Public Health and Ethics, SARS - Research Paper Example

Public Health Paper on Surveillance Ethics Based on a Case Study Public Health Paper on Surveillance Ethics based on a case study Thus far, world systems have been centered on managing various infections, some of which have turned out to be quite challenging. Indeed, viral mutations have seen various joint efforts to combat the many arising viral diseases fail to realize their objectives. In some instances, the methodologies used in managing and controlling the various viral infections have aroused public outcry based on their suitability and ethical compliance. For instance, the management of the respiratory disease, currently referred to as the Severe Acute Respiratory Syndrome (SARS), has been subject to opposition; noting that strategies such as quarantine not only contravene personal rights, but are also legally wanting. Notably, SARS is a highly contagious and airborne infection caused by mutant viral strains. The disease is characterized with acute fever, headaches, muscle pains and breathing problems, just to mention a few. Its pandemics have been observed in various parts of the world, including; China, the UK and Canada and in some sections of the United States. So far, the most effective control measure put forward to combat the menace is controlled movement and quarantine, while antibiotics and antiviral drugs are also used in it management. In this case, the ethical concerns surrounding SARS are critically reviewed. Several ethical considerations should be taken into account in proposing public health strategic plans. Firstly, the program to be implemented must be in a position to promote benefits of the individual and community involved. Since programs are hardly seamless, chances of encountering impediments in the public health program are very high. As a result, the proposed program must be able to aid in alleviation, prevention and total elimination of harm (Petrini, 2013). In cases where the challenges cannot be fully eliminated, the program to be implemented should be in a position to balance the harm and the benefits that are likely to result from its implementation. This implies that in order for the strategy to be enforced to be fully acceptable, it must exhibit an ability to fairly distribute the benefits and burdens to be incurred in it. Also, the plan should be able to promote public participation thus giving a chance to the affected populations to be heard, and an opportunity to air their concerns. Through such allowance of the public participation, there should be due respect for autonomy and liberty of the masses. Further, respect to privacy and confidentiality is vital if specific programs are to be acceptable to the public. Through such commitments, the implementing bodies should be well placed to live by commitments made when creating public awareness. On the contrary though, the program should categorically define instances under which commitments may be broken in a bid to create transparency (Gostin, Bayer and Fairchild, 2003). As earlier noted, this breathing disorder caused by the corona virus is a great challenge to health systems, both in its management and surveillance. As a consequence, many arising concerns have been directed based on the validity and authenticity of strategies being employed in such management ventures, and the compliance thereof of the mechanisms to the various rights and privileges constitutionally accorded to the people. Indeed, it is without doubt that proper surveillance and tracking of the spread of the infectious disease is vital in its successful management. Similarly, it is worth noting that any strategies employed by various healthcare networks in managing the health situation must ensure protection to privacy and safety of the patient, while at the same time taking into account the general good of the un-infected populations that risk getting infected through continued association with the carriers. Thus far, it is a major concern that the tracking strategies put in place to control further spread of the pandemic, as evident in the SARS case study, are not only impractical, but are a general failure in meeting the WHO standards of patient safety and privacy. Indeed, tracking data have been used in promotion of negative ethnicity and racism, a prospect that the world has so far been fighting to alleviate. For instance, it is evident that the widespread cases of SARS in the China locality led to negative stereotype directed towards the Chinese in various parts of the world (Gostin, Bayer & Fairchild, 2003). In some cases, such tracking techniques have hardly been effective following negligible support from the partner institutions such as medical firms. Apparently, many hospitals have hardly implemented rigorous strategies to monitor contact spread of the infection. Also, in cases where the strategies are implemented, this article cites hectic measures that are against the principle of a free and conducive working environment. It beats logic to imagine of intensive questioning of healthcare workers twice daily, and subjecting them to tests that may be against their personal will. Indeed, it is unquestionable that healthcare practices stipulate voluntary testing measures as ideal ways of getting the best out of the employees. The cases of SARS’ monitoring strategies, on the contrary, contravene this general rule by forcefully imposing data checks on the populations. On the positive perspective though, the argument that such forceful implementation of the stringent strategies are aimed at protecting the general public renders the practices ethically valid. It is sometimes necessary for healthcare firms and allied institutions to break certain recessive cultural and social norms to realize the general good for the larger population health. In regards to this pandemic, quarantine and isolation have been widely implemented to curb its further spread. Through isolation, the allied institutions have attempted to create physical boundaries thus limiting association and interactions of the infected people with the general population. The success of this preventive strategy, aimed at limiting the spread of the infection is, nevertheless, questionable; with many issues being raised in regard to its compliance to the limits between liberty and protection. Many have seen this mechanism as a measure that has effectively denied victims the freedom to effectively exploit the full potentials of their lives. On a different front, quarantine, which involves mass segregation and restriction of mobility of persons suspected to have been predisposed to the infection, is more concerning. Arguably, such quarantine techniques, involving restricted movements, can negatively impact on the economic and social being of a people. As revealed in this case, mass quarantine, following suspected cases of SARS, massively paralyzed delivery of public services in the healthcare sector, education sector, and transport systems, and within the hospitality industry. Despite the above developments and challenges in the implementation of the quarantine and isolation strategies, the motives behind such isolative techniques are ethically binding. The aspect of travel advisories should, therefore, be reconsidered, since it is a challenge to the general global good. Based on various legislative measures, the extent to which privacy is fostered in the healthcare sector, in regard to various disease outbreaks, is highly questionable. This questionability of the private aspect comes into specific focus when considering the chains of command followed within the healthcare sector. In this aspect, healthcare firms are required by law to report any instances of SARS to their national centers, which are obligated to report to the WHO for strategic planning and implementation of protective and preventive measures. As such, it is ideal to conclude that total privacy can hardly be realized in a healthcare setting. However, this persistent trend may be concerning, noting the increasing instances of stigmatization and alienation that come with such breach of privacy. Despite this general observation, though, the infringement is a compulsory aspect that is vital to protection of larger populations. Basically, the major objective of the Healthcare sector is to protect further spread of infections to uninfected persons. Before carrying out such venture and taking the bold step of violating privacy standards, it is vital to enlighten the public and the persons involved. Such enlightenment is vital in creating awareness against discriminative acts that may see the sick holding back thus promoting further spread of the infections. As an example, if the infringement of privacy on the extent of the spread of the infection became public, following campaigns to enlighten masses on the same, the extent of racial and ethnic segregation observed could have been highly limited. Moreover, it is, at times, vital to consult with local communities prior to making certain reports public. This strategic measure is ideal in attempts to align the healthcare issue to cultural and social aspirations of a people. Alleviation of such cultural and social conflicts directed towards healthcare is key in ensuring successful protection of a people. Finally, when privacy details are breeched, the information should solely be used for health purposes, and under no circumstance should such information be subjected to politicking and promulgation of social unrest (Gostin, Bayer and Fairchild, 2003). While individualism and communal wellness are antagonistic factors that can hardly be satisfied simultaneously, efforts should be directed in ensuring a non-bias approach and strategy that is vital in the healthcare sector. In this respect, it is unethical to disclose and segregate people in a bid to develop communal good. Equally, it is utterly blatant to protect vital information in order to protect individual privacy. A harmonization of factors surrounding the two vital aspects of healthcare delivery and monitory of contagious diseases, such as SARS, is vital. As a consequence, it is vital for healthcare firms to make the affected individuals understand the need for their periodic alienation. With such understanding, it becomes easier for the people to come out and report cases of SARS to healthcare delivery systems thus making response strategies more effective and non-discriminatory (Institute of Population and Public Health, 2012). It should also be noted that while opinions of the residents in the locality to be subjected to quarantine may be sought after, in attempts to ensure transparency and accountability of the programs, there are vital instances when people must be forcefully subjected to quarantine or isolation. This forceful strategy is, especially, vital in instances where the citizens are less cooperative or futile towards the disease management programs. For instance, while is ideal for the people to be provided with the opportunity to undertake tests that determine whether they are to be subjected to quarantine or not, some people in the region may turn out to be aggressive towards such test programs. In such cases, the non- compliant individuals must be forcefully quarantined. Even if such a measure may appear unethical at individual level, it is communally ethical and ideal. Following such quarantine measures, various compensatory measures should be put in place to support the livelihood of the victims of the program. This program is ideal, noting that restricted movement highly poses a negative impact on the economic freedom and ability of the people. It is hence critical to support the success of poor communities and personalities by availing aid programs (Petrini, 2013). For quite a long time, disease outbreaks in various localities have often received travel restrictions, as currently observed with the Ebola cases in West Africa. However, the suitability of such advisories to the general well-being and international integration is questionable. With increased globalization, the level of dependence on world economies has been increased, with the less advantaged developing nations highly depending on the developed economies to spearhead the revitalization of the developing economies. The result has seen massive progress, with many students and business personnel traversing the world to improve livelihoods in their home countries. Sadly though, the travel advisories have often hampered this free movement of people and goods in and out of areas purported to be under SARS prevalence. This aspect is deleterious to the success gained in international integration. In addition, such advisories may affect the welfare of individuals who are not infected with the disease (Gostin, Bayer and Fairchild, 2003). Despite the above concerns though, it must be noted that the rapidity with which the nations and states respond to the outbreaks is vital in attempts to initiate timely management of the situations. Therefore, it is ideal to impose screening services on individuals from the sections of the world under scrutiny for SARS. Further it is necessary to mount alienation of such people for some time, since the infections may be in their incubation period thus rendering seemingly healthy people a threat to social welfare. In fact, some of the persons from the regions under scrutiny for the infection who appear healthy may turn out to be super-spreaders of SARS. In cases where immigrants are found to be carriers of, or infected with SARS, they should be accorded the opportunity to choose whether to continue with the alienation program within their new locality, or whether they would like to be deported back to their nations of origin. This latter strategy of deportation acts as the maximal limit to which the freedom of choice can be accorded in this state, if freedom of choice of the individuals is to be considered in regards to societal or communal safety. Further, travel advisories should only be given out by the respective nations in instances where it is proved beyond reasonable doubt that the purposed disease is existent in the specified region (Institute of Population and Public Health, 2012). In view of the declaration of Helsinki, it is a normal requirement that one is only exposed to risk under their personal consent. This is, however, hardly experienced in normal settings. The state is obligated to accord maximal protection to people, both at individual and communal levels (Nuffield Council on Bioethics, 2007). This concerning observation, where the rights of an individual to liberty is infringed, is common in systems with various health inequalities. Therefore, it is often vital to create liberal frameworks to control such inequalities. Through such liberal programs, the state of ill health should be minimized and even alleviated, with various support facilities established to aid in creating equality within the unequal sectors. In the case of tracking SARS, it is notable that different strategies have often been employed by different nations to stem the spread. Concerning though is the realization that economic and political influences have often played critical roles in the implementation of vital programs like quarantine. Through such external influences, discrimination against given sections of the population have often been effected. This is against the principle of equality and minimal external influence advocated for in health systems by the WHO guidelines. In more serious cases, a ‘one-fits-all’ approach has often been implemented. The concern with this type of approach, however, is the observation that socio-economic perspectives have greater influence on healthcare outcomes in different localities. As a result, the acceptability and opposition to various programs remarkably vary from one end of the earth to another. As a result, it is conclusible that; while imposing quarantine may be effective in one locality, say Canada, it may equally be futile, less acceptable and less effective in another region like China. Therefore, the most ideal way of tackling health challenges is to eliminate unfair inequalities. This involves promotion of equality of opportunities, outcomes and statuses (Nuffield Council on Bioethics, 2007). So far, a major challenge has been encountered in attempts to create equal social and economic setups, a move which is vital in curbing further spread of SARS. However, strategic improvement of the welfare of the worst affected, while equally lowering the welfare of those at the top may prove vital in this cause. Such a move helps in promotion of both individual and communal ethical values. Indeed, it is high time the information-only approach was replaced with the more practical action-oriented approach. It is only when the various legislative measures to stem inequality, and curb the spread of SARS are implemented; when successful alleviation of the viral pandemic can be realized. In view of the Mill’s Harm Principle, it is obvious that while individual liberty, as advocated by the libertarians, is ideal under normal circumstances, special circumstances may call for governmental intervention and control; as outlined the collectivist sects. Being a highly contagious infection, the management of SARS requires governmental intervention strategies, including quarantine, regardless of whether such intervention would imply an infringement into personal rights as entailed within the constitution. Indeed, the freedom to liberty and personal decisions is a highly regulated right, which can only remain valid as long as the welfare of the community is fully taken into account. According to Mill, the sole-end to which mankind is warranted is self protection. This directly implies that power can be practiced over a person in attempts to ensure protection to others. In this respect, it is worth highlighting that personal welfare is not a reason sufficient enough to warrant harm to others (Nuffield Council on Bioethics, 2007). As such, it is important for the state to intervene in special circumstances to warrant protection to the endangered populations, including; women and children. For instance, in the case of the SARS discussed herein, it is obvious that an individual infected with the corona virus poses great threat to the community. Similarly, the Mill’s principle should be strategically employed in isolation of such patients, and consequent administration of practical treatment and preventive measures. Reference Canadian Institutes of Health Research – Institute of Population and Public Health. (2012). Population and public health ethics: cases from research, policy, and practice. University of Toronto Joint Centre for Bioethics: Toronto. Gostin, L., Bayer, R. & Fairchild, A. (2003). Ethical and legal challenges posed by severe acute respiratory syndrome: implications for the control of severe infectious disease threats. Journal of American Medical Association. Nuffield Council on Bioethics. (2007). Public health: ethical issues. Nuffield Council on Bioethics. Petrini, P. (2013). Ethics in public health surveillance. Istituto Superiore di Sanità. Read More