As flu season approaches and public health outbreaks are making headlines, physicians and health systems across the country are reviewing disaster preparedness procedures. The AMA Code of Ethics and physician-authored articles provide guidance on ethical deliberations the medical community should consider regarding public health and disaster preparedness.

The Code gives guidance on physician obligation in epidemics and other public health emergencies, stating that “individual physicians have an obligation to provide urgent medical care during disasters.” It also states that physicians “should take appropriate advance measures to ensure their ability to provide medical service at the time of disasters, including keeping current on relevant knowledge and skills.

Outside of the Code, there are further discussions when it comes to ethics in public health emergencies, including:

  • Ethics and public health emergencies: Encouraging responsibility.” It’s extremely difficult to predict whether people and institutions will live up to their responsibilities in a crisis and plan accordingly. Examining the professional duty to treat and the legitimate questions it raises can provide insight into other actors’ responsibilities.
  • When pestilence prevails … Physician responsibilities in epidemics.” Physicians’ responses to epidemics throughout history suggest an evolving acceptance of the professional duty to treat contagious patients. This article suggests that a renewed embrace of physicians’ duty to treat patients during epidemics—despite conditions of personal risk—might improve capacity to prepare for threats such as bioterrorism and new epidemics.
  • Should I stay or should I go? The physician in time of crisis.” In the face of an epidemic, where do physicians’ obligations lie? The ethical definition of obligation often provides little guidance for how one should behave in the face of conflicting duties.
  • Duty to treat versus personal safety.” In becoming a professional, a physician takes an oath to be a healer and serve the sick. There is an implied contract between patients and clinicians, which must be considered in determining whether to treat a patient or care for one’s own personal safety.
  • Ethics and public health emergencies: Rationing vaccines.” A recent U.S. shortage of annual influenza vaccine, combined with the threat of pandemic flu, has given policymakers an opportunity to think about rationing in very concrete terms. 

In addition, the AMA’s online ethics journal Virtual Mentor has an issue dedicated to ethics questions raised by emerging epidemics.

Looking for more ethics discussions? Visit the Virtual Mentor website.

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