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Lives on the line? Ethics and practicalities of duty of care in pandemics and disasters

¹ Clinical and Academic Unit of Sleep and Breathing, Royal Brompton & Harefield NHS Trust, and ² St George's Hospital Medical School, University of London, London, UK.

CORRESPONDENCE: A. K. Simonds, Clinical and Academic Unit of Sleep and Breathing, Royal Brompton & Harefield NHS Trust, London, SW3 6NP, UK. E-mail: A.Simonds{at}rbht.nhs.uk

Keywords: Avian influenza, duty of care, ethics, medical disasters, pandemic influenza, swine influenza

Received: March 14, 2009
Accepted May 6, 2009

Pandemics and acute emergencies raise pressing medical, ethical and organisational challenges. These include global governance, priority setting, triaging of patients, allocation of scarce resources and restricting individual liberty in the interests of public health. We will focus particularly on an issue of direct relevance to all respiratory team members, i.e. what is the duty of the healthcare worker to continue working in the face of personal risk, and draw lessons from guidelines, ethical considerations, past pandemics and evolving experience with H1N1 swine influenza.