The objectives of this article are (i) to identify the most challenging ethical dilemmas and questions arising from the experiences of communities and professionals affected by or involved in volcanic eruptions, including risk management, the dissemination of information, and tourism; and (ii) to provide arguments for intercultural ethics to address these dilemmas. Intercultural ethics provide invaluable resources to disaster ethics across all three phases of the complete disaster management cycle. In this article, intercultural ethics (...) is viewed as an ethics grounded in ongoing dialogue, facilitating the examination and establishment of norms and a critical reflection on values and their evolution. This approach recognizes power dynamics that may influence fair participation in dialogues and aims to address them, while also integrating elements of deliberative ethics to ensure that dialogues genuinely contribute to legitimizing decisions. Intercultural sensibility helps bridge the gap between experts and non-experts in both directions (a) by emphasizing the duty of transferring scientific knowledge (for experts) and the responsibility of acquiring scientific literacy (for citizens); and (b) by highlighting the importance of a ‘knowledge dialogue’ that acknowledges the non-scientific knowledge of citizens, rooted in their cultural background and experiences of dealing with past disasters, and shaping life in volcanic territories. (shrink)

Ethical dilemmas affect several essential elements of humanitarian aid, such as the adequate selection of crises to which to provide aid and a selection of beneficiaries based on needs and not political or geostrategic criteria. Other challenges encompass maintaining neutrality against aggressors, deciding whether to collaborate with governments that violate human rights, and managing the allocation and prioritization of limited resources. Additionally, issues arise concerning the safety and protection of aid recipients, the need for cultural and political sensitivity, and recognition (...) of the importance of local knowledge, skills, and capacity. The appropriateness, sustainability, and long-term impact of actions; security risks for aid personnel; and the need for transparency and accountability are also crucial. Furthermore, humanitarian workers face the duty to report and engage in civil activism in response to human rights violations and the erosion of respect for international humanitarian law. Lastly, the rights of affected groups and local communities in the decision-making and implementation of humanitarian aid are vital. The traditional foundations and approaches of humanitarian aid appear insufficient in today’s landscape of disasters and crises, which are increasingly complex and divergent, marked by a diminished capacity and shifting roles of various actors in alleviating suffering. This article reviews the historical evolution of the conceptualization of humanitarian aid and addresses some of its ethical challenges and dilemmas. (shrink)

Traditional ethical frameworks are challenged in disaster settings as they are often too rigorous to be applied to such situations. Nonetheless, the role of moral theories in discussions on disasters should not be dismissed. Indeed, some of the ideas and concepts in traditional ethical frameworks and moral theories may be a source of inspiration in such debates. Therefore, the present paper presents the two main concepts in Albert Schweitzer’s philosophical thinking: the concept of cultural crisis and his understanding of (...) ethics. These concepts form the basis of Schweitzer’s formulation of an ethics of the reverence for life as an answer to the cultural crisis and the need for a new ethics for a modern, humane civilisation. His thinking is reflected through the scope of disaster ethics and its potential to enrich discussions on disaster ethics is critically analysed. (shrink)

The ethics of social consequences is a means of satisficing non-utilitarian consequentialism that can be used to approach disaster issues. The primary values in the ethics of social consequences are humanity, human dignity and moral rights, and these are developed and realized to achieve positive social consequences. The secondary values found in the ethics of social consequences include justice, responsibility, moral duty and tolerance. Their role and purpose is given by their ability to help achieve and (...) realize moral good. Fair treatment within moral issues stems from applying primary as well as secondary values. The nature of these values cannot be determined exclusively in ordinary circumstances. However, in extraordinary circumstances (disasters), not all the requirements relating to the value structure of the ethics of social consequences need be considered in its entirety. In extraordinary circumstances, values are prioritised and realized. Primary values are realized prior to secondary ones. When prioritizing primary values, the realization of positive social consequences, or at least minimizing the negative social consequences, takes priority over other primary values. In disaster bioethics especially, it is often necessary to find a way to minimize the negative social consequences; thus, actions where positive social consequences are prevalent are preferred. (shrink)

This book presents the first critical examination of the overlapping ethical, sociocultural, and policy-related issues surrounding disasters, global bioethics, and public health ethics. These issues are elucidated under the conceptual rubric: Public health disasters. The book defines PHDs as public health issues with devastating social consequences, the attendant public health impacts of natural or man-made disasters, and latent or low prevalence public health issues with the potential to rapidly acquire pandemic capacities. This notion is illustrated using Ebola and pandemic (...) influenza outbreaks, atypical drug-resistant tuberculosis, and the health emergencies of earthquakes as focal points. Drawing on an approach that reckons with microbial, existential, and anthropological realities; the book develops a relational-based global ethical framework that can help address the local, anthropological, ecological, and transnational dynamics of the ethical issues engendered by public health disasters. The book also charts some of the critical roles that relevant local and transnational stakeholders may play in translating the proposed global ethical framework from the sphere of concept to the arena of action. This title is of immense benefit to bioethics scholars, public and global health policy experts, as well as graduate students working in the area of global health, public health ethics, and disaster bioethics. (shrink)

Ethics for Disaster addresses the moral aspects of the aftermath of natural disasters such as hurricanes, earthquakes, and tornadoes. The book explores how these catastrophes illuminate the existing inequalities in society, combining a unique philosophical approach with new moral thinking. Zack stresses the obligation of both individuals and government in preparing for and responding to dangerous times, forcefully arguing for the preservation of normal moral principles even in times of crisis and national emergency.

Rabbinic tales of drought, disaster, and charismatic holy men illuminate critical questions about power, ethics, and ecology in Jewish late antiquity. Through a sustained reading of the Babylonian Talmud's tractate on fasts in response to drought, this book shows how Bavli Taʿanit challenges Deuteronomy's claim that virtue can assure abundance and that misfortune is an unambiguous sign of divine rebuke. Employing a new method for analyzing lengthy talmudic narratives, Julia Watts Belser traces complex strands of aggadic dialectic to (...) show how Bavli Taʿanit's redactors articulate a strikingly self-critical theological and ethical discourse. Bavli Taʿanit castigates rabbis for misuse of power, exposing the limits of their perception and critiquing prevailing obsessions with social status. But it also celebrates the possibilities of performative perception - the power of an adroit interpreter to transform events in the world and interpret crisis in a way that draws forth blessing. (shrink)

This Open Access Book is the first to examine disasters from a multidisciplinary perspective. Justification of actions in the face of disasters requires recourse both to conceptual analysis and ethical traditions. Part 1 of the book contains chapters on how disasters are conceptualized in different academic disciplines relevant to disasters. Part 2 has chapters on how ethical issues that arise in relation to disasters can be addressed from a number of fundamental normative approaches in moral and political philosophy. This book (...) sets the stage for more focused normative debates given that no one book can be completely comprehensive. Providing analysis of core concepts, and with real-world relevance, this book should be of interest to disaster scholars and researchers, those working in ethics and political philosophy, as well as policy makers, humanitarian actors and intergovernmental organizations.. (shrink)

We are morally obligated to plan for disaster because it affects human life and well-being. Because contemporary disasters affect the public, such planning should be public in democracies and it should not violate the basic ethical principles of normal times. Current Avian Flu pandemic planning is restricted to a response model based on scarce resources, or inadequate preparation, which gives priority to some lives over others. Rather than this model of ‘Save the Greatest Number,’ the public would be more (...) ethically served by a model of ‘Save All Who Can Be Saved,’ which is based on adequate preparation. And where events exceed adequate preparation, scarce resources should be allocated fairly. (shrink)

The ethics of managing obstetric patients in medical disasters poses ethical challenges that are unique in comparison to other disaster patients, because the medical needs of two patients—the pregnant patient and the fetal patient—must be considered. We provide an ethical framework for doing so. We base the framework on the justice-based prevention of exploitation of populations of patients, both obstetric and non-obstetric, in medical disasters. We use the concept of exploitation to identify a spectrum from ethically acceptable, to (...) ethically challenging, to ethically unacceptable, management of obstetric patients in medical disasters. We also address the ethics of the care of obstetric and neonatal patients when the resources of a hospital are completely overwhelmed in a large-scale medical disaster. (shrink)

Neither in theory nor in practice does there exist a single model of decision making. It is very difficult to identify a model, or models, which would be most useful during and after a disaster. Within the disaster timeframe (a difficult and complex situation), specific moral dilemmas arise. All the decision making theories tend to be associated with different assumptions about human nature, the quality of the decisions made and the manner in which they are made. Different assumptions (...) may result in different tools being used and subsequently different consequences. The paper will provide a general introduction to the ethical decision making model, and will suggest two ways in which decisions in ethics might be made. The paper will try to deepen the discussion, and suggest answers to questions such as which type of ethical decision making is better in a specific situation such as a disaster? Is there any need to use a different decision making model (from an ethical point of view) in a disaster than in another event? Nonetheless, the article does not provide explicit solutions to these questions, since providing them would require further investigation than is the aim of this paper. (shrink)

Paul A. Vatter, Lawrence E. Fouraker Professor of Business Administration, Harvard University, writing of Global Disasters: Inquiries into Management Ethics, ‘In my view one of the most important things that can be done to improve ethics in management is, through cases, to sensitize managers to ethical issues in situations in which they did not perceive themselves as being involved. His well-documented and detailed cases stimulate great interest. His diagnosis of the process through which ethical behavior could have prevented (...) each disaster is provocative and sensitising.’ -/- A. L. Minkes, Fellow, Royal Society of Arts, Emeritus Professor of Business Organization, University of Birmingham, in writing of Global Disasters: Inquiries into Management Ethics, ‘Dr. Allinson has very substantially enlarged the whole nature of the discussion of crisis, disaster and safety. The powerful and highly apposite phrase that he has coined, ‘The Buck Stops Here and It Stops Everywhere Else As Well’, illustrates the significant contribution of his philosophical analyses to a wide range of applied managerial problems in organizations. -/- S. Prakash Sethi, Director, Center for Management Development and Organization Research, Baruch College, City University of New York, writing of Global Disasters: Inquiries into Management Ethics, ‘Global Disasters is a thought-provoking book and provides excellent insights into how management systems can be built that would prevent hitherto “unpreventable” disasters. Professor Allinson makes a convincing argument and an intriguing suggestion that, notwithstanding commonly held beliefs, most industrial crises are preventable through sound management structures and decision-making processes only when they are rooted in ethical values and beliefs on the part of top management.’ This book, by a professor of philosophy at Soka University of America, former professor of philosophy at The Chinese University of Hong Kong and former Visiting Fellow of Business Ethics at the University of Oxford argues that major disasters can be prevented. He shows how corporate management must accept its moral responsibility to create a corporate ethos that recognizes the basic principle that people matter most. (shrink)

Feminist reflections on the sexual division of labour have given rise to a body of knowledge on the ethics of care from different disciplines, including philosophy, in which outstanding contributions to the topic have been formulated. This approach is applicable to the analysis of any phenomenon and particularly that of disasters. As various investigations have highlighted, the consequences on the population throughout all of a disaster’s phases (prevention, emergency, and reconstruction) require an analysis of differentiated vulnerabilities based on (...) gender and other identity categories, such as social class, ethnicity, age, disability, sexual identity, etc. The interrelation between all these variables gives rise to differentiated impacts that cannot be ignored in catastrophic contexts, where survival and sustaining life are at stake, so care becomes a central issue. Research on the topic has also identified that, along with the analysis of social vulnerability, we must consider the capacity for agency, both individual and collective, where care is once again of vital importance. Considering the gender approach and its multiple intersections is thus a fundamental theoretical-practical proposal for the study of disasters from philosophy, as it implies an unavoidable epistemic, ontological, and ethical reflection in the face of risk reduction. (shrink)

Ethical issues are very relevant in the field of women’s, gender and/or feminist studies. The aim of this article is to highlight the ethical challenges faced by the authors in their research process, with specific reference to two projects on gender and disasters in which they have been involved. In general, we try to avoid sexist bias throughout the complete research process, from the definition of the objectives themselves to the methodology design, where we ensure diversity in the selection of (...) participants in order to take into consideration the variety of voices present in society, especially those of women. Also, when developing our research, we take into account the power relationships involved, both between those who participate in the fieldwork and with the researchers themselves. To counteract the effects of such relations, we have considered people’s wellbeing and the humanization of the whole process. Finally, when it comes to the dissemination of the results and their transfer to society at large, we follow the same principles and actively integrate the people involved. Considering these issues benefits the research process and makes the resultant knowledge more ethical and socially useful, in addition to promoting more egalitarian gender relations. (shrink)

PurposeThis paper aims to argue that traditional ethical theories used in disaster response may be inadequate and particularly strained by the emergence of new technologies and social media, particularly with regard to privacy. The paper suggests incorporation of care ethics into the disaster ethics nexus to better include the perspectives of disaster affected communities.Design/methodology/approachThis paper presents a theoretical examination of privacy and care ethics in the context of social media/digitally enhanced disaster response.FindingsThe paper (...) proposes an ethics of care can fruitfully by used by public and private agents in disaster management. Its relational ontology restores the priority of fostering good relationships between stakeholders, thus giving central importance to values such as transparency and trust and the situated knowledge of disaster-affected communities.Research limitations/implicationsThis paper presents theoretical research and is limited by the availability of empirical data. There is opportunity for future research to evaluate the impact of a conscious adoption of an ethics of care by disaster management agents.Practical implicationsAn ethos of care ethics needs to be mainstreamed into disaster management organisations and digital initiatives.Social implicationsThis paper argues that power asymmetry in disaster response renders the public vulnerable to abuse, and that the adoption of care ethics can support disaster management agents in recognising this power imbalance and wielding power responsibly.Originality/valueThis paper examines the applicability of an alternative ethical framework to novel circumstances. (shrink)

Natural disasters in populated areas may result in massive casualties and extensive destruction of infrastructure. Humanitarian aid delegations may have to cope with the complicated issue of patient prioritization under conditions of severe resource scarcity. A triage model, consisting of five principles, is proposed for the prioritization of patients, and it is argued that rational and reasonable agents would agree upon them. The Israel Defense Force's humanitarian mission to Haiti following the 2010 earthquake serves as a case study for the (...) various considerations taken into account when designing the ethical-clinical policy of field hospitals. The discussion focuses on three applications: the decision to include an intensive care unit, the decision to include obstetrics and neonatal units, and the treatment policy for compound fractures. (shrink)

The conduct of research in settings affected by disasters such as hurricanes, floods and earthquakes is challenging, particularly when infrastructures and resources were already limited pre-disaster. However, since post-disaster research is essential to the improvement of the humanitarian response, it is important that adequate research ethics oversight be available. We aim to answer the following questions: 1) what do research ethics committee members who have reviewed research protocols to be conducted following disasters in low- and middle-income (...) countries perceive as the key ethical concerns associated with disaster research?, and 2) in what ways do REC members understand these concerns to be distinct from those arising in research conducted in non-crisis situations? This qualitative study was developed using interpretative description methodology; 15 interviews were conducted with REC members. Four key ethical issues were identified as presenting distinctive considerations for disaster research to be implemented in LMICs, and were described by participants as familiar research ethics issues that were amplified in these contexts. First, REC members viewed disaster research as having strong social value due to its potential for improving disaster response, but also as requiring a higher level of justification compared to other research settings. Second, they identified vulnerability as an overarching concern for disaster research ethics, and a feature that required careful and critical appraisal when assessing protocols. They noted that research participants’ vulnerabilities frequently change in the aftermath of a disaster and often in unpredictable ways. Third, they identified concerns related to promoting and maintaining safety, confidentiality and data security in insecure or austere environments. Lastly, though REC members endorsed the need and usefulness of community engagement, they noted that there are significant challenges in a disaster setting over and above those typically encountered in global health research to achieve meaningful community engagement. Disaster research presents distinctive ethical considerations that require attention to ensure that participants are protected. As RECs review disaster research protocols, they should address these concerns and consider how justification, vulnerability, security and confidentially, and community engagement are shaped by the realities of conducting research in a disaster. (shrink)

BackgroundDuring a disaster, nurses face complex ethical challenges because of risky situations. It is necessary to identify trends and ethical issues of nurses in disasters to improve the quality...

Conducting research during or in the aftermath of disasters poses many specific practical and ethical challenges. This is particularly the case with research involving human subjects. The extraordinary circumstances of research conducted in disaster settings require appropriate regulations to ensure the protection of human participants. The goal of this study is to systematically and qualitatively review the existing ethical guidelines for disaster research by using the constant comparative method. We performed a systematic qualitative review of disaster research (...) ethics guidelines to collect and compare existing regulations. Guidelines were identified by a three-tiered search strategy: 1) searching databases, 2) an Internet search, and 3) a search of the references in the included documents from the first two searches. We used the constant comparative method for analysis of included guidelines. Fourteen full text guidelines were included for analysis. The included guidelines covered the period 2000-2014. Qualitative analysis of the included guidelines revealed two core themes: vulnerability and research ethics committee review. Within each of the two core themes, various categories and subcategories were identified. Some concepts and terms identified in analyzed guidelines are used in an inconsistent manner and applied in different contexts. Conceptual clarity is needed in this area as well as empirical evidence to support the statements and requirements included in analyzed guidelines. (shrink)

The nuclear disaster that Japan suffered at Fukushima in the months following March 11, 2011 has been compared with other major nuclear disasters, especially, Three Mile Island (1979) and Chernobyl (1986). It is more like Chernobyl in severity, the only other 7 on the International Nuclear Event Scale; more like Three Mile Island in long-term effects. Yet Fukushima is not just another nuclear disaster. In ways important to engineering ethics, it is much more like Katrina’s destruction of (...) New Orleans than like any nuclear disaster. It is (primarily) a consequence of a natural disaster, the enormous earthquake and tsunami that wrecked much of northeast Japan. One lesson of Fukushima, one shared with Katrina, concerns the different roles engineers have at different stages in an engineering project (planning, designing, management, and operations). In the planning stage, engineers seem to have relatively little power to affect certain early large-scale trade-offs between public safety and public welfare. Another lesson may be the importance of not leaving complex technical systems untended. The events that made the disasters at Three Mile Island and Chernobyl inevitable lasted only a few minutes or hours; the events that made the disasters in New Orleans and Fukushima inevitable were spread over several days. Fukushima avoided a more serious disaster because the plants were not abandoned in the way New Orleans was. A third lesson concerns our ideas of heroism, especially our sense that heroism is sometimes one’s duty. An engineer’s duty sometimes includes protecting others from harm even at the risk of the engineer’s life. (shrink)

This paper addresses the ethical issues of secondary uses of samples collected for identification purposes following mass disasters. It studies norms governing secondary use of samples , ultimately concluding that limited secondary research uses of these samples should be permissible.

Health Care professionals working in disaster situations have to face urgent choices which diverge from their normal deontological ethos and are more utilitarian. Such is the triage system used to choose whom to treat. Instead of entering a crisis these professionals should be thought that ethics is not harmonizable to all situations and that there are situations in which saving as many lives as possible mean sacrificing others. This calls for defining a perimeter zone in which such choices (...) occur, and a time frame (a space–time niche) in which it ought to be considered ethical and legitimate to use such value laden choices. (shrink)

Disaster research has grown in scope and frequency. Research in the wake of disasters and during humanitarian crises – particularly in resource-poor settings – is likely to raise profound and unique ethical challenges for local communities, crisis responders, researchers, and research ethics committees. Given the ethical challenges, many have questioned how best to provide research ethics review and oversight. We contribute to the conversation concerning how best to ensure appropriate ethical oversight in disaster research and argue (...) that ethical disaster research requires of researchers and RECs a particular sort of ongoing, critical engagement which may not be warranted in less exceptional research. We present two cases that typify the concerns disaster researchers and RECs may confront, and elaborate upon what this ongoing engagement might look like – how it might be conceptualized and utilized – using the concept of real-time responsiveness. The central aim of RTR, understood here as both an ethical ideal and practice, is to lessen the potential for research conducted in the wake of disasters to create, perpetuate, or exacerbate vulnerabilities and contribute to injustices suffered by disaster-affected populations. Well cultivated and deployed, we believe that RTR may enhance the moral capacities of researchers and REC members, and RECs as institutions where moral agency is nurtured and sustained. (shrink)

In the trauma surrounding mass disasters, the need to identify victims accurately and as soon as possible is critical. DNA identification testing is increasingly used to identify human bodies and remains where the deceased cannot be identified by traditional means. This form of testing compares DNA taken from the body of the deceased with DNA taken from their personal items or from close biological relatives. DNA identification testing was used to identify the victims of the terrorist attack on the World (...) Trade Center in New York on September 11, 2001, and of the victims of the Tsunami that hit Asia on December 26, 2004. Shortly after the 9/11 attack, police investigators asked the victims' families for personal items belonging to the missing, and for DNA samples from family members themselves. The New York medical examiner's office coordinated the DNA identification testing program; however, some of the identification work was contracted out to private laboratories. (shrink)

The noticeable turn to technology in humanitarian action raises issues related to humanitarianism, sovereignty, as well as equality and access for at-risk populations in disaster zones or remote areas lacking sufficient healthcare services. On a technical level, practical challenges include heightened risks of data safety and security, and the potential malicious use of technology. On a societal level, humanitarian innovation may disrupt relations between different stakeholders, may widen inequality between those with access and those without, and may threaten privacy, (...) disproportionately affecting the vulnerable population. Drawing on the empirical findings of a case study of the 2015 Nepal earthquake, this paper presents an in-depth normative analysis to identify contextualised ethical considerations, and illuminate the wider debate about how technological innovation in the aid sector should be operationalised. In conclusion, on the normative level, a prudent attitude in adopting novel technology in the aid sector is required; while on the operational level, proposals for actionable ethical standards to guide and safeguard sector-wide innovation practices are needed. (shrink)

In emergencies and disasters, ethics are affected by both personal and organizational factors. Given the lack of organizational ethical guidelines in the disaster management system in Iran, the present study was conducted to explain the personal factors affecting ethics and ethical behaviors among disaster healthcare workers. The present qualitative inquiry was conducted using conventional content analysis to analyze the data collected from 21 in-depth unstructured interviews with healthcare workers with an experience of attending one or more (...) fields of disaster. According to the data collected, personal factors can be classified into five major categories, including personal characteristics such as age and gender, personal values, threshold of tolerance, personal knowledge and reflective thinking. Without ethical guidelines, healthcare workers are intensely affected by the emotional climate of the event and guided by their beliefs. A combination of personal characteristics, competences and expertise thus form the basis of ethical conduct in disaster healthcare workers. (shrink)

Bioethics, Volume 36, Issue 9, Page 901-901, November 2022.

With the increasing number of human disasters in recent years, disaster service workers are faced with an ever-growing challenge of criticism concerning their professional competence. The workers also realize the limitation inherent in their practice, as well as bioethics problems regarding autonomy and heteronomy. Therefore, professionals and researchers of human service devote to the issue of post-disaster rehabilitation of the people so as to identify an effective way and practice to aid the post-disaster individual, family and community. (...) This study explores the effectiveness of rehabilitative function of disaster service workers through the action research of Typhoon Morakot and the 2014 Gas Explosion in Kaohsiung City, Taiwan. The case studies serves as a platform for thediscussion of principles of bioethics and the analysis of the process of self-discipline of the workers of human services in hope of ultimately establishing bioethical principles for heteronomy during disasters and work indicators for post-disaster community restoration. Discuss Issues are 1. How can self-discipline in bioethics be achieved for the human service workers during times of disaster? 2. In post-disaster reconstruction, how does the human service worker take into? account bioethical principles to serve and partake in the restoration of the postdisaster life of community residents? 3. During the process of a disaster research, what are the bioethical considerations to be taken into for the test subjects? Conclusion and suggestions: To formulate indicators for a post-disaster “community of health and wellness;” to establish bioethical principles of heteronomy for disaster service workers. (shrink)

Victims of disaster suffer, not only at the very moment of the disaster, but also years after the disaster has taken place, they are still in an emotional journey. While many moral perspectives focus on the moment of the disaster itself, a lot of work is to be done years after the disaster. How do people go through their suffering and how can we take care of them? Research on human suffering after a major catastrophe, (...) using an ethics of care perspective, is scarce. People suffering from disasters are often called to be in distress and their emotional difficulties ‘medicalised’. This brings them often into a situation of long term use of medication, and one can wonder if medication is of help to them in the long run. In our paper, we will explore another moral perspective, focusing on the importance of the victims’ narrative and their lived experiences. We will use Paul Ricoeur’s phenomenological reflections from ‘Suffering is not the same as pain’ for conceptualizing human suffering and how to apply it to victims of disaster. Ricoeur suggests that suffering is not a quantity that can be measured, but a characteristic that should be studied qualitatively in interpersonal and narrative contexts. Above all, the perspective of care and listening could offer an opportunity to reconcile people from their loss and suffering. (shrink)

The earthquakes which struck Nepal’s capital in 2015 were humanitarian disasters. Not only did they inflict tragic loss of life and livelihoods, they also destroyed parts of the Kathmandu Valley’s unique UNESCO World Heritage site. These monuments were not just ornate structures but living monuments playing central roles in the daily lives of thousands, representing portals where the heavens touch earth and people commune with guiding deities. Their rehabilitation was also of economic importance as they represent a major source of (...) tourist income and employment. Unfortunately, the social and political desire for rapid reconstruction resulted in the swift removal of many traditionally constructed foundations and their replacement with modern materials without assessments of whether they contributed towards the collapse of individual monuments. These actions, combined with the wholesale removal, mixing and dumping of modern and historic debris, contributed to a second, equally destructive, cultural catastrophe – irreversible damage to Kathmandu’s Medieval fabric, in a process which frequently excluded local communities and custodians. This case study draws from our collective reflections and lessons learned from our attempts to enable equitable and ethical research partnerships between UK and Nepali colleagues as well as local communities in the debris of the Kasthamandap, Kathmandu’s eponymous monument. After briefly describing the potential of mobilising archaeologists in post-disaster contexts and outlining the challenges of undertaking research in such a setting, our case study utilises the TRUST Code to assess the character and success of our multidisciplinary collaboration in a time of crises. (shrink)

During disasters, clinicians may be forced to play dual roles, as both a provider and an allocator of scarce resources. At present, a clear framework to govern resource stewardship at the bedside is lacking. Clinicians who find themselves practicing in this ethical gap between clinical and public health ethics can experience significant moral distress. One provider describes her experience allocating an oxygen tank in the intensive care unit at a hospital in Port-au-Prince, Haiti, immediately following the 2010 earthquake. Using (...) a clinical vignette and reflective narrative she attempts to identify the factors that influenced her allocation decision, opening up the factors for commentary and debate by an ethicist. A better paradigm for the ethical care of patients during disasters is needed to better guide provider choices in the future. (shrink)

In his article ‘The Ebola Clinical Trials: a precedent for research ethics in disasters’, Philippe Calain constructs a compelling case as to why and how experiences from the recent Ebola epidemic should be used to develop a framework for disaster research ethics. In particular, Calain proposes a useful model for assessing whether or not an unproven intervention could be suitable for human use in a disaster context, and makes a powerful argument against the separation of patient (...) care from research goals. In this commentary, I argue that the separation of patient care goals from research goals is also unhelpful in the context of other forms of participant disadvantage even when that disadvantage is less severe than an ongoing public health emergency. I contend that recognising that research in disadvantaged populations is an intervention that could and should aim to produce positive outcomes for participants, just as it should in disaster contexts, therefore seems a well-justified lesson that can be extrapolated from the experience of the Ebola epidemic. (shrink)

ABSTRACT:Translational ethics is a practice that aims to apply bioethics insights and process to the real-world contexts of clinical medicine, but also government policy, systems issues, and public health. This work has been a career focus for a relatively small number of bioethicists over the years, but it has drawn greater attention due to the pandemic and a greater realization of the impact of health inequities and systemic injustice. This essay discusses the pathway, rewards, and challenges of translational bioethics (...) as experienced by one bioethicist working with state and national groups on a range of translational ethics issues, often related to public health disasters. There is much remaining work to be done, and the goal of the essay is to encourage rising bioethicists to engage in translational bioethics. (shrink)

Funding broadly connotes the notion of an institution and/or institutions making money and other resources available to individual researchers and organizations to accomplish specific projects. Whi...

Given the unprecedented scope and stakes of contemporary environmental crisis, ethicists have raised critical questions about whether traditional religious texts can speak in a meaningful way to climate change and other environmental risks in the anthropocene. Building on the ethical urgency of the environmental justice movement, this essay offers a feminist reading of Jewish narratives from the Babylonian Talmud that centers attention on issues of power, privilege, and social inequality in the midst of disaster. Talmudic tales of the destruction (...) of Jerusalem critique the moral oblivion of wealthy residents who failed to act in response to crisis. Articulating a Jewish feminist reconstituative ethics, the author uses these tales to trace the ethical costs of epistemologies of ignorance—the complex strategies and social processes through which privileged communities cultivate ignorance of environmental suffering, maintain social distance from environmental risk, and disown moral culpability for environmental injustice. (shrink)

This book review outlines and critiques Robert Allinson's book _Global Disasters: Inquiries into Management Ethics_ (New York: Prentice Hall, 1993). The reviewer first outlines the structure of the book and then moves on to discussing the main arguments of the book, including but not limited to the distinctions between "monocausality" and "multi-causality" and "scapegoating" and "multiple responsibility" that Allinson highlights. Central to Allinson's argument is the thesis that problems in management (and the disasters that often result from them) are conceptual (...) problems first of all. The review concludes by praising the bold and timely contribution of this volume. (shrink)

Guideline 20 of the updated International Ethics Guidelines for Health‐related Research Involving Humans (2016) by the Council for International Organizations of Medical Sciences (CIOMS) provides guidance on research in disasters and disease outbreaks against the background of the need to generate knowledge quickly, overcome practical impediments to implementing such research, and the need to maintain public trust. The guideline recommends that research ethics committees could pre‐screen study protocols to expedite ethical reviews in a situation of crisis, that pre‐arrangements (...) be made regarding data sharing and biomedical sample sharing, and that sponsors and research ethics committees seek to minimize risk to researchers conducting research during a disaster. This paper critiques these recommendations against the background of the findings of a survey of public health officials and chairs of research ethics committees in the Caribbean during 2016, which sought to determine the best template for the expeditious ethical review of research proposals in emergency and epidemic situations in the Caribbean, and whose findings can serve as a model for other low‐ and middle‐income countries. (shrink)

The West African Ebola epidemic has set in motion a collective endeavour to conduct accelerated clinical trials, testing unproven but potentially lifesaving interventions in the course of a major public health crisis. This unprecedented effort was supported by the recommendations of an ad hoc ethics panel convened in August 2014 by the WHO. By considering why and on what conditions the exceptional circumstances of the Ebola epidemic justified the use of unproven interventions, the panel's recommendations have challenged conventional thinking (...) about therapeutic development and clinical research ethics. At the same time, unanswered ethical questions have emerged, in particular: the specification of exceptional circumstances, the specification of unproven interventions, the goals of interventional research in terms of individual versus collective interests, the place of adaptive trial designs and the exact meaning of compassionate use with unapproved interventions. Examination of these questions, in parallel with empirical data from research sites, will help build pragmatic foundations for disaster research ethics. Furthermore, the Ebola clinical trials signal an evolution in the current paradigms of therapeutic research, beyond the case of epidemic emergencies. (shrink)