Ethical Dilemmas

Preventing an outbreak might always seem like the right thing to do. And that is often the case. Though the right way to prevent, slow, or stop outbreaks can present a number of ethical challenges. Fundamentally, the ethical challenge and epidemic response arises from the question of whether it is more helpful to prevent someone from getting sick in the future than to treat someone who is sick now. Or simply allocate those resources to addressing other social needs like housing, food, sanitation, and security. The tradeoff between preventative care and addressing acute needs is always present. But it is often more apparent in humanitarian emergencies. Because of this the World Health Organization has developed guidelines for the ethical considerations
Sanitation practices are difficult to maintain, and populations often become crowded. When deciding whether or not to initiate a vaccine based intervention, one must consider the good that can be done, but also avoid doing any harm. We must begin by first asking is there a demonstrated risk? For diseases that spread quickly such as measles and cholera, using vaccination to prevent or slow epidemic spread may be justified to prevent illness and death. But any intervention carries risks, and one must evaluate the specific outbreak risk based on the nature of the illness and local epidemiological conditions, the probability of transmission, disease severity and disease duration. An intervention, when not necessary, may take resources away from other public needs. Failure to help when possible and justified violates the principle of do no harm. With vaccination, this could be thought of, in terms of equitable distribution of the vaccine itself. Or distribution of the vaccine that results in the most equitable distribution of risk. Distributing vaccines most equitably, that is, ensuring that everyone has the same chance of
Because older children are more likely to be immune. However, real-time analysis of case data by epidemiologists indicated that a large proportion of cases were in older children, and the vaccination response was extended to all children under 15 years of age. Thus, allocating resources to surveillance and analysis early on allowed a more effective outbreak response overall. Experimental treatments and therapeutics may be tempting to use during crisis and outbreaks when conventional vaccines and medicines may be in short supply. This was highlighted during the 2014 Ebola outbreak. However, one must balance the potential to do good with experimental methods against the known ability of conventional strategies to work. In order to evaluate the benefit of a new vaccine or therapy, it must be evaluated against an individual who does not receive it, or who receives a placebo. Clearly, during an outbreak or in times of high outbreak risk, it may not be feasible or ethical to withhold treatment from some individuals to facilitate