Public Health Ethics in Pandemic Planning

Ethical Issues in Disaster and Pandemic Preparedness & Response

• The presentation covers ethical issues in disaster and pandemic preparedness and response, with a focus on global health themes.
• Key topics include public health ethics in disaster/emergency planning and responses, global health ethics, and ethical considerations in allocation of resources in a humanitarian crisis.
• The material references COVID-19 as a recent example of ethical challenges and discussions.
• Key concepts include disaster and pandemic preparedness and planning, emergency planning, ethical and legal considerations related to pandemics.
• The ethical analysis related to COVID-19 in Canada is discussed thoroughly.
• Professional responsibilities and duties in various contexts relevant to COVID-19 and other disasters/emergencies, and criticisms of global health ethics.
• Humanitarian work, pharmaceutical access, and nursing opportunities for novice nurses are mentioned.
• Key questions for guiding action in global health are identified.

Emergency Preparedness/Disaster Planning

• Four pillars of emergency management are prevention/mitigation, preparedness, response, and recovery.
• Prevention and mitigation involve minimizing risk, identifying and preventing them.
• Preparedness involves simulation and how to respond quickly during emergences.
• Response includes the immediate reaction, mobilizing responders, and coordinating appropriate care in a disaster context.
• Recovery involves returning to normal after the event and debriefing.
• There's a crucial link between emergency management and the CNA Code of Ethics. Nurses are instructed in the provision of care via appropriate safety precautions in accordance with legislation and guidelines.

Disaster Nursing Competencies

• The ICN Framework of Disaster Nursing Competencies, highlighting prevention/mitigation, preparedness, response, and recovery competencies is presented.
• The competencies involve Risk Reduction, Disease Prevention and Health Promotion, Policy Development and Planning, Ethical Practice, Legal Practice, Accountability, Communication and Information Sharing.
• Education and Preparedness, Care of the Community, Care of Individuals and Families, Psychological Care, Care of Vulnerable Populations, and Long-term Individual, Family, and Community Recovery.

Phases of Disaster Linked to the Nursing Process

• Each phase of a disaster (preparedness, response, and recovery) is linked to the nursing process.
• Preparedness involves assessing the region, conducting hazard vulnerability assessments, and developing care plans.
• Response involves implementation of care plans, training programs, drills, and exercises.
• Evaluation is necessary, including the evaluation of training, drills, and exercises for those with access and functional needs during disasters.
• Operational plans are also evaluated.

Ethical Considerations in Resource Allocation During Crises

• Scarcity is a primary ethical consideration.
• Prioritizing those who have the highest medical need and life expectancy, according to triage principles is highlighted.
• Ethical values and guiding principles are established for rationing resources in scarcity situations.
• These values include maximizing benefits, saving lives, and promoting instrumental values.
• Some triage methods are first-come, first-served, random selection, or selection based on prior medical contributions.

Ethical Considerations for Contact Tracing

• Surveillance and the use of data for contact tracing raised issues of human rights and liberties.
• This blurred line requires legal policies to contain the use of proximity tracking technologies.
• Data protection protocols in public health interventions are warranted.

Ethical Considerations for Global Health

• Issues of power imbalances, informed consent, access to care, confidentiality of research data, and equity in drug trials are addressed.
• Moral duties across nations and across political divides.
• Understanding of global health, and moral relativism versus universalism.
• Resource allocation and the problem of how to fairly allocate limited resources in developing countries and amongst various communities.
• Neo-colonial trends and their impact on ethical considerations.

Humanitarian Principles and Action

• Fundamental humanitarian principles, including the centrality of saving life, reducing suffering, and promoting human dignity are stated. Principles such as impartiality, neutrality, independence, and humanitarians aiding irrespective of political or economic considerations are discussed.
• Humanitarian action and its complexities during crises like the Covid-19 pandemic are cited, with attention to the need to prepare adequately in a context of growing displacement.
• Ethical considerations for humanitarian actions are highlighted, along with the potential for conflict and crises affecting the work of humanitarian organizations.
• The ethical framework for global action has to consider the power imbalances and cultural contexts of the involved parties.

Whistle Blowing

• Nurses have a responsibility to address organizational concerns and act responsibly, for instance protecting whistle-blowers who have provided reasonable grounds.
• The need to create moral communities is stressed.

What Should We Have Done Better?

• Lessons drawn from the COVID-19 pandemic response are articulated.
• The review highlights the need for capacity-building, transparent communication, increased collective engagement, and careful consideration of collateral impacts of the pandemic and its recovery.

Preserving Dignity in Neglect

• The presentation highlights the stark examples of neglect witnessed during the COVID-19 pandemic.
• Critical issues emphasized include the need for advocacy, family-centred care and a palliative approach.
• Structural vulnerabilities are noted as contributing factors in neglect situations.

Global Health Ethics for Students

• The material provides an overview of global health ethics, covering themes and considerations about power imbalances, ethical issues, resource allocation, and relevant ethical concerns.

This quiz explores the fundamental ethical principles and considerations in public health during a pandemic. It addresses topics such as health equity, resource triage, and the responsibilities of healthcare workers. Participants will gain insights into the ethical dilemmas faced in global health discussions, particularly in crisis situations.