GESTIÓN EN SALUD PÚBLICA: Healthcare workers and the duty to treat Ebola patients

domingo, 26 de agosto de 2018

Healthcare workers and the duty to treat Ebola patients

Healthcare workers and the duty to treat Ebola patients

Bioedge

Healthcare workers and the duty to treat Ebola patients

by Xavier Symons | 25 Aug 2018 |

Do healthcare workers have a duty to treat Ebola patients?

This question has becoming more pressing in recent years, with the repeated outbreaks of the Ebola virus in Western and Central Africa and a high mortality rate among healthcare professionals. 105 cases of Ebola have now been confirmed in the latest outbreak, centering on the North Kivu region of the Democratic Republic of Congo.

On one view, bioethical principles such as beneficence and justice mandate that doctors provide treatment to patients when they are in dire need. A failure to leaves patients without treatment and risks creating inequalities in the delivery of care in society.

Yet in some cases doctors may be putting their lives at risk, specifically when dealing with highly contagious viruses such as Ebola in poorly resourced healthcare facilities.

Dr. Sheikh Umar Khan, a virologist from Sierra Leone, died in July 2014 after treating over 100 patients for Ebola in Kenema, a major city in the most affected part of the country. He was just one of hundreds of healthcare workers who succumbed to virus over the course of the three year West African Ebola epidemic, which was finally declared finished by the WHO in July 2016. During that epidemic, healthcare workers were between 21-32 times more likely to be infected with Ebola than the general public.

A new study published the Journal of Medical Ethics summarises the attitudes of 220 Guinean health care workers and 252 Guinean lay persons towards the duties of healthcare professionals to treat patients with Ebola. The study found that almost half of participants (47%) felt that the duty to care was not absolute, but rather contingent on factors such as working conditions and on one’s family responsibilities. A small minority of participants (23%) felt that HCPs did not have any duty to care at all.

Sunday, August 26, 2018

The Norwegian bioethicist Ole Martin Moen has published an unusual but intriguing article in the journal Bioethics. He analyses the arguments in the half-mad manifesto of the Unabomber, Ted Kaczynski. For those whose memories don’t stretch back that far, Kaczynski was a brilliant mathematician who became obsessed with the decay of American society. He retired to a backwoods cabin and worked as a serial postal bomber whose handiwork killed three people and maimed 23 between 1978 and 1995. The New York Times published his 35,000-word manifesto in 1995 which eventually led to his capture.

Moen says that Kaczynski’s concerns should be taken seriously and refuted philosophically, even if he is a terrorist. “Although philosophers can only play a modest role in fighting terrorism, it is striking that, today, the most obvious line of response to one’s adversaries—to listen carefully, to show that one has understood their position, and to explain why one believes they are mistaken—is hardly even attempted as a means to discourage terrorists.”

His words can usefully be applied to many other areas of public discourse today, not just dialogues with ideologically-motivated terrorists. It’s very seldom that opposing sides listen carefully to each other. In the Middle Ages, academic battles took the form of “disputation and debate”. Stating the other side’s argument in the strongest possible form was an essential part of the process – before demolishing it, of course. We need a bit more of this fairness, even for madmen like Kaczynski.