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3. Ethical issues
In preparing for and responding to an influenza pandemic, people working at all levels, from Government to those on the front line, will face difficult decisions and choices. These will impact on the freedom, health and, in some cases, survival prospects of individuals. Many people are also likely to face individual dilemmas and tensions between their personal, professional and work obligations. Given expected levels of additional demand, capacity limitations, staffing constraints and potential shortages of medical supplies, hard choices and compromises are likely to be particularly necessary in the fields of health and community care.
It is important that any guidance advocating the prioritisation of healthcare resources to certain groups of patients must have a sound and defensible ethical basis. People are more likely to accept the need for and the consequences of difficult decisions if these have been made in an open, transparent and inclusive way. National and local preparations for an influenza pandemic should therefore be based on widely held ethical values, with the choices that may become necessary discussed openly as plans are developed so that they reflect what most people will accept as proportionate and fair.
The UK Committee on Ethical Aspects of Pandemic Influenza ( CEAPI) was set up to advise on the ethical issues in health and community care and in public health arising from an influenza pandemic, and has developed an ethical framework to inform the development and implementation of health and community care and public health response policy. The systematic use of the principles it contains can act as a checklist to ensure that all the ethical aspects have been considered.
The overarching ethical principle of equal concern and respect (with its eight component principles listed in the guidance document Responding to pandemic influenza: The ethical framework for policy and planning) has been used to help develop this guidance. The way that these principles have been reflected in this guidance is detailed in Appendix 2.
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