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Interventions of proven efficacy, implemented under conditions in which their benefits to society outweigh their well-understood and potentially far-reaching consequences. Establishment of clear authority for public health decision making during a pandemic see Item 3 below.


Workshop participants noted several critical weaknesses in current structures and strategies for pandemic planning. It is worth noting that the application of ethical values in formulating plans may be as, or more, important than the ethical values in the plans themselves, although both are critical elements in the planning process.

Longstanding conflicts between federal and state claims to public health authority, as demonstrated following hurricanes Katrina and Rita.

Pandemic influenza

Insufficient engagement of state public health officials by federal pandemic planners. Poor communication between state and local public health officials and hospital administrators. Transparency in policy making and clear risk communication are necessary, but not sufficient, to ensure that fairness and justice prevail in the face of a threatened pandemic.

Many workshop participants suggested that there was a need for a transparent, ethical decision-making process that incorporates public debate and deliberation and that has as its goal the selection of interventions that are both understood by, and acceptable to, most people.

Manual Preparing for Pandemic Flu (Irem Key Report)

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IOM Institute of Medicine. Kotalik J. Preparing for an influenza pandemic: Ethical issues. Bioethics 19 4 Last JM, Ed. A Dictionary of Epidemiology. Rosenberg C. What is an epidemic? AIDS in historical perspective. In Rosenberg C, ed. New York: Cambridge University Press. On pandemics and the duty to care: Whose duty?

Who cares? BMC Medical Ethics Reflections on the swine flu vaccination program. Emerging Infectious Diseases 12 1 Sokol DK. Emerging Infectious Diseases 12 8 Sutton V. The Georgetown Public Policy Review A multidisciplinary approach to an ethic of biodefense and bioterrorism. Ready or Not? Upshur RE. Principles for the justification of public health intervention. Canadian Journal of Public Health 93 2 Based on feedback from you, our users, we've made some improvements that make it easier than ever to read thousands of publications on our website.

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