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Implement control measures equitably

Measures to control transmission often put restrictions on individuals. Ensure that those burdens do not fall disproportionately on some group, especially those who already suffer from health and economic disparities.

  • As part of pandemic influenza planning, policymakers should establish a process for setting priorities and promoting equitable access. WHO Ethics in Pandemic Flu
  • Equal opportunity to access resources should be assured to those within agreed upon priority groups. CDC Ethics in Pandemic Flu
  • Restrictions on personal freedom should be equitably applied. It should be exceedingly clear why particular individuals or communities are being restricted and that the criteria that justify a restriction would be equally applied to any and all individuals meeting these same criteria. Care must be taken to avoid stigmatization of individuals or groups. CDC Ethics in Pandemic Flu
  • Considera­tions of equity may lead to giving priority to: the worst-off (in terms of severity of illness), vulnerable and disabled populations, uninfected persons who are at high-risk of de­veloping severe complications and dying from influenza if they become infected. Different views exist on whether it is appropriate to consider age in making prioritization decisions. WHO Ethics in Pandemic Flu
  • Policymakers should ensure that criteria for prior­ity setting do not discriminate against individuals based on inappropriate characteristics, including but not limited to: gender, race and ethnicity, religion, political affiliation, national origin, or social or economic status. WHO Ethics in Pandemic Flu
  • Age-based prioritization criteria should be adopted only after wide public consultation. Such criteria should rely on broad life stages, rather than rank­ing individuals based on differences of only a few years. WHO Ethics in Pandemic Flu
  • Distribution criteria that would generally not be ethically supported in pandemic influenza planning include race, ethnicity, religious belief, gender, sexual orientation, or IQ, when used to make discriminations that are only invidious and not morally relevant. CDC Ethics in Pandemic Flu
  • Ensure that resulting interventions do not have a disproportionately negative impact on minority or otherwise vulnerable populations (including children and elders) and that there is an effort to enhance the resilience of populations and ecosystems to prevent future harm. APHA Code of Ethics, 4.2.9.
  • Avoid unintentional stigmatization of specific groups within the community. APHA Code of Ethics, 4.5.5.
  • Be attuned to cultural, social, and historical contexts that influence community health and receptivity to public health partnerships. APHA Code of Ethics, 4.4.7.
  • Consider and, where possible, address determinants of health that reside outside a person’s genetic endowment and personal behaviors, including the circumstances in which people grow, live, work, and age. These determinants might include individual resources, community resources, hazardous exposures, and opportunity structures. APHA Code of Ethics, 4.5.7.
  • Reduce or eliminate negative impacts on communities and the environment, particularly as these negative impacts tend to be disproportionately experienced by individuals already faced with health inequities. APHA Code of Ethics, 4.5.8.
  • Ensure that public health policies and plans are sensitive to race, ethnicity, sex, sexual orientation, gender identity, and other unique characteristics of individuals affected by the policies or plans. APHA Code of Ethics, 4.5.11.
  • Plans related to social-distancing measures should to the extent possible, provide means of miti­gating adverse cultural, economic, social, emo­tional, and health effects for individuals and communities. WHO Ethics in Pandemic Flu
  • International and national monitoring should pay particular attention to the needs of all popula­tions, regardless of their legal status, especially with respect to access to health care. Such popula­tions include but are not restricted to: displaced persons, refugees, asylum seekers, migrants, travellers. WHO Ethics in Pandemic Flu
  • Base health promotion efforts on respect for the dignity and capability of individuals, not on strategies of stigmatization or on appeals to motivations of fear, disgust, and shame. APHA Code of Ethics, 4.7.3.
  • Recognize and act upon the fact that the ethical obligation to provide access to health care is not limited to persons with citizen status only. APHA Code of Ethics, 4.7.1.
  • Where information sharing is important to protecting the public health, measures that safeguard personal, private information should be in place and support should be given to ill individuals, family members, and others potentially stigmatized by real or potential illness. CDC Ethics in Pandemic Flu
  • Have safeguards in place so that public health information does not harm individuals or communities. APHA Code of Ethics, 4.1.5.
  • Balance the public’s need for information with the possibility that an investigation’s results will create undue burdens or stigma for populations, groups, or individuals or cause other adverse outcomes. APHA Code of Ethics, 4.2.6.
  • Policies must be implemented consistently to ensure fairness and equal opportunity for care. Indiana University
  • Broad international cooperation in the develop­ment and dissemination of vaccines and treat­ments is in the interests of all countries as such cooperation offers the best chance of minimizing the global impact of an influenza pandemic. WHO Ethics in Pandemic Flu
  • National and international policymakers should establish and test mechanisms to provide coor­dinated assistance to countries in need. WHO Ethics in Pandemic Flu

 



What is Pandemic Ethics?

A pandemic is pervasive in scope and touches virtually every human-made system. In this dashboard, we focus on ethics in a government’s or an employer’s actions in a pandemic.

Public health ethics addresses the relationship between those governing or administrating and the population or employees they serve. They are best summarized by the Public Health Code of Ethics of the American Public Health Association.

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