Selected Issues > Pandemic Planning
Pandemic Planning
pandemic imageCausing more deaths than World War I, the 1918 influenza pandemic took more lives worldwide over the course of two years than AIDS has in the past twenty-five. Now the public health system—much of which was established or significantly overhauled in the wake of the 1918 pandemic—faces new challenges in preventing a similar influenza threat in 21st century. Scientists almost universally agree that another influenza that can pass from human to human will occur; the question is not if, but when the next pandemic will break out.

From the Hastings Center

2012 May-June

The Influenza Controversy: Should Limits Be Placed on Science?

by Lawrence O. Gostin
Should government have the power to place limits on a scientific pursuit that holds the potential for both good and harm—on what is called “dual-use research”?

Bioethics Briefing Book

Influenza Pandemic

By Alexandra Minna Stern and Howard Markel

Special Report

The Five People You Meet in a Pandemic - and What They Need from You Today

Hard copy: $10 Purchase from The Hastings Center

2009 January-February

Medicine’s Duty to Treat Pandemic Illness: Solidarity and Vulnerability

By Howard Brody and Eric N. Avery
In the wake of SARS and with the possibility of bioterror, pandemic avian influenza, and other emerging infections looming, bioethicists are exploring the extent of a health professional’s duty to treat the victims of such an infectious outbreak, even at substantial risk to the caregiver’s own health or life. Dr. Carlo Urbani of Médecins Sans Frontières, who with others initially identified SARS as a new infectious disease in Hanoi, voluntarily quarantined himself and eventually died of SARS, leaving a widow and three children. Should we regard Dr. Urbani as a medical hero, or as a physician simply doing his duty? Physicians’ moral duties arise from at least two sources. As members of society, they owe the same general duties to others as any citizen. In addition, they assume a further set of moral duties connected with the nature of medicine as a practice. But these are insufficient to sustain a robust duty to treat. The discussion must be broadened from physicians to include not only all health professionals, but also the nonprofessional service workers without whom any hospital would soon cease to function. The health care worker’s other obligations, especially for the care of family members, must be considered alongside duties owed to patients. Finally, a deeper account of the professional’s duty to treat will eventually have to address in detail important concerns of social solidarity.

Hastings Center Report

Why Should We Care about Social Justice?

By Lawrence O. Gostin
Deep and enduring socioeconomic inequalities form the backdrop to any public health policy, and influenza policy is no different. And although social justice is a core value of public health, it is important to be reminded that public health officials can neglect the disadvantaged and even exacerbate underlying inequalities. In this issue of the Report, Lori Uscher-Pines and colleagues give us such a reminder.

Hastings Center Report

Planning for an Influenza Pandemic: Social Justice and Disadvantaged Groups

By Lori Uscher-Pines, Patrick S. Duggan, Joshua P. Garoon, Ruth A. Karron, and Ruth R. Faden
An influenza pandemic could have devastating global effects, and people who are already economically and socially disadvantaged will probably suffer the most. Because of this, countries should take special measures to mitigate the effect of a pandemic on existing social inequalities. In July 2006, an international panel of experts produced three principal criteria for the just development of pandemic preparedness and response plans: planners should (1) explicitly identify disadvantaged groups within society; (2) engage these groups in the planning process, either directly or through their representatives; and (3) identify and address the special needs of disadvantaged groups in the context of a pandemic. Unfortunately, there is little evidence that these criteria have been observed.

Bioethics Forum

Quarantine and the Covenant of Trust

Wendy E. Parmet


Bioethics Backgrounder, "Flu Pandemic and the Fair Allocation of Scarce Life-Saving Resources"

Pandemic Flu Planning in the Community, Cambridge Quarterly of Healthcare Ethics

J. Thomas et al., “Ethics in a Pandemic: A Survey of the State Pandemic Influenza Plans,” American Journal of Public Health 97, no. S1 (2007): S26-S31.

E. Emanuel and A. Wertheimer, “Who Should Get Influenza Vaccine When Not All Can?” Science 312 (2006): 854-55.

S. Glazer, “Avian Flu Threat: Are We Prepared For the Next Pandemic?” CQ Researcher 16, no. 2 (2006).

L. Gostin, “Medical Countermeasures for Pandemic Influenza: Ethics and the Law,” Journal of the American Medical Association 295 (2006): 554-56.

J. Hick and D. O’Kaughlin, “Concept of Operations for Triage of Mechanical Ventilation in an Epidemic,” Academic Emergency Medicine 13, no. 2 (2006).

E. Toner and R. Waldhorn, “What Hospitals Should Do to Prepare for an Influenza Pandemic,” Biosecurity and Bioterrorism 4, no. 4 (2006): 397-402.

University of Toronto Joint Centre for Bioethics, Pandemic Influenza Working Group, Stand on Guard for Thee: Ethical Considerations in Preparedness Planning for Pandemic Influenza (University of Toronto, 2005).

N. Pesik et al., “Terrorism and the Ethics of Emergency Medical Care,” Annals of Emergency Medicine 37, no. 6 (2000): 642-46.