Context and Ethical Challenges During the Ebola Outbreak in West Africa

The philosophical discipline of ethics examines good, bad, right, wrong and how people live as individuals within a community. Bioethics investigates research in healthcare and medicine, examining public policy as it relates to healthcare and how resources are allocated. This includes: difficult, private, individual decisions, which occur in clinical settings; dilemmas during clinical trials; and controversies surrounding novel research. It is important to understand that ethical considerations related to health care ethics and those that pertain to public health are often seen from different perspectives. In public health, decisions are made within a context and a framework through principles which guide action that affect communities and populations. These decisions and actions are made with and involve, stakeholders to include: traditional, community and religious leaders; government officials; and private and commercial stake holders. The underlying principles of both public health ethics and bioethics are the same, namely equality, justice, beneficence, non-maleficence, veracity and fidelity. Health care ethics supports the rights of individuals. Under the same umbrella of health care ethics are medical ethics, clinical ethics and research ethics. These disciplines offer views that support the rights of individuals. Ethics in public health is very complex with a myriad of issues to include diverse groups of people in different situations, which have to be taken into account from the view of what is best for the population. Evaluating the components of a public health system, how resources are developed and the economic support available to communities is crucial. Access to care and the equitable and just allocation of resources are important factors; and questions about equal access for the poor, the socially disadvantaged and immigrants should be examined.