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Center for Public Health Preparedness

Ethics and Public Health in an Age of Terrorism

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Ethics in the Age of Terrorism

Terrorism, whether biological, chemical, or nuclear presents special challenges to caregivers, healthcare institutions, community organizations, and governmental agencies. Major natural disasters offer many of the same challenges. Finding one's way ethically is particularly problematic. When decisions must be made rapidly, under anxiety-filled and emergency conditions, being prepared to face the ethical issues is a necessary part of public health services. Issues of professional conduct and responsibility, of civil rights and civil liberties, of conscience, are bound to appear.

Ethics and Public Health in an Age of Terrorism is a carefully-crafted curriculum that explores the role of public health in addressing the ethical, emotional and legal dilemmas confronting those who plan for and respond to all hazards. This course offers preparation for the moral dimensions of a terrorism event, emerging infectious disease or other disaster.

Audience

This course is intended for public health personnel, first responders, and other preparedness stakeholders. It will also be of interest to leaders of community organizations whose efforts will be needed in meeting the problems resulting from catastrophic events – natural or man-made

Objectives

This course examines the ethics side of ten issues that may emerge during public health emergencies. The ten issues and the specific objectives for each:

  1. Civil Liberties and Civil Rights –
    • Identify historic roots and basic meanings of civil liberties and civil rights in American society
    • Recognize the challenges a terror event and a “war on terror” make to civil liberties and civil rights
    • Describe the ways the these challenges are met in law and in practice
  2. Governmental Powers and Political Responsibility –
    • Identify the differing roles of the various branches of government and the problem of jurisdiction
    • Explain the limits on government actions imposed by a separation of powers and what happens to these limits in an age of terror
    • Summarize the authority and responsibility provided by the Emergency Powers Act
    • Discuss the ethical issues raised by the potential conflicts between “command” authority and the separation of powers
    • Examine the problems and possibilities of citizen participation
  3. Quarantine and Isolation –
    • Define and explain the similarities and differences between quarantine and isolation
    • Recognize the limits of quarantine and isolation in dealing with communicable diseases
    • Describe the ethical issues raised by the quarantine or isolation of individuals and communities
    • Explain how the “harm principle” is used as a justification for implementing quarantine and isolation measures
    • Describe the use of the “precautionary principle” in deciding whether or not to implement quarantine and isolation measures
  4. Risk and Crisis Communication –
    • Explain the the difference between communication, risk communication, and propaganda
    • Explain the relationship between knowledge, communication, and action
    • Identify the roles and responsibilities of public authorities, health care professionals, the media, and others in a time of terror
    • Recognize the myths and realities about sharing information with the public
    • Discuss the practical and ethical consequences of nondisclosure of information, of “spin,” and of misinformation
  5. Psychosocial Issues –
    • Identify the effects of a terror event on individuals' attitudes, behaviors, and relationships
    • Describe how community and culture shape the ways in which individuals cope with terror
    • Describe how community and culture are influenced by a terror event or during an “age of terrorism”
    • Recognize the strengths that people and communities bring to disasters and to terror events
  6. Religion, Spirituality, and Culture –
    • Discuss how spiritual, religious, and cultural values affect our attitudes and our conduct
    • Describe the diversity of customs and practices surrounding death and dying, medical treatment, public health authority, and political power
    • Describe the effects of history and practice on the attitudes and conduct of religious and cultural minorities
    • Recognize how poverty and institutional bias undermine the effectiveness of public health efforts
    • Recognize how trust, justice, and fairness are necessary to effective responses to terror
  7. Allocation of Resources –
    • Describe the competitive forces at work in allocation policies
    • Identify the difference that an “age of terrorism” has made in setting priorities
    • Recognize the relationship between budget priorities and ethical decisions
    • Explain the social and political factors that shape budget priorities
    • Discuss the ethical issues that arise from this competitive situation
  8. Allocation of Scarce Medical Resources –
    • Distinguish between ordinary medical priorities and those that appear after a WMD/T attack
    • Recognize the conflicting roles, responsibilities, and choices facing caregivers and others
    • Discuss the moral requirements of community-focused as opposed to individually-focused medical ethics
  9. Agriculture and Terrorism –
    • Recognize the systemic relationships involved in the “food chain”
    • Describe the particular vulnerabilities to which the food supply and its human, animal, and plant producers are subject
    • Discuss the implications of the divide between urban and rural communities
  10. Professional Obligation –
    • Recognize the relationship between professional community, tradition, and duty.
    • Define the meaning of the phrase “duties and privileges,” which marks the recognition of someone's professional status
    • Discuss the usefulness and limits of professional codes of conduct
    • Describe the consequences when caregivers and other professionals fail to meet their professional responsibilities or complete assigned tasks
    • Identify the similarities and differences between obligations under conditions of clinical emergencies, natural disasters, and terror events

Technical Requirements

This course is built to XHTML 1.1 specifications. A modern web browser such as Microsoft Internet Explorer or Mozilla Firefox is required to view the pages.

Version

Originally launched August 7, 2008

Time

Estimated time for this course is 10 hours.

Cost

Free and open to the public.

Acknowledgement

This program on which this online course is based was developed by the University of South Carolina Center for Public Health Preparedness. Curriculum development has been a collective effort of Dr. Howard B. Radest, PhD, adjunct professor of philosophy at USC – Beaufort; Dr. Harvey Kayman, former chief of the Bureau of Maternal Child Health at the South Carolina Department of Health and Environmental Control (DHEC); and Dr. Jane Richter, director and co-principal investigator of the USC Center for Public Health Preparedness (USC-CPHP). The online course was developed by Susan Jewell of the Professional Development Program, Rockefeller College, University at Albany in collaboration with the University at Albany Center for Pubic Health Preparedness.

The development of the original curriculum was supported by Cooperative Agreement Number U90/CCU424245-02 from the CDC (Centers for Disease Control and Prevention) to the University of South Carolina Center for Public Health Preparedness at the Arnold School of Public Health. Although development is supported by the CDC, the content is solely the responsibility of the author and does not necessarily represent the official views of the CDC.”

 

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