Given limited supplies of vaccines, antiviral drugs, and ventilators, non-pharmaceutical interventions are likely to dominate the public health response to any pandemic, at least in the near term. The six papers that make up this chapter describe scientific approaches to maximizing the benefits of quarantine and other nonpharmaceutical strategies for containing infectious disease as well as the legal and ethical considerations that should be taken into account when adopting such strategies. The authors of the first three papers raise a variety of legal and ethical concerns associated with behavioral approaches to disease containment and mitigation that must be addressed in the course of pandemic planning, and the last three papers describe the use of computer modeling for crafting disease containment strategies.
More specifically, the chapter’s first paper, by Lawrence Gostin and Benjamin Berkman of Georgetown University Law Center, presents an overview of the legal and ethical challenges that must be addressed in preparing for pandemic influenza. The authors observe that even interventions that are effective in a public health sense can have profound adverse consequences for civil liberties and economic status. They go on to identify several ethical and human rights concerns associated with behavioral interventions that would likely be used in a pandemic, and they discuss ways to minimize the social consequences of such interventions.
The next essay argues that although laws give decision makers certain powers in a pandemic, those decision makers must inevitably apply ethical tenets to decide if and how to use those powers because “law cannot anticipate the specifics of each public health emergency.” Workshop panelist James LeDuc of the Centers for Disease Control and Prevention (CDC) and his co-authors present a set of ethical guidelines that should be employed in pandemic preparation and response. They also identify a range of legal issues relevant to social-distancing measures. If state and local governments are to reach an acceptable level of public health preparedness, the authors say, they must give systematic attention to the ethical and legal issues, and that preparedness should be tested, along with other public health measures, in pandemic preparation exercises.
LeDuc’s fellow panelist Victoria Sutton of Texas Tech University also considered the intersection of law and ethics in public health emergencies in general and in the specific case of pandemic influenza.
