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Opinion: Ethics and Pandemics and Nurses

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  • Opinion: Ethics and Pandemics and Nurses


    Opinion: Ethics and Pandemics
    Preparation is the ethically right thing to do
    By Pam Meredith, RN, NP
    Monday October 20, 2008

    The concern in healthcare is not if a pandemic will come, but when. And the aftermath could be just as devastating as the disease itself. The ethical dilemmas that will present themselves are being investigated by biomedical ethicists everywhere in an attempt to prepare us for what is probably inevitable ? a severe and widespread outbreak of influenza.

    One institution that has considered the ethics of pandemic planning is the Johns Hopkins Berman Institute of Bioethics in Baltimore (online at Its report, which came out in early October and soon will be published in the journal Biosecurity and Bioterrorism, says, "... if the public has limited or no access to food, water, sewage systems, fuel, and communications, the secondary consequences [of a pandemic] may cause greater sickness, death, and social breakdown than the virus itself."

    We, as nurses, need to be cognizant of the ramifications a pandemic would bring if essential people are not around to provide basic services. And, we need to tell others how to prepare for the public health problems that could follow an outbreak of infection.
    At such a time, government assistance will be spread thin, commodities will be scarce, and the ethical responsibility for individuals to have preparedness plans already in place will be paramount.

    The Berman Institute report says individuals and families who can afford it should do their best to prepare for any disaster. In particular, the paper states, "... the middle class and the wealthy have an ethical responsibility to prepare for self-sufficiency in order to free up scarce supplies and allow first responders to direct their attention toward those too poor or vulnerable to prepare themselves."

    Why is this ethical responsibility especially pertinent to nurses? It's because we are probably more aware of the health problems a post-pandemic scenario could bring and because we are steeped in the concepts of prevention. In case of disaster, we must ensure we are each capable of sustained self-sufficiency to prevent draining precious resources that could be used elsewhere. And we need to urge others to do the same.

    As nurses, we can teach our patients to prepare for being without basic necessities for as long as three months in the event of a pandemic or any other catastrophe. Stockpiling food, water, paper goods, batteries, medicines, and other needed supplies will make us all less vulnerable in the event there is a break in the supply chain that would interrupt access to these goods. Having the basics on hand will not only make us all safer and more secure, but according to the Berman Institute's report, it's also the right thing to do.

    While reminding people to prepare for an emergency, tell them to get a flu shot, too. And get one yourself. Primary prevention of influenza to stay safe and curtail its spread is another one of the ethically right things to do.

    The American Red Cross has detailed information online about planning for a disaster at,00.html.

    Pam Meredith, RN, NP, is Editorial Director for Nursing Spectrum's DC/Maryland/Virginia edition.

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