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Ethics of emerging infectious disease outbreak responses: Using Ebola virus disease as a case study of limited resource allocation
Emerging infectious diseases such as Ebola Virus Disease (EVD), Nipah Virus Encephalitis and Lassa fever pose significant epidemic threats. Responses to emerging infectious disease outbreaks frequently occur in resource-constrained regions and under high pressure to quickly contain the outbreak prio...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7853513/ https://www.ncbi.nlm.nih.gov/pubmed/33529237 http://dx.doi.org/10.1371/journal.pone.0246320 |
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author | Nichol, Ariadne A. Antierens, Annick |
author_facet | Nichol, Ariadne A. Antierens, Annick |
author_sort | Nichol, Ariadne A. |
collection | PubMed |
description | Emerging infectious diseases such as Ebola Virus Disease (EVD), Nipah Virus Encephalitis and Lassa fever pose significant epidemic threats. Responses to emerging infectious disease outbreaks frequently occur in resource-constrained regions and under high pressure to quickly contain the outbreak prior to potential spread. As seen in the 2020 EVD outbreaks in the Democratic Republic of Congo and the current COVID-19 pandemic, there is a continued need to evaluate and address the ethical challenges that arise in the high stakes environment of an emerging infectious disease outbreak response. The research presented here provides analysis of the ethical challenges with regard to allocation of limited resources, particularly experimental therapeutics, using the 2013–2016 EVD outbreak in West Africa as a case study. In-depth semi-structured interviews were conducted with senior healthcare personnel (n = 16) from international humanitarian aid organizations intimately engaged in the 2013–2016 EVD outbreak response in West Africa. Interviews were recorded in private setting, transcribed, and iteratively coded using grounded theory methodology. A majority of respondents indicated a clear propensity to adopt an ethical framework of guiding principles for international responses to emerging infectious disease outbreaks. Respondents agreed that prioritization of frontline workers’ access to experimental therapeutics was warranted based on a principle of reciprocity. There was widespread acceptance of adaptive trial designs and greater trial transparency in providing access to experimental therapeutics. Many respondents also emphasized the importance of community engagement in limited resource allocation scheme design and culturally appropriate informed consent procedures. The study results inform a potential ethical framework of guiding principles based on the interview participants’ insights to be adopted by international response organizations and their healthcare workers in the face of allocating limited resources such as experimental therapeutics in future emerging infectious disease outbreaks to ease the moral burden of individual healthcare providers. |
format | Online Article Text |
id | pubmed-7853513 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-78535132021-02-09 Ethics of emerging infectious disease outbreak responses: Using Ebola virus disease as a case study of limited resource allocation Nichol, Ariadne A. Antierens, Annick PLoS One Research Article Emerging infectious diseases such as Ebola Virus Disease (EVD), Nipah Virus Encephalitis and Lassa fever pose significant epidemic threats. Responses to emerging infectious disease outbreaks frequently occur in resource-constrained regions and under high pressure to quickly contain the outbreak prior to potential spread. As seen in the 2020 EVD outbreaks in the Democratic Republic of Congo and the current COVID-19 pandemic, there is a continued need to evaluate and address the ethical challenges that arise in the high stakes environment of an emerging infectious disease outbreak response. The research presented here provides analysis of the ethical challenges with regard to allocation of limited resources, particularly experimental therapeutics, using the 2013–2016 EVD outbreak in West Africa as a case study. In-depth semi-structured interviews were conducted with senior healthcare personnel (n = 16) from international humanitarian aid organizations intimately engaged in the 2013–2016 EVD outbreak response in West Africa. Interviews were recorded in private setting, transcribed, and iteratively coded using grounded theory methodology. A majority of respondents indicated a clear propensity to adopt an ethical framework of guiding principles for international responses to emerging infectious disease outbreaks. Respondents agreed that prioritization of frontline workers’ access to experimental therapeutics was warranted based on a principle of reciprocity. There was widespread acceptance of adaptive trial designs and greater trial transparency in providing access to experimental therapeutics. Many respondents also emphasized the importance of community engagement in limited resource allocation scheme design and culturally appropriate informed consent procedures. The study results inform a potential ethical framework of guiding principles based on the interview participants’ insights to be adopted by international response organizations and their healthcare workers in the face of allocating limited resources such as experimental therapeutics in future emerging infectious disease outbreaks to ease the moral burden of individual healthcare providers. Public Library of Science 2021-02-02 /pmc/articles/PMC7853513/ /pubmed/33529237 http://dx.doi.org/10.1371/journal.pone.0246320 Text en © 2021 Nichol, Antierens http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Nichol, Ariadne A. Antierens, Annick Ethics of emerging infectious disease outbreak responses: Using Ebola virus disease as a case study of limited resource allocation |
title | Ethics of emerging infectious disease outbreak responses: Using Ebola virus disease as a case study of limited resource allocation |
title_full | Ethics of emerging infectious disease outbreak responses: Using Ebola virus disease as a case study of limited resource allocation |
title_fullStr | Ethics of emerging infectious disease outbreak responses: Using Ebola virus disease as a case study of limited resource allocation |
title_full_unstemmed | Ethics of emerging infectious disease outbreak responses: Using Ebola virus disease as a case study of limited resource allocation |
title_short | Ethics of emerging infectious disease outbreak responses: Using Ebola virus disease as a case study of limited resource allocation |
title_sort | ethics of emerging infectious disease outbreak responses: using ebola virus disease as a case study of limited resource allocation |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7853513/ https://www.ncbi.nlm.nih.gov/pubmed/33529237 http://dx.doi.org/10.1371/journal.pone.0246320 |
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