Disaster Medicine and Public Health Preparedness

Case Report

Ethical Guidelines in Pandemic Influenza: Recommendations of the Ethics Subcommittee of the Advisory Committee of the Director, Centers for Disease Control and Prevention

Kathy Kinlaw, Drue H. Barrett c1 and Robert J. Levine


Because of the importance of including ethical considerations in planning efforts for pandemic influenza, in February 2005 the Centers for Disease Control and Prevention requested that the Ethics Subcommittee of the Advisory Committee to the Director develop guidance that would serve as a foundation for decision making in preparing for and responding to pandemic influenza. Specifically, the ethics subcommittee was asked to make recommendations regarding ethical considerations relevant to decision making about vaccine and antiviral drug distribution prioritization and development of interventions that would limit individual freedom and create social distancing. The ethics subcommittee identified a number of general ethical considerations including identification of clear goals for pandemic planning, responsibility to maximize preparedness, transparency and public engagement, sound science, commitment to the global community, balancing individual liberty and community interests, diversity in ethical decision making, and commitment to justice. These general ethical considerations are applied to the issues of vaccine and antiviral drug distribution and use of community mitigation interventions. (Disaster Med Public Health Preparedness. 2009;3(Suppl 2):S185–S192)

(Received July 28 2008)

(Accepted April 23 2009)

Key Words

  • ethics;
  • guidelines;
  • pandemic;
  • influenza


c1 Address correspondence and reprint requests to Drue H. Barrett, PhD, 1600 Clifton Rd, Mail Stop D-50, Atlanta, GA 30333(e-mail: dbarrett@cdc.gov).

Ms Kinlaw is Associate Director, Center for Ethics, Emory University; Dr Barrett is Public Health Ethics Coordinator, Office of the Chief Science Officer, Centers for Disease Control and Prevention; and Dr Levine is Senior Fellow, Center for Bioethics, Yale University.