Ethical concerns for anesthesiologists during an Ebola threat

PURPOSE: The World Health Organization has proclaimed the current Ebola outbreak as a public health emergency. If an outbreak of Ebola should occur in Canada, anesthesiologists and anesthesia departments may be called upon to respond. The purpose of this review is to highlight and discuss potential ethical concepts that may be relevant to anesthesiologists. SOURCE: A thorough literature search was conducted using a variety of MEDLINE(®) sources, and we used Stand on Guard for Thee. Ethical Considerations in Preparedness Planning for Pandemic Influenza, a report by The University of Toronto Joint Centre for Bioethics Pandemic Influenza Working Group, as the framework for our review. PRINCIPAL FINDINGS: Two groups of ethical concerns were identified. The first group relates to public health ethics, which analyzes the morality of public health interventions, and the second group relates to medical ethics, particularly to “the duty to care”. The Canadian Medical Association Code of Ethics is vague in the description of duties of physicians who may respond to high-risk contagious diseases. CONCLUSIONS: Government, public health authorities, and anesthesia departments need to be prepared to respond to an outbreak of Ebola. Anesthesiologists have a skill that is suited to treat the complications of Ebola virus disease, and in case they are called for duty, anesthesiologists should be aware of the ethical concerns of treating a highly contagious communicable disease.