Emergency Preparedness: Applying Ethical Practices to Deliver Alternative Methods of Care for an Ebola Outbreak in the United States

According to the CDC (2014), the West African Ebola outbreak could spread to over half a million people if current trends continue.  The World Health Organization reports that there has been over 22,000 confirmed cases of Ebola across Guinea, Liberia, Sierra Leone, Nigeria, as well as in many countries across the globe.  Although the outbreak has primarily been contained to West African countries, the possibility that an outbreak can occur on U.S. soil has become a reality, with both the air travel of civilians and the practice of evacuating American health care workers infected with Ebola from West Africa to the U.S. for treatment.  So far, preparedness for an Ebola outbreak in the U.S. has focused largely on developing a vaccine and effective treatment practices.  However, no preparedness plan is complete without addressing the ethical issues likely to confront our society during an outbreak.

There are difficult moral questions that the U.S. needs to address while there is still time to think critically, carefully, and calmly about what ethical values should guide decision makers, healthcare workers, and the general public in the event of an Ebola outbreak in the U.S. These questions include, among others:

• Do health care workers have a duty to help Ebola victims even if doing so means risking their own lives or those of their families?
• If health care workers bravely accept these risks, what will society give them in return? 
• How will Americans react when outbreak containment measures such as isolation and quarantine are implemented?
• Who should have priority for limited healthcare supplies such as vaccines and convalescent blood transfusions?

This presentation will seek to answer these questions by using ethical principles and values and by applying similar ethical guidelines developed for pandemic influenza in the U.S.  It is imperative that we ethically maintain the value of justice by directing scarce resources to where they will do the most good for us all and by letting the public know why it is we have chosen a particular distribution method. The preparation for an outbreak will ultimately ensure that the U.S. can survive.