Ethical Issues in the Response to Ebola Virus Disease in US Emergency Departments: A Position Paper of the American College of Emergency Physicians, the Emergency Nurses Association and the Society for Academic Emergency Medicine

Abstract

The 2014 outbreak of Ebola Virus Disease (EVD) in West Africa has presented a significant public health crisis to the international health community and challenged US emergency departments to prepare for patients with a disease of exceeding rarity in developed nations. With the presentation of patients with Ebola to US acute care facilities, ethical questions have been raised in both the press and medical literature as to how US emergency departments, emergency physicians, emergency nurses and other stakeholders in the healthcare system should approach the current epidemic and its potential for spread in the domestic environment. To address these concerns, the American College of Emergency Physicians, the Emergency Nurses Association and the Society for Academic Emergency Medicine developed this joint position paper to provide guidance to US emergency physicians, emergency nurses and other stakeholders in the healthcare system on how to approach the ethical dilemmas posed by the outbreak of EVD. This paper will address areas of immediate and potential ethical concern to US emergency departments in how they approach preparation for and management of potential patients with EVD.

Healthcare Workers' Attitudes Toward Patients With Ebola Virus Disease in The United States

“…A question that arises in light of those findings and ours is, what are physicians' obligations to society to care for patients with EVD, and, pari passu, what are society's obligations to physicians? The question of whether there is a duty to treat even when providing care puts the HCW at risk has been addressed by professional organizations whose guidelines suggest that although there is a professional obligation, it is not absolute [ 10 ]. The American Medical Association Code of Ethics states that “Because of their commitment to care for the sick and injured, individual physicians have an obligation to provide urgent medical care during disasters.…”

How Can Emergency Departments Better Prepare for Emerging Infectious Disease Threats? A Returned Traveler With Fever Walks Into Triage…

“…The Journal of Emergency Medicine 569 workers adequate protection that encourages use (18). Furthermore, broader implementation of infection control guidelines would protect against more common infections such as influenza.…”

Emergency Nursing, Ebola, and Public Policy: The Contributions of Nursing to the Public Policy Conversation

“…6 Below we describe this process and the guiding ethical principles, particularly as they pertain to the role of nurses in the ED and in shaping U.S. public policy to protect patients, providers, and society at large. 6 Below we describe this process and the guiding ethical principles, particularly as they pertain to the role of nurses in the ED and in shaping U.S. public policy to protect patients, providers, and society at large.…”

“…To address these concerns, the American College of Emergency Physicians (ACEP), the Emergency Nurses Association (ENA), and the Society for Academic Emergency Medicine (SAEM) worked collaboratively in developing a joint position paper to provide guidance to U.S. emergency physicians, emergency nurses, and other stakeholders in the health care system regarding the approach and management of the ethical issues that arise when responding to public health emergencies like Ebola. 6 Below we describe this process and the guiding ethical principles, particularly as they pertain to the role of nurses in the ED and in shaping U.S. public policy to protect patients, providers, and society at large. EVD raised important ethical and logistical questions for health care providers.…”