what was the negligence on part of the country of origin ? what steps should have been taken by that country to control the spread of disease
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Answer:
Given limited supplies of vaccines, antiviral drugs, and ventilators, non-pharmaceutical interventions are likely to dominate the public health response to any pandemic, at least in the near term. The six papers that make up this chapter describe scientific approaches to maximizing the benefits of quarantine and other nonpharmaceutical strategies for containing infectious disease as well as the legal and ethical considerations that should be taken into account when adopting such strategies. The authors of the first three papers raise a variety of legal and ethical concerns associated with behavioral approaches to disease containment and mitigation that must be addressed in the course of pandemic planning, and the last three papers describe the use of computer modeling for crafting disease containment strategies.
More specifically, the chapter’s first paper, by Lawrence Gostin and Benjamin Berkman of Georgetown University Law Center, presents an overview of the legal and ethical challenges that must be addressed in preparing for pandemic influenza. The authors observe that even interventions that are effective in a public health sense can have profound adverse consequences for civil liberties and economic status. They go on to identify several ethical and human rights concerns associated with behavioral interventions that would likely be used in a pandemic, and they discuss ways to minimize the social consequences of such interventions.
The next essay argues that although laws give decision makers certain powers in a pandemic, those decision makers must inevitably apply ethical tenets to decide if and how to use those powers because “law cannot anticipate the specifics of each public health emergency.” Workshop panelist James LeDuc of the Centers for Disease Control and Prevention (CDC) and his co-authors present a set of ethical guidelines that should be employed in pandemic preparation and response. They also identify a range of legal issues relevant to social-distancing measures. If state and local governments are to reach an acceptable level of public health preparedness, the authors say, they must give systematic attention to the ethical and legal issues, and that preparedness should be tested, along with other public health measures, in pandemic preparation exercises.
LeDuc’s fellow panelist Victoria Sutton of Texas Tech University also considered the intersection of law and ethics in public health emergencies in general and in the specific case of pandemic influenza. In particular, Sutton identified several “choke points”—particularly thorny ethical and legal issues—that present barriers to pandemic mitigation. In addition to the problem of leadership, which is addressed in the next chapter, these issues include the role of interdisciplinary and intersectoral approaches in decision-making; the tradeoffs between personal freedom and public good that are implicit in social-distancing measures; the global implications of quarantine and travel restrictions; the need for consistency among various disease-control policies; and the definition of appropriate, measurable “triggers” for when to impose each potential countermeasure.
The third paper in this chapter considers quarantine, one of the most ethically and legally complex tactics used in combating pandemic disease. In this article, Martin Cetron of CDC and Julius Landwirth of Yale University describe the modern practice of quarantine and its potential implementation as outlined in the U.S. Department of Health and Human Services (HHS) plan for containing pandemic avian influenza. Whenever the possibility of using a quarantine is discussed, they observe, decision makers confront the central dilemma arising from the contrast between public health ethics, which emphasizes collective action for the good of the community, and therapeutic medicine, with its focus on the individual. The authors identify various means to address this tension and offer examples of how ethical considerations can be incorporated into pandemic preparedness plans.