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      Medical Ethics in Disasters

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          Abstract

          Disasters frequently create demands that outstrip available existing medical and societal resources. This may be particularly problematic for giving medical care, because disasters may destroy the infrastructures necessary to both provide patients care and keep new health problems from emerging. Disaster may, for example, not only strike care providers and hospital facilities directly; they may decimate communities’ capacities to provide food to the population and carry out critical waste disposal services. All these effects may be most important to policymakers and care providers deciding triage priorities during disasters. Referring to just these two examples, food and waste disposal services, for instance, care providers should treat first not only other care providers, who can, then, take care of others, but food preparers and waste disposal personnel, likewise, to save the most lives. These two examples are just a few among many that warrant priority for this same reason.

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          Most cited references 25

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          Ethical and legal challenges posed by severe acute respiratory syndrome: implications for the control of severe infectious disease threats.

          The appearance and spread of severe acute respiratory syndrome (SARS) on a global level raised vital legal and ethical issues. National and international responses to SARS have profound implications for 3 important ethical values: privacy, liberty, and the duty to protect the public's health. This article examines, through legal and ethical lenses, various methods that countries used in reaction to the SARS outbreak: surveillance and contact tracing, isolation and quarantine, and travel restrictions. These responses, at least in some combination, succeeded in bringing the outbreak to an end. The article articulates a set of legal and ethical recommendations for responding to infectious disease threats, seeking to reconcile the tension between the public's health and individual rights to privacy, liberty, and freedom of movement. The ethical values that inform the recommendations include the precautionary principle, the least restrictive/intrusive alternative, justice, and transparency. Development of a set of legal and ethical recommendations becomes even more essential when, as was true with SARS and will undoubtedly be the case with future epidemics, scientific uncertainty is pervasive and urgent public health action is required.
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            Heroes of SARS: professional roles and ethics of health care workers

            Summary Objectives. To examine the professional moral duty of health care workers (HCWs) in the outbreak of severe acute respiratory syndrome (SARS) in 2003. Methods. Descriptive discussion of media reports, analysis of ethical principles and political decisions discussed in the outbreak, with particular emphasis on the events in mainland China and Taiwan. Results. There were differences in the way that Taiwan and mainland China responded to the SARS epidemic, however, both employed techniques of hospital quarantine. After early policy mistakes in both countries HCWs were called heroes. The label ‘hero’ may not be appropriate for the average HCW when faced with the SARS epidemic, although a number of self-less acts can be found. The label was also politically convenient. Conclusions. A middle ground for reasonable expectations from HCW when treating diseases that have serious risk of infection should be expected. While all should act according to the ethic of beneficence not all persons should be expected to be martyrs for society.
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              Concept of Operations for Triage of Mechanical Ventilation in an Epidemic

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                Author and article information

                Contributors
                jryan@sgul.ac.uk
                102184300 , 102183002 , apcchb@freeler.nl
                cbeadling@cdham.org
                mozumdera138@mod.uk
                d.nott@imperial.ac.uk
                norman.rich@usuhs.edu
                +31104229960 , whenny@online.nl
                dmacgarty@hotmail.com
                edmund.howe@usuhs.edu
                Journal
                978-1-4471-2927-1
                10.1007/978-1-4471-2927-1
                Conflict and Catastrophe Medicine
                Conflict and Catastrophe Medicine
                A Practical Guide
                978-1-4471-2926-4
                978-1-4471-2927-1
                18 July 2013
                : 91-110
                Affiliations
                [1 ]GRID grid.264200.2, ISNI 0000 0000 8546 682X, Department of Cardiac and Vascular Sciences, , St George's University of London, ; London, United Kingdom
                [2 ]Buma Health Care Services, Rotterdam, The Netherlands
                [3 ]GRID grid.265436.0, ISNI 0000000104215525, Department of Military and Emergency Medicine, Center for Distaster and Humanitarian Assistance Medicine, Uniformed Services, , University of Health Sciences, ; Bethesda, Maryland USA
                [4 ]Defence Medical Services-Whittington, Lichfield, Staffordshire United Kingdom
                [5 ]GRID grid.439369.2, Department of Surgery, , Chelsea and Westminster Hospital, ; London, United Kingdom
                [6 ]GRID grid.265436.0, ISNI 0000000104215525, The Norman M. Rich Department of Surgery, Uniformed Services, , University of Health Sciences, ; Bethesda, Maryland USA
                [7 ]GRID grid.10419.3d, ISNI 0000000089452978, Formerly of Department of Surgery, , University Hospital, ; Rotterdam, The Netherlands
                [8 ]GRID grid.416224.7, ISNI 0000000404170648, Department of Gastroenterology, , Royal Surrey County Hospital, ; Guildford, Surrey United Kingdom
                GRID grid.265436.0, ISNI 0000000104215525, Department of Psychiatry, , Uniformed Services University of the Health Sciences, ; Bethesda, MD 20814 USA
                Article
                6
                10.1007/978-1-4471-2927-1_6
                7121800
                © Springer-Verlag London 2014

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

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                © Springer-Verlag London 2014

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