health Planning and Response, which addresses several ethical challenges, including ethical dimensions of public health preparedness, ethical justification for U.S. engagement in global health response, the use of liberty-restricting public health interventions, and selected research ethics issues, that emerged during the response to the 2014-2016 Ebola epidemic in western Africa.

This podcast focuses on the use of restrictive measures, such as quarantine and travel restrictions. Upon their return from affected regions, some health care workers were subjected to restrictive measures by state governments and local public health agencies. Restrictive meaures are sometimes necessary during an epidemic in order to maintain public safety. However, some of the measures used during the Ebola epidemic were overly restrictive, and were issued by state governments and public health agencies in response to the public fear that accompanied Ebola, rather than on the best available scientific evidence. The Commission addressed the stigma and discrimination that can accompany public health emergencies, which can be exacerbated by the use of restrictive measures, and reviewed the historical use of such measures in response to other epidemics. The Commission recommended that governments and public health agencies use the least restrictive interventions necessary, such that interventions are grounded in the best available scientific evidence, and ensure that both the ethical and evidentiary rationale for these measures is clearly communicated, with particular attention to the needs of those most directly affected.

The podcast opens with Dr. Patricia Henwood, an emergency medicine physician and the co-founder and president of the PURE initiative, which examines the use of point-of-care ultrasounds in regions with limited resources. Dr. Henwood recounts her experience of traveling to Liberia during the Ebola epidemic to provide medical care to over 100 patients before the Commission during the Commission’s 20th public meeting. After her return, Dr. faced unclear guidance about what restrictive measures were necessary. Dr. Henwood decided to limit contact with friends and family members during her 21-day monitoring period so they would not have to undergo unnecessary measures. Of her experiences, Dr. Henwood said she and her colleagues were “often touted as heroes while working in West Africa, [but] felt like pariahs once we were back in the United States.”

The podcast also includes an interview with Commission member Dr. Barbara Atkinson, the Founding Dean of the University of Nevada, Las Vegas School of Medicine. Hillary Wicai Viers, former Communications Director with the Bioethics Commission, conducted this interview. Dr. Atkinson discussed some of the ethical challenges surrounding restrictive measures. Regarding the decisions surrounding the use of restrictive measures, Dr. Atkinson said “the people who were making the decisions at a state level were responding to the fear of the public, [not] the scientific facts. The public was very worried about the lethal nature of this virus, and so they responded in a political way, which was to segregate [health care workers].”

The podcast is available on our website, as well as on our SoundCloud, YouTube and iTunes pages. In addition to this episode, listeners also can access the first episode, “Safeguarding Children.” Listeners can follow the podcast using the hashtag #EthicallySound or following us on twitter @bioethicsgov. Stay tuned for the third episode in our series, “Anticipate and Communicate,” which will be available on September 26, 2016. We welcome comments and feedback at info@bioethics.gov.

 

]]>
Introducing the Bioethics Commission’s New Educational Module: Community Engagement in Ethics and Ebola https://bioethicsarchive.georgetown.edu/pcsbi/blog/2016/07/13/introducing-the-bioethics-commissions-new-educational-module-community-engagement-in-ethics-and-ebola/ https://bioethicsarchive.georgetown.edu/pcsbi/blog/2016/07/13/introducing-the-bioethics-commissions-new-educational-module-community-engagement-in-ethics-and-ebola/#respond Wed, 13 Jul 2016 09:00:19 +0000 https://bioethicsarchive.georgetown.edu/pcsbi/blog/?p=1870 The Presidential Commission for the Study of Bioethical Issues (Bioethics Commission) has released a new module titled “Community engagement in Ethics and Ebola.” This module is designed to introduce the role and demonstrate the importance of community engagement in public health preparedness. The module builds on the work our most recent report, Bioethics for Every Generation: Deliberation and Education in Health, Science and Technology and the report Ethics and Ebola: Public Health Planning and Response.

The module, part of a series on community engagement, helps students, professionals, and interested individuals learn how community engagement can impact public health efforts, particularly during public health emergencies. The module includes the Bioethics Commission’s recommendations on community engagement related to domestic and international research, the collecting and sharing of biospecimens, and public health communication. The module includes questions and topics for discussion, as well as learning exercises that engage with real-life ethical scenarios.

This module begins by introducing community engagement. Community engagement modules are also available based on our work on synthetic biology, human subjects research protections, and large-scale genomic sequencing. We also have module series on compensation in research, informed consent, privacy, research design, and vulnerable populations, as these topics have been discussed throughout our reports. All modules are available for free download, and can be combined to create a course or incorporated into existing curricula as instructors or curriculum facilitators see fit.

Please stay tuned for information about forthcoming educational materials, including a series of educational materials about science hype in the media involving neuroscience, public health, and biotechnology.

All Bioethics Commission educational materials are free and available at www.bioethics.gov/education. The Bioethics Commission encourages feedback on its materials at education@bioethics.gov.

]]>
https://bioethicsarchive.georgetown.edu/pcsbi/blog/2016/07/13/introducing-the-bioethics-commissions-new-educational-module-community-engagement-in-ethics-and-ebola/feed/ 0
New Educational Module from the Bioethics Commission on Research Design in Ethics and Ebola https://bioethicsarchive.georgetown.edu/pcsbi/blog/2016/03/09/new-educational-module-from-the-bioethics-commission-on-research-design-in-ethics-and-ebola/ https://bioethicsarchive.georgetown.edu/pcsbi/blog/2016/03/09/new-educational-module-from-the-bioethics-commission-on-research-design-in-ethics-and-ebola/#respond Wed, 09 Mar 2016 22:56:42 +0000 https://bioethicsarchive.georgetown.edu/pcsbi/blog/?p=1812 The Presidential Commission for the Study of Bioethical Issues (Bioethics Commission) has released a new educational module on research design in the context of a public health emergency. The module integrates material from the Bioethics Commission’s report Ethics and Ebola: Public Health Planning and Response (Ethics and Ebola).

This module serves as a guide for instructors to help students understand key ethical challenges that might arise when conducting clinical research during public health emergencies. The module identifies ethical considerations of various approaches to clinical research during public health emergencies, including randomized controlled trials.

The Research Design in Ethics and Ebola module provides background information on randomized controlled trials and considers the differences between vaccine and treatment trials, the interpretation of what constitutes “best available” supportive care, the necessity of research to be responsive to the host and affected communities, and the importance of designing trials that yield scientifically valid results. Through discussion questions, scenarios, exercises, and illustrative and timely examples, the module guides instructors to help students reflect on ethically relevant concerns that arise in designing research during a public health emergency.

The Bioethics Commission’s topic-based educational modules are grounded in contemporary ethical questions addressed by the Commission and are designed to provide instructors with foundational information, ethical analysis, discussion questions, problem-based learning scenarios, exercises, and additional resources to support ethics education and the integration of bioethical analysis into coursework across disciplines.

All Bioethics Commission educational materials are free and available at www.bioethics.gov/education. The Bioethics Commission encourages feedback on its materials at education@bioethics.gov.

]]>
https://bioethicsarchive.georgetown.edu/pcsbi/blog/2016/03/09/new-educational-module-from-the-bioethics-commission-on-research-design-in-ethics-and-ebola/feed/ 0
The History of Bioethics Series – National Bioethics Commissions https://bioethicsarchive.georgetown.edu/pcsbi/blog/2016/01/27/the-history-of-bioethics-series-national-bioethics-commissions/ https://bioethicsarchive.georgetown.edu/pcsbi/blog/2016/01/27/the-history-of-bioethics-series-national-bioethics-commissions/#respond Wed, 27 Jan 2016 16:33:35 +0000 https://bioethicsarchive.georgetown.edu/pcsbi/blog/?p=1783 This is the first post in our “History of Bioethics” series in which we will examine some of the seminal events that shaped the landscape of bioethics and its practice in the world today. This first blog will focus on the creation of the national bioethics advisory bodies in the United States and their different iterations throughout the years.

From our History of Bioethics Commissions page…

The current advisory group, the Presidential Commission for the Study of Bioethical Issues, established by a 2009 Executive Order from President Barack Obama, continues the more than 40-year history of bodies established by the President or Congress to provide expert advice on topics related to bioethics. These groups have differed in their composition, methods, and areas of focus, yet they all have shared share a common goal – to promote the careful examination and analysis of ethical considerations that underlie our nation’s activities in science, medicine, and technology.

The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research (1974-78) is generally viewed as the first national bioethics commission. Established as part of the 1974 National Research Act, the National Commission is best known for the development of the Belmont Report, a document that laid out the ethical principles and guidelines for research involving human subjects. This document has been used as a basis for further federal regulations in the area of human subjects protections.

The Presidential Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research (1978-83), also established by Congress, produced reports on foregoing life-sustaining treatment and access to health care, among other topics. Its 1981 report Defining Death was the basis of the Uniform Determination of Death Act, a model law that was enacted by most U.S. states.

The Advisory Committee on Human Radiation Experiments (1994-95) was created by President Bill Clinton to investigate human radiation experiments conducted from 1944 -1974 as well as radiation intentionally released into the environment for research purposes. The committee considered the ethical and scientific standards for evaluating these events and provided recommendations aimed at ensuring that similar events could not be repeated.

Since the mid-1990s, each of the past three presidents has established bioethics commissions to explore ethical issues in science, medicine, and technology. The National Bioethics Advisory Commission (1996-2001), created by President Clinton, examined topics including cloning, human stem cell research, and research involving human subjects. President George W. Bush established the President’s Council on Bioethics (2001-2009), which issued reports on stem cell research, human enhancement, and reproductive technologies, among other topics.

The Presidential Commission for the Study of Bioethical Issues was established in November 2009 and is chaired by Dr. Amy Gutmann, President of the University of Pennsylvania and renowned political philosopher and educator. The Bioethics Commission has dealt with topics ranging from neuroscience, to Ebola, to whole genome sequencing, and more. All of the Bioethics Commission’s reports can be viewed and downloaded for free at Bioethics.gov. A major point of emphasis for the current Bioethics Commission is to educate and inform the nation about bioethics. So far, in its tenure, the Bioethics Commission has created and disseminated materials for a variety of audiences in traditional and non-traditional educational settings. To date over fifty education materials have been developed and are disseminated freely through the website.

Stay tuned to this blog for upcoming posts on the “History of Bioethics”!

]]>
https://bioethicsarchive.georgetown.edu/pcsbi/blog/2016/01/27/the-history-of-bioethics-series-national-bioethics-commissions/feed/ 0
Deliberation and Education in Ethics and Ebola https://bioethicsarchive.georgetown.edu/pcsbi/blog/2015/12/17/deliberation-and-education-in-ethics-and-ebola/ https://bioethicsarchive.georgetown.edu/pcsbi/blog/2015/12/17/deliberation-and-education-in-ethics-and-ebola/#respond Thu, 17 Dec 2015 19:17:51 +0000 https://bioethicsarchive.georgetown.edu/pcsbi/blog/?p=1776 This is the last post in our “Deliberation and Education” series. In each blog post, we have discussed the role that deliberation and education have played in each of the reports issued by the Presidential Commission for the Study of Bioethical Issues (Bioethics Commission). This post will examine deliberation and education in the Bioethics Commission’s brief Ethics and Ebola: Public Health Planning and Response, released in February 2014.

In Ethics and Ebola, the Bioethics Commission turned its attention to the ethical and prudential reasons for U.S. engagement in the global response to the ongoing Ebola epidemic. The Commission recommended policies and practices to support a proactive response to global public health emergencies. In the brief, the Commission considered several lessons that the U.S. response to the epidemic in western Africa has for ethics preparedness and future public health emergencies, related to engagement, infrastructure, communications, and ethics integration.

The Bioethics Commission recognized that democratic deliberation is an important component of public health emergency preparedness because it fosters dialogue with affected communities and promotes flexible decision making. The Commission acknowledged that while the process of democratic deliberation can be challenging during a crisis, when decisions must be made quickly, public engagement is still necessary and possible during a health emergency.

The Bioethics Commission explicitly included education in its third overarching recommendation:

Public officials have a responsibility to support public education and communication regarding the nature and justification of public health responses.

The Bioethics Commission recognized that effective communication can help to educate the public on the nature of the health emergency; provide information on the rationale for policies and programs; and help mitigate the stigma and discrimination associated with many public health emergencies.

Education and democratic deliberation play key roles during both public health emergencies and throughout the work of the Bioethics Commission. These two principles, the cornerstones of the Commission’s work and process, will be the focus of the Commission’s forthcoming capstone report. Ethics and Ebola and all other Commission reports and educational materials are available at Bioethics.gov.

]]>
https://bioethicsarchive.georgetown.edu/pcsbi/blog/2015/12/17/deliberation-and-education-in-ethics-and-ebola/feed/ 0
New Educational Module from the Bioethics Commission on Privacy in Ethics and Ebola Now Available https://bioethicsarchive.georgetown.edu/pcsbi/blog/2015/12/10/new-educational-module-from-the-bioethics-commission-on-privacy-in-ethics-and-ebola-now-available/ https://bioethicsarchive.georgetown.edu/pcsbi/blog/2015/12/10/new-educational-module-from-the-bioethics-commission-on-privacy-in-ethics-and-ebola-now-available/#respond Thu, 10 Dec 2015 17:15:57 +0000 https://bioethicsarchive.georgetown.edu/pcsbi/blog/?p=1770 The Presidential Commission for the Study of Bioethical Issues (Bioethics Commission) has posted a new educational module on its website, Bioethics.gov. This module on privacy focuses on the Bioethics Commission’s work in Ethics and Ebola: Public Health Planning and Response (Ethics and Ebola). This new privacy module on Ethics and Ebola adds to the privacy resources already produced by the Bioethics Commission. Additional materials on privacy include a background module and a module that accompanies the Bioethics Commission’s report Privacy and Progress in Whole Genome Sequencing. Other topics covered by the Bioethics Commission’s educational modules include community engagement, compensation for research-related injury, informed consent, research design, and vulnerable populations.

The Privacy in Ethics and Ebola module briefly introduces the concept of privacy as it relates to the collection, use, and sharing of biospecimens during public health emergencies; sets forth the ethical principles that guide consideration of the privacy issues raised by the collection, use, and sharing of biospecimens during public health emergencies; and describes the privacy protections, including anonymization and de-identification, available for biospecimens that are collected, used, and shared.

The educational modules produced by the Bioethics Commission are based on the contemporary ethical issues addressed by the Commission, and are designed to provide instructors with foundational information, ethical analysis, discussion questions, problem-based learning scenarios, exercises, and additional resources to support ethics education and the integration of bioethical analysis into coursework across disciplines.

All Bioethics Commission educational materials are free and available at http://www.bioethics.gov/education. The Bioethics Commission encourages feedback on its materials at education@bioethics.gov.

]]>
https://bioethicsarchive.georgetown.edu/pcsbi/blog/2015/12/10/new-educational-module-from-the-bioethics-commission-on-privacy-in-ethics-and-ebola-now-available/feed/ 0
Bioethics Commission Makes Recommendations on Research Ethics in Public Health Emergencies https://bioethicsarchive.georgetown.edu/pcsbi/blog/2015/03/12/bioethics-commission-makes-recommendations-on-research-ethics-in-public-health-emergencies/ https://bioethicsarchive.georgetown.edu/pcsbi/blog/2015/03/12/bioethics-commission-makes-recommendations-on-research-ethics-in-public-health-emergencies/#respond Thu, 12 Mar 2015 15:46:20 +0000 https://bioethicsarchive.georgetown.edu/pcsbi/blog/?p=1584 In its recently published brief, Ethics and Ebola: Public Health Planning and Response, the Presidential Commission for the Study of Bioethical Issues (Bioethics Commission) considered what lessons might be drawn from U.S. engagement in the global response to the Ebola epidemic. The brief examined two areas of human subjects research ethics that have been particularly controversial in the current Ebola epidemic: clinical trial design and the use of placebos; and the collection, use, and international sharing of biospecimens for research.

Public health emergencies add ethical complexity to the conduct of clinical research and yet the Bioethics Commission recognizes the importance of such research—especially when an emergency presents the best, or only, opportunity to conduct research on potential preventive or therapeutic interventions, as is the case for Ebola. As large clinical trials are planned or already underway in western Africa to investigate experimental Ebola vaccines and therapies, the Commission considered whether it is ethically appropriate to conduct randomized placebo-controlled trials to evaluate these interventions. The Bioethics Commission considered two perspectives on this question, one against and one in support of placebo-controlled trials in the current Ebola epidemic, as well as possible middle grounds, while underscoring ethically relevant aspects of conducting clinical research in the Ebola epidemic that might help to resolve tensions between these two viewpoints, such as the role of different levels of supportive care and responsiveness to the needs of communities in which the research is conducted.

Ultimately the Bioethics Commission recommended that the full range of trial designs that protect and promote the welfare of participants and are capable of yielding credible and reliable data on the safety and effectiveness of the interventions should be considered:

Research during the Ebola epidemic should provide all participants with the best supportive care sustainably available in the community in which the research is conducted. Trial designs should be methodologically rigorous and capable of generating results that are clearly interpretable, acceptable to the host communities and, to the extent possible, minimize delays to completing the research. Properly designed placebo-controlled trials can meet these conditions, and innovative designs, such as adaptive randomization, ought to be considered as a means of addressing these research goals. Research teams should actively engage with affected communities while planning research to determine the trial design that best reflects these ethical and scientific requirements.

The Bioethics Commission also considered the ethical and practical challenges of collecting and sharing biospecimens in the context of a communicable disease outbreak like Ebola. The analysis concluded that researchers and other stakeholders should work to ensure equitable access to the benefits that result from research using shared biospecimens and emphasized the importance of ethical acquisition of samples, informed consent, and strong privacy protections.

The Bioethics Commission recommended that the United States should play a leading role in establishing best practices for sharing the benefits of research using biospecimens:

The U.S. government should ensure that Ebola virus related biospecimens are obtained ethically, including addressing the challenges of obtaining informed consent during a public health emergency and ensuring adequate privacy protections. The U.S. government should also, in collaboration with partners, facilitate access to the benefits that result from related research to the broadest group of persons possible. This can be achieved by engaging in dialogue with global partners and working collaboratively with local scientists whenever possible to develop effective strategies for ensuring equitable distribution of the benefits of research both in the United States and abroad.

A public health emergency can magnify and complicate ethical concerns associated with research, both clinical and non-clinical, and challenge research protections for vulnerable participants. In Ethics and Ebola, the Bioethics Commission navigated these dilemmas by considering practical realities and applying core ethical principles, including beneficence and justice and fairness. It emphasized the importance of broad and inclusive public engagement and democratic deliberation in advance of public health emergencies to anticipate and address the ethical, societal, legal, and practical challenges that emerge in such crises.

Ethics and Ebola: Public Health Planning and Response, and all other Bioethics Commission reports, are available at www.bioethics.gov.

]]>
https://bioethicsarchive.georgetown.edu/pcsbi/blog/2015/03/12/bioethics-commission-makes-recommendations-on-research-ethics-in-public-health-emergencies/feed/ 0
Using the Least Restrictive Limits in Public Health Emergencies https://bioethicsarchive.georgetown.edu/pcsbi/blog/2015/03/05/using-the-least-restrictive-limits-in-public-health-emergencies/ https://bioethicsarchive.georgetown.edu/pcsbi/blog/2015/03/05/using-the-least-restrictive-limits-in-public-health-emergencies/#respond Thu, 05 Mar 2015 15:08:46 +0000 https://bioethicsarchive.georgetown.edu/pcsbi/blog/?p=1580 The Presidential Commission for the Study of Bioethical Issues (Bioethics Commission) recently released Ethics and Ebola: Public Health Planning and Response. In this brief, the Bioethics Commission examined U.S. engagement in the global response to the Ebola epidemic with the goals of 1) determining what lessons might be learned from the U.S. response and 2) creating recommendations to support proactive response to public health epidemics.

The Bioethics Commission considered in detail the U.S. public health emergency response with regard to the ethical use of liberty-restricting public health measures that involve monitoring or restricting movement and association, such as quarantine, and the impact of such measures on western African and U.S. health care workers. The Commission’s analysis of the use of restrictive measures highlighted the importance of the principle of least infringement, which holds that the least restrictive measures—grounded in the best available scientific evidence—should be taken to protect the public health and health care workers. Specifically, the Bioethics Commission recommended that:

Governments and public health organizations should employ the least restrictive means necessary—on the basis of the best available scientific evidence—in implementing restrictive public health measures, such as quarantines and travel restrictions, intended to control infectious disease spread. In addition, governments and public health organizations should be prepared to communicate clearly the rationale for such measures and provide ongoing updates to the public about their implementation, with particular attention to the needs of those most directly affected.

The Bioethics Commission stressed the importance of ethical preparedness and planning, with an emphasis on transparency and consensus in decision making through democratic deliberation, a process that fosters public engagement. The Commission emphasized using deliberative democratic processes to provide citizens with sound scientific and ethical justifications for public health policies. Drawing on the principles of least infringement, beneficence and non-maleficence, reciprocity, justice and fairness, and the harm principle—in addition to lessons from the current Ebola epidemic and other public health crises, including HIV/AIDS, SARS, and tuberculosis—the Bioethics Commission concluded that public health officials should implement the least restrictive measures that are effective in controlling disease transmission during a public health emergency.

The brief and all other Bioethics Commission reports are available at Bioethics.gov.

]]>
https://bioethicsarchive.georgetown.edu/pcsbi/blog/2015/03/05/using-the-least-restrictive-limits-in-public-health-emergencies/feed/ 0
Bioethics Commission Releases Brief on Ebola and Ethics Preparedness for Public Health Emergencies https://bioethicsarchive.georgetown.edu/pcsbi/blog/2015/02/26/bioethics-commission-releases-brief-on-ebola-and-ethics-preparedness-for-public-health-emergencies/ https://bioethicsarchive.georgetown.edu/pcsbi/blog/2015/02/26/bioethics-commission-releases-brief-on-ebola-and-ethics-preparedness-for-public-health-emergencies/#respond Thu, 26 Feb 2015 13:02:18 +0000 https://bioethicsarchive.georgetown.edu/pcsbi/blog/?p=1575 Today, the Presidential Commission for the Study of Bioethical Issues (Bioethics Commission) released a brief, Ethics and Ebola: Public Health Planning and Response, to the administration and the public on ethical preparedness for public health emergency response, with a focus on the U.S. response to the current Ebola epidemic in western Africa. The brief considers what lessons the U.S. response to the epidemic has for ethics preparedness for future public health emergencies, emphasizing the role of proactive democratic deliberation in developing responses that reflect public values in a pluralistic society and an increasingly interconnected world. The brief also considers two areas of particular controversy: 1) the ethical use of liberty-restricting public health measures, such as quarantine; and 2) the ethical conduct of research during public health emergencies.

In this brief the Bioethics Commission endorsed the ongoing participation of the United States in the global response to the Ebola epidemic for both ethical and prudential reasons. Public health crises like the Ebola epidemic often occur in countries and communities least equipped to manage and control them. The magnitude of suffering caused by these crises, and global inequalities in wealth and power that contribute to them, provide a strong moral imperative grounded in humanitarianism and justice to contribute to response efforts. In addition, given the capacity of infectious diseases to travel easily in an interconnected world, addressing epidemics at their source is justified on prudential grounds. Safeguarding national health security provides a strong pragmatic reason to respond to public health emergencies where they occur, and to support ongoing efforts to strengthen capacity and public health infrastructure in affected areas.

Strong international and U.S. federal public health infrastructures are essential for responding effectively to public health emergencies and their short- and long-term consequences. In Ethics and Ebola the Bioethics Commission recommended that the United States strengthen key elements of its domestic and global health emergency response capabilities, including leadership and global collaboration, and engage actively in effective public education and communication.

Ethics preparedness for emergency response, both at home and abroad, calls for an approach to policy making that prioritizes early public engagement, building consensus, and transparency. A proactive process of democratic deliberation before the onset of a crisis can inform and facilitate the development of public health policies that reflect shared values. However, democratic deliberation can be particularly challenging in the midst of a crisis, when information is changing rapidly, and policies and their implementation might need to be reconsidered. The Bioethics Commission recommended that ethical principles be integrated into public health decision making, and that qualified public health ethics expertise be readily available in an emergency to ensure that decision makers identify and respond to relevant ethical considerations in light of real-time available evidence.

In its next project the Bioethics Commission will consider in more depth the importance of democratic deliberation and public education in bioethics. The U.S. response to the Ebola epidemic in western Africa is a timely reminder of why broader public engagement in the ethical dimensions of health decision making is critical, both now and in anticipation of the future.

The brief is available at Bioethics.gov. Look for additional blog posts about each of the brief’s recommendations to be posted to blog.Bioethics.gov.

]]>
https://bioethicsarchive.georgetown.edu/pcsbi/blog/2015/02/26/bioethics-commission-releases-brief-on-ebola-and-ethics-preparedness-for-public-health-emergencies/feed/ 0