Outbreaks of disease, especially those that are declared a Public Health Emergency of International Concern, present substantial ethical challenges. Here we start a discourse (with a continuation of the dialogue in Ethics of Outbreaks Position Statement. Part 2: Family-Centered Care) concerning the ethics of the provision of medical care, research challenges and behaviors during a Public Health Emergency of International Concern with a focus on the proper conduct of clinical or epidemiologic research, clinical trial designs, unregistered medical interventions (including vaccine introduction, devices, pharmaceuticals, who gets treated, vulnerable populations, and methods of data collection), economic losses, and whether there is a duty of health care providers to provide care in such emergencies, and highlighting the need to understand cultural diversity and local communities in these efforts.
This position statement uses a literature review and expert consensus from the Society of Critical Care Medicine Ethics committee. The committee had representation from ethics, medical philosophy, critical care, nursing, internal medicine, emergency medicine, pediatrics, anesthesiology, surgery, and members with international health and military experience.
Keywords: disease outbreaks, ethics, experimental therapies, medical research, moral duty, public health
Thomas J. Papadimos, MD,; Evadne G. Marcolini, MD; Mehrnaz Hadian, MD; George E. Hardart, MD; Nicholas Ward, MD; Mitchell M. Levy, MD; Stanislaw P. Stawicki, MD, MBA; Judy E. Davidson, DNP, RN