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.
KeywordsDisaster bioethics Public health ethics Research ethics Personalism Triage Rationing Evidence
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.
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