The current Ebola outbreak in West Africa is the biggest in history and is affecting multiple countries. To address the grave situation, U of T’s Joint Centre for Bioethics convened a panel discussion on the ethical issues surrounding the global public health responses towards the outbreak. The multidisciplinary panel featured Dr. Udo Schüklenk from Queen’s University and Dr. Nancy Walton from Ryerson University, in addition to Dr. Alison Thompson, Dr. James Lavery, and Dr. Ross Upshur from U of T. Dr. Temidayo Ogundiran and Dr. Abha Saxena joined the coversation remotely from Nigeria and the World Health Organization respectively.
The discussion covered a wide variety of issues, with the most urgent being the lack of resources available. Schüklenk, recently having returned from Nigeria and having noticed the overcrowding of treatment facilities, pointed out that the demand for centres was far from being fulfilled.
Given the high demand for and low supply of drugs, vaccines, and treatment facilities, the question of whether limited resources should be directed to data collection on the ground needs to be considered. Despite acknowledging the cost, Schüklenk was convinced that research should not be jeopardized.
However, current research fails to respond adequately to the outbreak. On this front, Walton said, “Research guidelines are fantastic, but the context in which they could be applied is very narrow.” She believes that in order for any discussion to be meaningful, certain rules need to be broken for actions such as fast-tracking a vaccine, but deciding which rule to override is an issue.
Another of the many of obstacles to an acceptable global health response is the lack of public trust. Thompson asked the audience to think from a different perspective. She said, “You have people coming in, in spacesuits, telling you that you cannot bury your mom the way you want to… there’s a profound mistrust in Africa around foreigners.”
According to Upshur, we know the ethical issues and have the analytical tools. However, the disconnect between the thinking and planning out of possible solutions, and the application of those plans in case of emergency, is the largest obstacle. “We can talk about ethics as much as we like but it’s not going to impact how we practice it,” he said.
