Step1: Ethical Issues Analysis
Whatpublic health problems, needs, concerns are at issue?
Ebolais a dangerous viral disease that involve sudden fever, pain in themuscles, intense weakness, sore throat, internal and externalbleeding. The main health concern of Ebola is its rapid outbreak andhigh risks of infection to other people within short time. As a viraldisease, Ebola needs quick intervention and prevention measures tocurb its spread. Furthermore, Ebola has no vaccine or cure and thismakes it more dangerous and fatal (Thompson, 2014).
Whatare appropriate public health goals in this context?
Ebolais a dangerous fatal viral infection and its outbreak demandsstringent public health goals that focus on prevention and control.In particular, prevention methods require adequate public awarenessand education on quick response in the event symptoms are observed.In addition, to public education and awareness is proper isolationand effective disposal of dead bodies and accessories used by thevictims (Thompson, 2014). However, the main public health goal is‘drastic actions’ that encompasses swift response, surveillanceand putting in place effective health infrastructure to provideefficient and quick response to Ebola victims
Whatare the source and scope of legal authority, if any, and which lawsand regulations are relevant?
Ebolacase lies under the World Health Organization. WHO is the legalentity tasked with such health crisis but does not have effectivelaws and regulations to combat such crisis. To this end, there isneed for a model of Emergency Global health Act whose aim would belaying out swift legal framework of addressing health crisis(Thompson, 2014). In addition, the WHO needs more Global health lawdevelopment that will bridge the health inequities between thedeveloped and developing nations. More laws are required to empowerglobal health organizations such as WHO in advancing global healthjustice to all mankind regardless of development.
Whatare the relevant norms and claims of stakeholders in the situationand how strong or weighty are they?
Ebolacrisis falls under the control of international stakeholders such asWHO, UN, UNICEF as well as other intergovernmental health bodies. Therelevant norms of these stakeholders are to respond quickly to suchsituations. WHO, UN and UNICEF responded swiftly after the firstcases of Ebola were reported. However, due to lack of effectivediagnosis officials from these health institutions were not quick toassess the situation.
However,lack of effective public health facilities and superstitious beliefsby the locals interfered with early prevention and reporting leadingto the spread of the disease. Although these claims may be valued,there lies some doubt as to why the disease has remained a threat inWest Africa today. The response and preparedness for emergency by themajor stakeholders needs improvements (Thompson, 2014).
Arethere relevant precedent legal and ethical cases?
Theunprecedented outbreak and continued spread of Ebola presents stronglegal cases. Ethical and legal concerns have been raised in regard tothe production and testing of Ebola vaccine. So far, Ebola vaccinetrials on human have proved fatal and this raises serious ethical andlegal cases on the efficacy of developed vaccine (Thompson, 2014). Inaddition, the continued quarantine practice has elicited variousethical and legal concerns. One is that treatment is risky formedical staffs and the provision of treatment is emotionally drainingto doctors. Furthermore, patients require moral, emotional andphysical support from society member and this is hard due torequirement for isolation. Medical staffs also face quarantine andthis is dehumanizing (The Network for Public Health Law, 2014).
Whichfeatures of the social-cultural-historical context are relevant?
Traditionalbeliefs and rituals on matters of dead has been the greatesthindrance in effectively implementing preventive measures againstEbola. The notion of quarantine is rare in most Western Africancountries communities and this was a great impediment to diseaseprevention. Ebola has long history and it was first discovered inZaire with other subsequent reports in Sudan, Congo and now westernAfrica. Ebola’s prevalent in Western Africa is attributed to socialcultural beliefs and superstitions. Poverty and lack of adequatehealth infrastructure is also to blame (Sambo, 2014).
Doprofessional codes of ethics provide guidance?
Ideally,the treatment, control and prevention of Ebola is just like in therediseases. As such, relevant health and ethical professional codeswere part and parcel of the intervention measures.
Step2: Assess the Ethical Dimensions of the Public Health Options
Utility: Does a particular public health option produce a balance of benefitsover harms?
Theintervention measures adopted in Ebola are fairly balanced onbenefits and harms. For instance the prevention methods of quarantineand proper disposal of dead bodies is well balanced to prevent moresocial harm thereby protecting the community against infections.However, medical staffs face adverse challenges especially beingsubject to 21 days of quarantine before integrating to the community.However, the benefits to the larger society outweigh the individualharms.
Justice: Are the benefits and burdens distributed fairly, and do legitimaterepresentatives of affected groups have the opportunity toparticipate in making decisions?
Oneof the prevention and control strategy implemented in the process ofEbola control has been integrating the communities in decisions onhow to participate in preventing Ebola spread. However, culturalbeliefs and traditions have hampered effective cooperation betweenthe communities and health staffs in Ebola preventions (Sambo, 2014).
Respectfor liberty: Does the public health action respect individualchoices and interests such as autonomy, liberty, and privacy?
Responseto Ebola crisis was and has been an emergency and less time was takento assess individual choices and interests, In Ebola situation thereis no guarantee for liberty and individual choices (The Network forPublic Health Law, 2014). For instance, a doctor serving the Ebolavictims must be subjected to 21 days of isolation to assess is theyhave contacted Ebola. In this case, individual choices and interestsare not guaranteed. Ebola is an emergency serious crisis that cannotbe compromised with individual’s quest for personal interest. Thisavoids jeopardizing prevention measures (Sambo, 2014).
Respectfor legitimate public institutions: Does the public health actionrespect professional and civic roles and values such as transparency,honesty, trustworthiness, promise-keeping, protectingconfidentiality, and protecting vulnerable individuals andcommunities from undue stigmatizations?
Itis reported that Ebola has created a new avenue of stigmatizationespecially from Western developed nations societies who were quick toisolate from immigrants perceived to be from West Africa. Even thelocal communities in most West African countries and Africa ingeneral have resulted to stigmatization of Ebola victims (Sambo,2014). However, no news has been received on accounts of patientnegligence or stigmatization by the medical staffs.
Step3: Providing justification for the selection Public Health action.
Effectiveness: Is the action likely to accomplish the public health goal?
Theprevention measures adopted especially the isolation of suspected anddiseased patient is an important approach that will successfullyavert more spread of Ebola. However, there is need for seriousmeasures to ensures that families of sick patients does not keep orencourage patients to run away from the isolation wards as it hashappened (Thompson, 2014).
Necessity: Is it necessary to override the conflicting ethical claims toachieve the public health goal?
Yesit is necessary and important to override conflicting ethical claimsfor the general good. For instance, many West African communitieshave been against isolation and burying of dead bodies away fromcommunity members (Sambo, 2014). In critical crisis such as Ebolasituation, it is important that individual interest or ethical claimsbe surpassed with measures that promote the general good.
LeastInfringement: Is the action the least restrictive and leastintrusive?
Theintervention actions used in fighting the scourge of Ebola can betermed as both least intrusive and restrictive. The actions are leastrestrictive because community members are involved fully in the fightagainst the spread of Ebola. In addition, the intervention measuressuch as isolation are least restrictive because only infectedindividuals are placed under surveillance.
Proportionality: Will the probable benefits of the action outweigh the infringedmoral considerations and any negative effects?
Itis likely that most of the intervention measures employed to addressthe crisis of Ebola will outweigh the infringed moral considerationsespecially on matters of restricted isolation. War against Ebola justlike other epidemic diseases cannot be adequately won without someform of tradeoffs (Thompson, 2014). The intervention measures such asisolation and burying the dead away are against the local beliefs andtraditions. However, the probable benefits of reduced Ebola spreadwill surpass these negative effects (Sambo, 2014).
Impartiality: Are the burdens and benefits of the action distributed fairly?
Theburden of Ebola crisis has been adequately shared across the globeand this has enhanced concerted efforts and resources in fightingEbola spread and developing vaccine.
Publicjustification: Can public health officials offer publicjustification that citizens, and in particular, those most affected,would find acceptable in principle?
Publichealth officials in the affected areas can absolutely justify thatthe affected communities are well served without prejudice ordiscrimination. In fact, the WHO and UNICEF have formulated plansthrough which relatives of the affected can vast the victims. Thegoal is to enhance community acceptance on the intervention measuresapplied and thereby enhance public participation in the fight againstEbola (Sambo, 2014).
SamboGomes, (2014). “The Ebola epidemic is a serious public healthproblem, but it can still be controlled.” Retrieved fromhttp://www.paho.org/hq/index.php?option=com_content&view=article&id=9822:la-epidemia-de-ebola-es-un-problema-serio-de-salud-publica-pero-todavia-puede-ser-controlado&Itemid=2&lang=en
TheNetwork for Public Health Law. (2014), “Ebola and the Law: what youneed to know.” Retrieved fromhttps://www.networkforphl.org/webinars/2014/08/11/481/ebola_and_the_law_what_you_need_to_know
Thompson,(2014). “Ebola’s deadly spread in Africa driven by Public Healthfailures, cultural beliefs. NationalGeographic.Retrieved fromhttp://news.nationalgeographic.com/news/2014/07/140702-ebola-epidemic-fever-world-health-guinea-sierra-leone-liberia/