Biomedical Ethics: Assignment Week 6

Chapter 21

Ethics Issues in Disaster Relief

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Definitions

• A disaster is an unexpected claustrophobic event or situation that depletes the survival resources and supplies in a relatively short timeframe.

• Disasters are generally divided into two categories: natural and anthropogenic.

• Disasters not only influence the environment, and society but also the human experience.

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Government Disaster Planning and Response

• September 11, 2001 created a movement to upgrade America’s ability to plan for all future disasters that continues to this day.

• When there is a disaster, programs require the partnership of government (regional, state, and local), voluntary organizations, health care systems including first responders, and individual citizens to work as a massive team.

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Government Disaster Planning and Response

• One response was the creation of the Department of Homeland Security (DHS).

• DHS is responsible for security at airports, protecting cargo, and sharing information.

• The DHS now includes several emergency management agencies.

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Government Disaster Planning and Response

• FEMA responds to both local and national disasters.

• It coordinates resources for disaster responses.

• It is also involved in helping people be prepared for disasters.

• FEMA provides direct assistance to qualified disaster survivors.

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Government Disaster Planning and Response

• The CDC tracks natural and human-made disasters and conducts research on ways to respond to the aftermath of these events.

• It provides information on a wide variety of topics to help businesses, hospitals, communities, and individuals prepare for disasters.

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Government Disaster Planning and Response

• The CDC is also involved in researching the aftermath of disasters to improve response times.

• It has also developed an national stockpile of pharmaceuticals to respond to needs in a disaster.

• The CDC also provides education on disaster preparedness.

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Government Disaster Planning and Response

• The American Red Cross (ARC) responds to immediate needs and relieves suffering particularly when disaster strikes on a local, regional, and national basis.

• Volunteers are trained by the ARC to provide services in a variety of disaster situations.

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Other Voices on Government Response

• Redlener suggests that governments have much more to do.

• A plan is needed to set benchmarks, correct methods of overseeing disaster planning, create accountability standards, and make the reduction of threats a priority among its features.

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Ethics Issues and Government Disaster Planning and Response

• Ethical responsibility begins with the plan itself.

• Conflicts of interest must be addressed. • The plan must balance utilitarian ideas with

the deontology of protecting individual rights.

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Ethics Issues and Government Disaster Planning and Response

• Triage is an example of an utilitarian ethics application to a disaster situation.

• Categorization of injuries is needed. • Even when triage is needed, the community’s

view must be considered. • Humanitarianism does not allow some to be

left behind without treatment.

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Ethics Issues and Government Disaster Planning and Response

• Autonomy is another ethical issue for disaster planning.

• How far do the rights of the individual go when they can negatively affect the community?

• Balance between utility and autonomy needs to be a part of the plan.

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Ethics Issues and Government Disaster Planning and Response

• Social justice is also an ethics issue. • For when large amounts of capital (in the

billions of dollars) are involved, the potential for fraud, abuse, and corruption exists.

• Communities do not find it just if individuals profit unethically from disasters.

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Health Care Organizations and Disaster Planning

• Hospitals and health care systems respond when disasters occur.

• The Joint Commission mandates a disaster management plan with standards and requirements.

• Plans are developed using a hazard analysis and are based on six capability areas.

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Health Care Organizations and Disaster Planning

• The ASPR provides guidance for implementing the Hospital Preparedness Program (HPP).

• The ASPR identified eight areas that are needed for disaster preparation.

• Guides are provided for assessing and creating preparedness plans for all eight areas.

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Ethics Issues for Organization Disaster Planning and Response

• Concepts of utilitarianism and deontology must be balanced when dealing with the use of scarce resources.

• Using the “greatest good for the greatest number” alone can lead to severe ethical problems for organizations and first responders.

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Ethics Issues for Organization Disaster Planning and Response

• Conflicts of duty can exist for those who respond to disasters?

• To whom do they owe a primary duty: the community or their own families?

• Planning needs to consider the families of staff so that the conflict can be reduced.

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Ethics Issues for Organization Disaster Planning and Response

• Social justice is also an ethical issue. • The community’s values and concept of

fairness must be considered in disaster planning and response.

• Plans must also address autonomy, nonmaleficence, beneficence, and justice.

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Individual Response to Disasters

• Despite news coverage of disasters, the American public continues to be unprepared.

• It seems to be part of human nature to think about worst-case situations.

• Vulnerable populations such as low income families are often the least prepared for dealing with emergencies.

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Individual Response to Disasters

• American should be “Red Cross Ready’ in the event of an emergency.

• The Red Cross gives guidelines on what an individual or family needs to be prepared.

• Preparedness also requires that individuals develop a plan in the event of an emergency.

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Individual Response to Disasters

• The CDC suggests that individuals may have to shelter-in-place when a disaster occurs.

• Choose a room in the home or business as a prepared shelter.

• The room should be equipped to be “Red Cross Ready” for emergencies.

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Individual Response to Disasters

• Citizens be physically prepared and also mentally ready for disasters and for survival.

• They need to be physically fit to survive and be CPR and first aid trained

• They also need to be aware of their situation at work, home, and the community.

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Individual Response to Disasters

• There also needs to be a family plan for dealing with emergencies.

• The plan should address how to care for the elderly or disabled.

• Families should be prepared for evacuation or sheltering in place.

• Communication issues should also be addressed.

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Ethics Implications for Individual Response to Disasters

• Disasters can cause a retreat to survival mode where dignity and rights of others are ignored.

• People also tend to expect their governments to respond in whenever any type of emergency occurs.

• People may have to handle emergencies on their own because help may not be eminent.

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Ethics Implications for Individual Response to Disasters

• Autonomy is another ethical issue for individuals.

• Government and organizations use higher and higher levels of technology as prevention for potential disasters.

• How much privacy and autonomy is lost versus the benefits gained?

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Ethics Implications for Individual Response to Disasters

• Beneficence is also an issue for individuals. • Without the acts of beneficence, many will

not survive. • However, an ethics issue exists concerning the

boundaries of beneficence.

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In Summary…

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