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National Center for Ethics in Health Care

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Ethical Issues in Ebola Virus Disease Preparedness and Response

VHA's National Center for Ethics in Health Care (NCEHC) has received requests for ethics resources and guidance related to Ebola Virus Disease (EVD), particularly guidance on the duty of VHA employees to provide care for patients, even at some personal risk to themselves. We are collaborating with the VHA Office of Public Health and other VHA program offices to develop those resources and to help ensure that protocols reflect ethical principles of respect, fairness, transparency, duty to care, and reciprocal obligations of the VA to protect and support staff.

Our EVD Ethics guidance is now available on the following topics:

  • EVD Ethics1: Under what circumstances, if any, would it be ethically justifiable to limit treatments, interventions, or other forms of care to patients diagnosed with EVD?
  • EVD Ethics2: Do VA health care providers and staff have a duty to provide care for patients with EVD even at some risk to themselves? If so:
    • What are the justifiable exceptions to this duty?
    • What are the reciprocal obligations of VA to health care providers and staff to enable them fulfill this duty?

NCEHC has also developed guidance and resources on Meeting the Ethical Challenges of Severe Pandemic Influenza (see sidebar for links). Although pandemic influenza and EVD are different infectious diseases, they raise some of the same ethical challenges, including:

  • How should health care providers and the institution as a whole meet the obligation to provide care during an infectious disease outbreak? Specifically, what steps should the institution take to minimize risk to health care workers, so that they can continue coming to work to assist in patient care?
  • How should decision makers ethically allocate scarce resources? Specifically, what steps are needed to ensure that decision making is transparent, reasonable, and fair?
  • What steps can decision makers take to limit the spread of disease, but at the same time ensure the least restrictions on individual liberties?

NCEHC is available to address specific questions or concerns from the VA community about ethical issues related to EVD. Please contact us at vhaethics@va.gov.  

The VHA Office of Public Health Ebola Virus Disease Web page can be accessed by Veterans and the public: http://www.publichealth.va.gov/ebola/.

We recommend that you educate yourself about EVD and begin discussions with your family and colleagues about what roles you would play in coming to the aid of those who fall ill, and the information and resources you would need to have in place to fulfil those roles.

 

 

Additional Resources

The NCEHC ethical guidance on pandemic influenza includes:

All of these materials are available on NCEHC's Web page Ethical Issues in Pandemic Influenza Preparedness and Response