Abstract
Disasters cause widespread devastation and destruction and raise many ethical issues in terms of planning and response. Both locally and globally, individuals and organizations have ethical responsibilities regarding these issues. Disaster bioethics is a developing field of scholarship and applied ethic, and overlaps with public health ethics with similar dilemmas and ethical frameworks being developed. Within disasters resources are always scarce, necessitating rationing. Injuries are usually widespread after disasters, often far exceeding the available healthcare resources. This necessitates triage strategies which are ethically challenging. Decision-making may need to switch from treating the most critically injured first to treating those most likely to survive first, which can conflict with normal healthcare ethics frameworks. This creates moral distress for many healthcare workers, pointing to the importance of training and preparation in disaster bioethics. Evidence is also needed to guide decision-making in disasters, but is often lacking. This creates a need for more research, which raises additional ethical challenges. These and other ethical issues are examined in this article, which also highlight the need for additional reflection and training in disaster bioethics.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Drazen, J. M., Kanapathipillai, R., Campion, E. W., Rubin, E. J., Hammer, S. M., Morrissey, S., Baden, L. R. (2014). Ebola and quarantine. New England Journal of Medicine, 371, 2029–2030.
Fink, S. (2013). Five days at memorial: Life and death in a storm-ravaged hospital. New York: Crown.
Gerdin, M., Wladis, A., & von Schreeb, J. (2012). Foreign field hospitals after the 2010 Haiti earthquake: How good were we? Emergency Medicine Journal, 30, e8.
Gostin, L. O. (2006). Medical countermeasures for pandemic influenza: Ethics and the law. Journal of the American Medical Association, 295(5), 554–556.
Johnstone, M.-J., & Turale, S. (2014). Nurses’ experiences of ethical preparedness for public health emergencies and healthcare disasters: A systematic review of qualitative evidence. Nursing and Health Sciences, 16, 67–77.
O’Mathúna, D. P. (2010). Conducting research in the aftermath of disasters: Ethical considerations. Journal of Evidence-Based Medicine, 3(2), 65–75.
O’Mathúna, D. P. (2015). Research ethics in the context of humanitarian emergencies. Journal of Evidence-Based Medicine, 8(1), 31–35.
Petrini, C. (2010). Triage in public health emergencies: Ethical issues. Internal and Emergency Medicine, 5(2), 137–144.
Petrini, C., & Gianotti, S. (2008). A personalist approach to public-health ethics. Bulletin of the World Health Organization, 86(8), 624–629.
Timbie, J. W., Ringel, J. S., Fox, D. S., Pillemer, F., Waxman, D. A., Moore, M., Hansen, C. K., Knebel, A. R., Ricciardi, R., & Kellermann, A. L. (2013). Systematic review of strategies to manage and allocate resources during mass casualty events. Annals of Emergency Medicine, 61(6), 677–689.
Twigg, J. (2014). Attitude before method: Disability in vulnerability and capacity assessment. Disasters, 38(3), 465–482.
United Nations International Strategy for Disaster Reduction. (2011). Hyogo framework for action 2005–2015 mid-term review. Retrieved from http://www.unisdr.org/we/inform/publications/18197
University of Toronto Joint Centre for Bioethics. (2005). Stand on guard for thee: Ethical considerations in preparedness for pandemic influenza. Retrieved from http://www.jcb.utoronto.ca/publications/documents/stand_on_guard.pdf
Wagner, J. M., & Dahnke, M. D. (2015). Nursing ethics and disaster triage: Applying utilitarian ethical theory. Journal of Emergency Nursing, 41(4), 300–306.
World Medical Association (WMA). (2006). Statement on medical ethics in the event of disasters. Retrieved from http://www.wma.net/en/30publications/10policies/d7/index.html
Yamada, S., Gunatilake, R. P., Roytman, T. M., Gunatilake, S., Fernando, T., & Fernando, L. (2006). The Sri Lanka Tsunami experience. Disaster Management & Response, 4(2), 38–48.
Further Readings
COST Action IS1201: Disaster bioethics. http://DisasterBioethics.eu
Humanitarian Health Ethics Network. http://humanitarianhealthethics.net
Hunt, M., Schwartz, L., Pringle, J., Boulanger, R., Nouvet, E., & O’Mathúna, D. (2014). A research agenda for humanitarian health ethics. PLOS Currents Disasters, 1, 1–18.
O’Mathúna, D. P., Gordijn, B., & Clarke, M. (Eds.). (2014). Disaster bioethics: Normative issues when nothing is normal. Dordrecht: Springer.
World Health Organization. (2015). Ethics in research, surveillance and patient care in epidemics, emergencies and disasters: Training manual. Geneva: World Health Organization.
Acknowledgments
The author is grateful to Kristi Koenig for helpful feedback on a draft of this article and to COST Action IS1201 (http://DisasterBioethics.eu) for funding that allowed discussions at Action events that contributed greatly to the ideas addressed in this article.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this entry
Cite this entry
O’Mathúna, D.P. (2016). Disasters. In: ten Have, H. (eds) Encyclopedia of Global Bioethics. Springer, Cham. https://doi.org/10.1007/978-3-319-09483-0_142
Download citation
DOI: https://doi.org/10.1007/978-3-319-09483-0_142
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-09482-3
Online ISBN: 978-3-319-09483-0
eBook Packages: Religion and PhilosophyReference Module Humanities and Social SciencesReference Module Humanities