Preparing for an Influenza Pandemic: Ethical Issues

Abstract

In the near future, experts predict, an influenza pandemic will likely spread throughout the world. Many countries have been creating a contingency plan in order to mitigate the severe health and social consequences of such an event. Examination of the pandemic plans of Canada, the United Kingdom and the United States, from an ethical perspective, raises several concerns. One: scarcity of human and material resources is assumed to be severe. Plans focus on prioritization but do not identify resources that would be optimally required to reduce deaths and other serious consequences. Hence, these plans do not facilitate a truly informed choice at the political level where decisions have to be made on how much to invest now in order to reduce scarcity when a pandemic occurs. Two: mass vaccination is considered to be the most important instrument for reducing the impact of infection, yet pandemic plans do not provide concrete estimates of the benefits and burdens of vaccination to assure everyone that the balance is highly favorable. Three: pandemic plans make extraordinary demands on health care workers, yet professional organizations and unions may not have been involved in the plans' formulation and they have not been assured that authorities will aim to protect and support health care workers in a way that corresponds to the demands made on them. Four: all sectors of society and all individuals will be affected by a pandemic and everyone's collaboration will be required. Yet, it appears that the various populations have been inadequately informed by occasional media reports. Hence, it is essential that plans are developed and communication programs implemented that will not only inform but also create an atmosphere of mutual trust and solidarity; qualities that at the time of a pandemic will be much needed.

Some factors affecting the decision on non-mandatory vaccination in an influenza pandemic: comparison of pandemic (H1N1) and seasonal influenza vaccination

“…Our findings may be of benefit in planning vaccination strategies in forthcoming influenza seasons. In the case of a pandemic threatening, more attention needs to be directed into (i) providing models that accord with the vaccination implementation strategy and (ii) educating and informing the general public about the influenza, the vaccine, vaccine manufacturing process, risk factors etc., with particular emphasis on risk communication in the mass media "that will not only inform but also create an atmosphere of mutual trust and solidarity" (36). Explaining the advantages and disadvantages of vaccination versus non-vaccination would help in achieving appropriate awareness among the public and assist the empowerment of an individual in regard to his/her health.…”

Pandemic influenza preparedness: an ethical framework to guide decision-making

“…When should hospitals cancel elective surgeries or restrict hospital visitation? To date, the bioethics community has been slow to respond to public health issues in general [6,7], and pandemic influenza planning in particular [8,9]. In this paper we discuss the need for ethics in pandemic influenza planning and discuss the ethical framework we developed to guide pandemic planning in hospitals.…”

Lay people's interpretation of ethical values related to mass vaccination; the case of A(H1N1) vaccination campaign in the province of Quebec (French Canada)

“…Participants were contacted by telephone by an independent survey enterprise through a random digit dialing method for each city until each focus group had reached its quota for each of the four criteria (global response rate 62%). Globally, the 100 participants were broken down as follows: gender (50 male, 50 female); age (18-24; n = 16), (25)(26)(27)(28)(29)(30)(31)(32)(33)(34): n = 17), (35)(36)(37)(38)(39)(40)(41)(42)(43)(44): n = 17), (45-54: n = 17), (55-64: n = 18), (65 + : n = 15); education (secondary: (n = 32), (some college: n = (34), (university: n = 32); vaccination (vaccinated: n = 51), (not vaccinated: n = 49). Focus group participants were invited to debate the following questions related to values challenged through vaccination interventions as well as by the media and public health institution communications strategies: Q1: Did public healthcare messages on civic duty (devoir civique) disturb you or make you feel guilty?…”