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Conference Summary
Ethics and Epidemics
Robert Baker,*
Wayne Shelton,† and Martin Strosberg*
*Graduate College of Union University, Schenectady, New York, USA; and
†Albany Medical College, Albany, New York, USA
Suggested
citation for this article
More than 90 people attended a March 25–27, 2004, conference on Ethics
and Epidemics. This conference was sponsored by the Albany Medical College–Graduate
College of Union University Masters in Bioethics Program, the University
at Albany School of Public Health, the New York State Department of Health,
and the Wadsworth Laboratories. Attendees came from Australia, Africa,
Asia, Europe, Canada, and the United States. Among the 24 papers and panels,
presentations were made by George Annas, professor and chair of Health
Law at the Boston University School of Public Health; Ezekiel Emanuel,
chair of the Department of Clinical Bioethics of the Magnuson Center of
the National Institutes of Health; Thomas R. Freiden, commissioner, New
York City Department of Health; Matthew Wynia, director of the Institute
of Ethics of the American Medical Association; Kenyan bioethicist Angela
Wassuna associate for International Affairs of the Hastings Center; and
19 other bioethicists and health professionals.
Presentations ranged from case studies to health policy debates. Many
reviewed the history of epidemics, emphasizing their global nature and
the imperative of global strategies for epidemic control. Several papers
examined recent epidemics and explored new strategies for dealing with
epidemic control while respecting human rights. The consensus was that
the old policeman model of public health needs updating. Discussion focused
on how best to balance public safety, professional responsibility, personal
liberty, and human rights, while effectively containing epidemics. Emanuel
and Wynia reaffirmed the responsibility of physicians and first responders
to put their health and lives at risk in combating epidemics. Yet, noting
the vulnerability of first responders (in the Toronto severe acute respiratory
syndrome [SARS] outbreak and elsewhere), they distinguished between bravery
and foolhardiness, arguing that just as professionals have a responsibility
to protect the public from disease, the public, in turn, has a responsibility
to provide the training, equipment, and resources to minimize the need
to take risks.
Virtually all conferees observed that the public health infrastructure
needs substantial rebuilding to cope effectively with epidemics. Annas,
however, noted that in bioterrorist assaults the control of biologic agents
is a public health problem to be dealt with by public health officials,
not by the U.S. Department of Defense or the U.S. Department of Homeland
Security. He further stated that policies on epidemic control that involve
consistent, open, and truthful communication with the public—like those
used in New York and Toronto during the recent SARS outbreak—create cooperative
environments that minimize conflicts between freedom and safety and limit
the effects of isolation and quarantine. However, Emanuel et al. asserted
that the traditional enforcement authority of public health law was essential
and needed as a fallback. The result of the debate was that 21st century
methods need to be developed to control infectious disease epidemics that
reconcile the need to protect public health and respect human rights.
The conference program is available on http://www.bioethics.union.edu
under "News." For further information contact bioethics@union.edu
or 518-388-8045.
Suggested citation
for this article:
Baker R, Shelton W,
Strosberg M. Ethics and epidemics [conference summary]. Emerg Infect Dis
[serial on the Internet]. 2004 Sep [date cited]. Available from:
http://www.cdc.gov/ncidod/EID/vol10no9/04-0407.htm
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