Hostname: page-component-7c8c6479df-ws8qp Total loading time: 0 Render date: 2024-03-28T20:38:21.382Z Has data issue: false hasContentIssue false

Ethical Issues in Disasters

Published online by Cambridge University Press:  07 October 2011

Fatimah Lateef*
Affiliation:
Senior Consultant, Emergency Medicine and Trauma, Director of Undergraduate Training and Education, Department of Emergency Medicine, Singapore General Hospital; Senior Clinical Lecturer, Yong Loo Lin School of Medicine, National University of Singapore, Senior Part-Time Lecturer, School of Health Sciences, Nanyang Polytechnic, Singapore
*
Correspondence: Associate Professor Fatimah Lateef Dept of Emergency MedicineSingapore General Hospital1 Hospital DriveOutram RoadSingapore 169608 E-mail: fatimah.abd.lateef@sgh.com.sg

Abstract

A disaster is a situation that overwhelms the local population’s capacity to respond, thus necessitating a request for assistance from outside the impacted area. In these circumstances, needs usually outweigh resources. The objective of response is to do the greatest good for the greatest number of people (the utilitarian principle). As such, some unique ethical considerations will arise that are not seen in day-to-day practice.

The adoption of medical ethics principles is important in such situations, but certain provisions must be accepted. In large-scale, complex disasters, it may be impossible to provide optimal care to each patient. This paper will discuss some of the challenges for healthcare personnel at “ground zero”, how training in preventive ethics may help, and what principles can be applied when working in disaster-affected areas or when responding to disasters.

Type
Original Research
Copyright
Copyright Lateef © World Association for Disaster and Emergency Medicine 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Centre for Research on the Epidemiology of Disasters (CRED): Definition of disaster. Available at http://www.cred.be/. Accessed 10 October 2010.Google Scholar
CRED: EM-DAT: The International Disaster Database. Available at http://www.emdat.be/natural-disaster_trends. Accessed 10 October 2010.Google Scholar
Mission, C, Guha-Sapir, D: The development of a database on disasters. Disasters 1992;16:8086.Google Scholar
Lin, JY, Anderson-Shaw, L: Rationing of resources: Ethical issues in disasters and epidemic situations. Prehosp Disaster Med 2009;24:215221.CrossRefGoogle ScholarPubMed
Kluge, EH: Code of ethics and other illusion. Can Med Asssoc J 1992;146:12341235Google Scholar
Wynia, MK: Ethics and public health emergencies: Rationing. Am J Bioeth 2006;6:47.CrossRefGoogle Scholar
Roberts, LW: Ethics as endeavour in psychiatry: principles, skills and knowledge. Psychiatric Times 2002;12:19.Google Scholar
Holt, GR: Making different ethical decisions in patient care during natural disasters and other mass casualty events. Otolaryngol Head Neck Surg 2008;139:181186.CrossRefGoogle Scholar
World Medical Association: Medical ethics in the event of disasters. Bull Med Ethics 1994;102:911Google Scholar
Von Ryn, M, Burke, J: The effect of patients’ race and socio-economic status on physicians’ perceptions of patients. Sac Sci Med 2000;50:813828.CrossRefGoogle Scholar
International Federation of Red Cross and Red Crescent Societies: Disaster management: About disasters: Complex emergencies.. Available at http://www.ifrc.org/what/disasters/about/types/manmade/conflict.asp. Accessed 10 October 2010.Google Scholar
Sztajnkrycer, MD, Madsen, BE, Alejandro, BA: Unstable ethical plateaus and disaster triage. Emerg Med Clin North Am 2006;24:749768.CrossRefGoogle ScholarPubMed
Okie, S: Dr Pon and the hurricane: Implications for patient care during disasters. NEJM 2008;358:15.CrossRefGoogle Scholar
World Medical Association: International Code of Medical Ethics. Available at http://www.wma.net/en/30publications/10policies/c8/index.html. Accessed 10 October 2010.Google Scholar
Khan, RI: Clinicians’ duty to care : A Kantian analysis. Law and Governance 2005;9:2536.Google Scholar
Sokol, D: Healthcare workers duty to care and severe infectious diseases. Available at www.medicalethicist.net/Thesis3.doc. Acccessed 10 October 2010.Google Scholar
Guyer, P, Kant, I, in Craig, E (ed): Routledge Encyclopedia of Philosophy Online. Available at http://www.rep.routledge.com/article/DB047SECT10. Accessed 10 October 2010.Google Scholar
Harris, CE Jr: Explaining disasters: The cause for preventive ethics. Technology and Society Magazine 1995;14:22–7.CrossRefGoogle Scholar
Levine Ariff, J: Preventive ethics: The development of policies top guide decision-making. Clin Issues Crit Care Nurs 1990;1:169–77.Google Scholar
Rosenstein, DL: Decision making capacity and disaster research. J Trauma Stress 2004;17:373–81.CrossRefGoogle ScholarPubMed
Iserson, KV, Heine, CE, Larkin, GL, et al: Fight or flight: The ethics of emergency physicians disaster response. Ann Emerg Med 2008;51:345–53.CrossRefGoogle ScholarPubMed