Ethics Subcommittee Documents

Ethical Guidance for Public Health Emergency Preparedness and Response: Highlighting Ethics and Values in a Vital Public Health Service

This document, “Ethical Guidance for Public Health Emergency Preparedness and Response: Highlighting Ethics and Values in a Vital Public Health Service,” provides ethical considerations that the Ethics Subcommittee of the Advisory Committee to the Director, Centers for Disease Control and Prevention (CDC), proposed to aid in decision making regarding the field of all-hazard public health emergency preparedness and response. It addresses not only CDC’s role in such activities, but also the role of public health professionals and officials at all levels. This document is intended as a white paper on the ethical orientation that should guide the planning and recovery phases in emergency preparedness and response. While the Ethics Subcommittee acknowledges and attempts to shed light on the ethical dilemmas that arise during the response phase of Public Health Emergency Preparedness and Response (PHEPR), they concluded that the best contribution of ethics is to inform advance planning and organization of emergency response so as to minimize the number of tragic choices that must be made. It has two main parts: (1) Considerations of the ethical nature and mission of public health emergency planning itself and suggested relevant ethical goals, principles and frameworks for ethical decision making, and; (2) Considerations of specific decisions that may need to be made by individuals developing and implementing emergency plans, including for example, allocating scarce resources; meeting the needs of vulnerable populations; the use of interventions that limit individual liberty; communication and participation with members of the public during times of crisis; professional, civic and personal responsibilities; and conducting research during emergency responses.

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Ethical Considerations for Decision Making Regarding Allocation of Mechanical Ventilators during a Severe Influenza Pandemic or Other Public Health Emergency

This document, Ethical Considerations for Decision Making Regarding Allocation of Mechanical Ventilators during a Severe Influenza Pandemic or Other Public Health Emergency, provides ethical considerations that the Ethics Subcommittee of the Advisory Committee to the Director, Centers for Disease Control and Prevention (CDC) proposes to aid in the decision making specific to allocation of mechanical ventilators during a severe influenza pandemic. The intent of this document is to provide decision makers at all levels–federal, tribal, territorial, state, and local–with an overview of the complex ethical landscape associated with decision making about allocation of scarce life-sustaining healthcare resources. This document is not meant to serve as detailed guidance about allocation decisions. Rather it is intended to serve as a conceptual framework to assist the planning process. Planning will need to occur at the state, local, and institutional level to develop specific operational details and implementation steps. Thus, this document does not address how to approach specific allocation decisions, but instead highlights ethical standards and principles relevant to allocation of ventilators during a severe pandemic or other public health emergency and discusses some of the advantages and disadvantages inherent in different approaches to allocation.

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Stockpiling Antivirals For Pandemic Influenza: The Key Ethical Principles

The Ethics Subcommittee of the Advisory Committee to the Director, Centers for Disease Control and Prevention offer these comments on key ethical considerations relevant to decision making about stockpiling antiviral drugs. It is important that recommendations on antiviral drug strategies (treatment and prophylaxis) recognize the burden that will be posed and the ethical questions raised in purchasing and stockpiling the drugs. This document focuses on addressing the key ethical principles that should be considered by decision makers who will be charged with assigning responsibility for the purchase of antiviral drugs.

Stockpiling Antiviral Drugs for Pandemic Influenza: The Key Ethical Principles (DOC – 59 Kb)
Prepared by Ethics Subcommittee of The Advisory Committee to the Director, CDC November 28, 2007

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Ethical Guidelines in Pandemic Influenza

As part of its planning for a possible outbreak of pandemic influenza, the Centers for Disease Control and Prevention (CDC) worked with the Ethics Subcommittee of the Advisory Committee to the Director, CDC to identify ethical considerations relevant to public health decision-making during planning for and responding to pandemic influenza.

CDC requested that the Ethics Subcommittee provide input on ethical considerations in vaccine and anti-viral drug distribution prioritization and in the development of interventions that would limit individual freedom and create social distancing. The resulting document, Ethical Guidelines in Pandemic Influenza (PDF, 111 KB), provides guidance that the Ethics Subcommittee proposes serve as a foundation for ethical decision making for pandemic influenza. We recognize the importance of having ethical perspectives provide practical assistance to those involved in the pandemic influenza planning and response process. Thus, we welcome your input on this document.

Based on information in the Ethical Guidelines, CDC developed the following fact sheet and checklist to summarize ethical issues relevant to pandemic influenza.
Pandemic Influenza Ethics Fact Sheet (DOC – 63Kb) – March 15, 2007
Pandemic Influenza Ethics Checklist (DOC – 52Kb) – March 15, 2007

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