Scientists and policy‐makers have long understood that the products of research can often be used for good or evil. Nuclear fission research can be used to generate electricity or create a powerful bomb. Studies on the genetics of human populations can be used to understand relationships between different groups or to perpetuate racist ideologies. While the notion that scientific research often has beneficial and harmful uses has been discussed before, the threat of bioterrorism—a concern that has only grown since 2001—has (...) led to increased awareness about the need to prevent the misuse of biomedical research, particularly when it involves dangerous pathogens or toxins. In 2012, the concern was ratcheted up another notch by two papers reporting the results of research on genetically engineered strains of the H5N1 avian influenza virus. Although the H5N1 papers have potential scientific and social value, some scientists and policy‐makers opposed their publication because they feared that terrorists (or others with nefarious motives) could use the research to create a bioweapon that could trigger a global pandemic. The H5N1 papers raise difficult questions concerning the ethics of knowledge. Should scientific research with dangerous applications be published? Should some types of research be kept secret or not be conducted at all? What type of government oversight of dangerous research is appropriate? In this essay, I will develop a framework for thinking about the ethics of knowledge and apply it to the H5N1 controversy, focusing on issues related to publication. I will argue that redacted publication would have been a reasonable response to the dilemmas posed by the H5N1 papers if not for practical and legal problems with this option. Given these problems, full publication seems appropriate. (shrink)

Avian Flu Pandemic – Flight of the Healthcare Worker? Content Type Journal Article Pages 365-385 DOI 10.1007/s10730-009-9114-9 Authors Robert B. Shabanowitz, Geisinger Medical Center, Dept. of OB/GYN 100 North Academy Avenue Danville PA 17822-2920 USA Judith E. Reardon, Geisinger Medical Center Center for Health Research 100 North Academy Avenue Danville PA 17822-3003 USA Journal HEC Forum Online ISSN 1572-8498 Print ISSN 0956-2737 Journal Volume Volume 21 Journal Issue Volume 21, Number 4.

A recent controversy over the US National Science Advisory Board for Biosecurity's recommendation to censor two publications on genetically modified H5N1 avian influenza has generated concern over the threat to scientific freedom such censorship presents. In this paper, I argue that in the case of these studies, appeals to scientific freedom are not sufficient to motivate a rejection of censorship. I then use this conclusion to draw broader concerns about the ethics of dual-use research.

This survey aimed to illustrate factors that contribute to nurses' fear when faced with a possible human-to-human avian flu pandemic and their willingness to care for patients with avian flu in Taiwan. The participants were nursing students with a lesser nursing credential who were currently enrolled in a bachelor degree program in a private university in southern Taiwan. Nearly 42% of the nurses did not think that, if there were an outbreak of avian flu, their working hospitals (...) would have sufficient infection control measures and equipment to prevent nosocomial infection in their working environment. About 57% of the nurse participants indicated that they were willing to care for patients infected with avian influenza. Nurses' fear about an unknown infectious disease, such as the H5N1 influenza virus, could easily be heightened to levels above those occurring during the 2003 severe acute respiratory syndrome outbreak in Taiwan. (shrink)

In 2006 we awoke, in Europe at least, to the odd situation in which twitchers – obsessive birdwatchers who spend much of their leisure time on the far-flung edges of countries – are being reinvented as the eyes and ears of the state, helping warn of new border incursions. These incursions are posited as taking an avian form that may bring with it very unwelcome pathogens. Everyday avian observations and knowledges of migratory routes are being reinvented as a (...) kind of border patrol, a first line of veterinary surveillance. (shrink)

This article takes two events in the ongoing story of a predicted UK avian flu epidemic—“the dead parrot” (October 2005) and “the dying swan” (April 2006)—and examines the role and use of three interconnected metaphor scenarios (related to the notions of “journey,” “war,” and “house”) in the UK press coverage about avian influenza in 2005 and 2006. These represent fundamental descriptive and explanatory structures that derive from culturally or phenomenologically salient objects or experiences, and which allow journalists, scientists, (...) and policymakers to reduce the complexity of the threat posed by a disease and to promote risk-management strategies for the disease that appear to make instinctive or intuitive sense to experts and the public. Although similar metaphor scenarios may be used over time, the kinds of reporting they are associated with and the policy scenarios that result from these framings differ depending on the perceived proximity of the disease threat. (shrink)

The flu has an interesting history with respect to health care rationing in the United States. Consider that just about two years ago, the American public faced a shortage of influenza vaccine. Dire predictions were made about how many people might perish, and rationing protocols were created. However, many of the rationing protocols were ignored. Luckily, that flu season did not result in the horrible fatalities that were predicted. For these reasons, problems of health care rationing around issues of the (...) flu were postponed, rather than resolved.Over the last year, the public has focused its anxious attention on the possible avian influenza pandemic. Last week I noticed that at least once each day I heard mention in some discussion or another of the threat of this disease becoming easily transmissible from human to human. (shrink)

This paper examines the case of a recent H5N1virus (avian influenza) outbreak in West Bengal, an eastern state of India, and argues that poorly executed pandemic management may be viewed as a moral lapse. It further argues that pandemic management initiatives are intimately related to the concept of health as a social 'good' and to the moral responsibility of protection from foreseeable social harm from an infectious disease. The initiatives, therefore, have to be guided by special moral obligations towards (...) biorisk reduction, obligations which remain unfulfilled when a public body entrusted with the responsibility fails to manage satisfactorily the prevention and control of the infection. The overall conclusion is that pandemic management has a moral dimension. The gravity of the threat that fatal infectious diseases pose for public health creates special moral obligations for public bodies in pandemic situations. However, the paper views the West Bengal case as a learning opportunity, and considers the lapses cited as challenges that better, more effectively conducted pandemic management can prepare for. It is hoped that this paper will provoke constructive bioethical deliberations, particularly pertinent to the developing world, on how to ensure that the obligations towards health are fulfilled ethically and more effectively. (shrink)

Moates, Anne The prospect of a virulent human influenza pandemic causing large scale mortality and morbidity is a cause for global concern. The most likely candidate is the avian or 'bird' flu which is a strain of influenza virus named because it is found in birds. There are three groups of flu viruses, influenza A, B and C. Type A viruses are able to infect a wide variety of warm-blooded animals. B and C types are mostly confined to humans. (...) Avian influenza is caused by a Type A virus and typically affects birds' respiratory, digestive and nervous systems.[1]. (shrink)

The recent appearance of an extremely widespread avian influenza virus (H5N1) that has crossed to humans in highly pathogenic form has lead to speculation that another outbreak of pandemic influenza could be imminent. However, neither the timing of the pandemic, nor the nature and epidemiology of the virus, can be predicted. This uncertainty presents major difficulties in identifying relevant ethical issues in decision-making. If the next pandemic is relatively mild, decisions may be restricted to prioritizing access to essential health (...) services during the peak of the pandemic. If the virus is more pathogenic, social stability may be threatened. It is clear that, irrespective of the nature of the next pandemic, health professionals will have a key role in decisions about allocating scarce health resources during its acute stages. It is essential that they are not forced to make decisions without the support of established guidance or protocols. Any such guidance must be practical (decisions will often have to be made rapidly on the basis of imperfect information), reasoned, based upon sound moral principles, and must enjoy as far as possible the confidence of the wider population. This paper looks in brief at some of the ethical issues that need to be considered when planning a response to pandemic flu. (shrink)

Ford, Norman Following on from the previous article by Anne Moates, I will take for granted the need for all infected birds to be tracked down and destroyed. I am assuming the scenario that some human beings may be infected by a mutated form of the highly pathogenic H5N1 avian influenza so that this modified bird flu virus can be transmitted from human to human by social contact. Some of the ethical issues that arise in this possible scenario need (...) to be briefly considered. (shrink)

Die Entdeckung der Aristotelischen Politica muss als einschneidendes Ereignis in der Geschichte der politischen Theorien im Mittelalter verstanden werden. Gleich nach dem Erscheinen der ersten vollständigen Übersetzung wurde dieses Werk von der gelehrten Welt des Abendlandes mit grossem Interesse studiert und kommentiert. Die berühmtesten politischen Werke des späten Mittelalters, wie der Bestseller De regimine principum von Aegidius Romanus oder die äusserst kontroversen Bücher wie die Monarchia von Dante oder der Defensor pacis von Marsilius von Padua basieren weitgehend auf der mittelalterlichen (...) Rezeption der Aristotelischen Politica. Von zentraler Bedeutung für das Verständnis politischer Theorien im 13. und 14. Jahrhundert sind natürlich auch die Kommentare zu diesem Werk. Weit über hundert Kommentare sind von circa 1270 bis 1500 überliefert. Sie zeigen, wie die politische Philosophie des den mittelalterlichen Verhältnissen angepasst werden musste und auf welche Weise das erste Mal im Abendland an der Universität politische Wissenschaft gelehrt wurde. Der zweite Teilband enthält ein Verzeichnis der Kommentare zur Politica and Yconomica im genannten Zeitraum. Besondere Aufmerksamkeit wird dabei den Kommentaren in Quaestionenform gewidmet, von denen jeweils auch die Tabula quaestionum ediert wird. (shrink)

Das Buch entwirft mithilfe von Befragungen des Politischen eine radikale und kritische politische Theorie. Hierfür ist zum einen wichtig, die derzeit vorherrschende politische Theorie und Philosophie, die auf umfassende normative Begründungsprogramme setzt, einer eingehenden Kritik zu unterziehen. Das geschieht in dieser Studie, indem die Konturen einer gesellschaftstheoretischen, kritischen und skeptischen politischen Theorie in Auseinandersetzung mit u.a. Hegel, Marx, Nietzsche, Foucault, Derrida, Lefort, Butler und Rancière ausgeleuchtet werden. Zum anderen wird das Potential dieser anderen kritischen politischen Theorie an drei grundlegenden Gegenstandsbereichen (...) erprobt: Subjektkonstitution, Gesellschaftsordnung und radikale Demokratie. (shrink)

Der Band stellt in Einzelportraits aktuelle Positionen zu einer kritischen Theorie der Demokratie sowie verschiedene Ansatze der Staatskritik von Autorinnen und Autoren der Politischen Philosophie aus Frankreich vor. Einige der hier vorgestellten Ansatze sind dem so genannten Poststrukturalismus zuzuordnen. Daruber hinaus kommt eine Reihe anderer demokratie- und staatstheoretischer Ansatze zur Sprache, insbesondere solcher Autorinnen und Autoren, die im deutschen Sprachraum (noch) nicht stark berucksichtigt werden. In den Beitragen zu den franzosischen Theoretikerinnen und Theoretikern werden deren zentrale demokratie- und staatskritische Thesen (...) dargestellt und eingehend diskutiert. Neben einem Uberblick uber die vielfaltigen gegenwartigen Debatten im franzosischsprachigen Diskurs uber Demokratietheorie und Staatskritik bietet der Band wichtige Impulse fur eine vertiefende Auseinandersetzung mit kritischer Demokratietheorie und deren Perspektiven - jenseits von Sprach- und Landesgrenzen auch auf der transnationalen und globalen Ebene. (shrink)

Kollektive und individuelle Selbstbestimmung lassen sich in pluralistischen Gesellschaften kaum verwirklichen, ohne die Besonderheiten sozialer Gruppen zu berücksichtigen. Die Autoren fragen, wie die politische Philosophie diese Herausforderungen normativ reflektieren kann. Es wird deutlich, dass die größte Aufgabe heute darin besteht, Besonderheits- und Gleichheitsforderungen miteinander zu vermitteln.

​Kaum ein Konzept in der jüngeren politischen Theoriegeschichte kann auf eine solch steile und, wie sich mittlerweile gezeigt hat, auch langanhaltende Karriere zurückblicken wie das der Deliberation. Die in diesem Sammelband vereinigten Überlegungen stehen unter der zweiteiligen übergreifenden Überschrift "Deliberative Kritik – Kritik der Deliberation", die in einem Zug den kritischen Sinn der Deliberation und die Notwendigkeit einer reflexiven Kritik am Konzept der Deliberation selbst deutlich macht. Neben Erkundungen der Ideengeschichte und der normativen Grundlagen der Deliberation geht es um eine (...) Auseinandersetzung mit alternativen Konzeptionen und institutionellen Kontexten. Angesichts des Umstands, dass sich politische Prozesse bekanntlich seit geraumer Zeit aus den nationalstaatlichen Rahmungen herauslösen, werden zudem transnationale und kosmopolitische Perspektiven umfassend ausgeleuchtet. All diese topoi berühren wesentliche Denklinien der Arbeiten Rainer Schmalz-Bruns’, dem dieser Sammelband zum sechzigsten Geburtstag gewidmet ist. (shrink)

Canonical texts -- Philosophy -- Literature and History.

This seminal collection on the ethical issues associated with infectious disease is the first book to correct bioethics’ glaring neglect of this subject. Timely in view of public concern about SARS, AIDS, avian flu, bioterrorism and antibiotic resistance. Brings together new and classic papers by prominent figures. Tackles the ethical issues associated with issues such as quarantine, vaccination policy, pandemic planning, biodefense, wildlife disease and health care in developing countries.

This seminal collection on the ethical issues associated with infectious disease is the first book to correct bioethics’ glaring neglect of this subject. Timely in view of public concern about SARS, AIDS, avian flu, bioterrorism and antibiotic resistance. Brings together new and classic papers by prominent figures. Tackles the ethical issues associated with issues such as quarantine, vaccination policy, pandemic planning, biodefense, wildlife disease and health care in developing countries.

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)

In this view from 2007–2009, the ethical challenges facing a potential global effort to control infectious disease are explored; they provide sobering insight into the challenges of later decades. Despite the devastating pandemic of HIV/AIDS that erupted in the early 1980s, despite the failure to eradicate polio and the emergence of resistant forms of tuberculosis that came into focus in the 1990s, and despite newly emerging diseases like Severe Acute Respiratory Syndrome (SARS) in 2003 and the fearsome prospect of human-to-human (...) avian flu, it is nevertheless a time of some excitement over prospects for effective control of much of infectious disease. Funded by national and international governmental and nongovernmental organizations (NGOs), private foundations, and even popular entertainers, large-scale new efforts are under way to address global killers like AIDS, tuberculosis, and malaria, among others. This “marvelous momentum” can be seen as part of a continuing effort from the time of Jenner onward. Extrapolating from this, we explore the notion of a “comprehensive global effort for the eradication, elimination or control of infectious disease”, with particular attention to the ethical issues that arise. This is to “think big” about disease-control efforts that are now often done in piecemeal ways. This chapter identifies five tracks along which such efforts need to be pursued: (1) national and international organizations and the development of collective will; (2) epidemiological and health care infrastructure; (3) scientific development; (4) religious, social, and cultural considerations; (5) legal and social protections for individuals and groups. Each of these poses significant ethical issues which, we argue, should be viewed in a comprehensive way, to ensure that practice, research, and policy in each of these areas understands the person with communicable infectious disease as both victim and (potential) vector. (shrink)

The DSM-III, DSM-IV, DSM-IV-TR and ICD-10 have judiciously minimized discussion of etiologies to distance clinical psychiatry from Freudian psychoanalysis. With this goal mostly achieved, discussion of etiological factors should be reintroduced into the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. A research agenda for the DSM-V advocated the "development of a pathophysiologically based classification system". The author critically reviews the neuroevolutionary literature on stress-induced and fear circuitry disorders and related amygdala-driven, species-atypical fear behaviors of clinical severity in adult (...) humans. Over 30 empirically testable/falsifiable predictions are presented. It is noted that in DSM-IV-TR and ICD-10, the classification of stress and fear circuitry disorders is neither mode-of-acquisition-based nor brain-evolution-based. For example, snake phobia and dog phobia are clustered together. Similarly, research on blood-injection-injury-type-specific phobia clusters two fears different in their innateness: 1) an arguably ontogenetic memory-trace-overconsolidation-based fear and 2) a hardwired fear of the sight of one's blood or a sharp object penetrating one's skin. Genetic architecture-charting of fear-circuitry-related traits has been challenging. Various, non-phenotype-based architectures can serve as targets for research. In this article, the author will propose one such alternative genetic architecture. This article was inspired by the following: A) Nesse's "Smoke-Detector Principle", B) the increasing suspicion that the "smooth" rather than "lumpy" distribution of complex psychiatric phenotypes may in some cases be accounted for by oligogenic transmission, and C) insights from the initial sequence of the chimpanzee genome and comparison with the human genome by the Chimpanzee Sequencing and Analysis Consortium published in late 2005. Neuroevolutionary insights relevant to fear circuitry symptoms that primarily emerge overconsolidationally are presented. Also introduced is a human-evolution-based principle for clustering innate fear traits. The "Neuroevolutionary Time-depth Principle" of innate fears proposed in this article may be useful in the development of a neuroevolution-based taxonomic re-clustering of stress-triggered and fear-circuitry disorders in DSM-V. Four broad clusters of evolved fear circuits are proposed based on their time-depths: 1) Mesozoic circuits hardwired by wild-type alleles driven to fixation by Mesozoic selective sweeps; 2) Cenozoic circuits relevant to many specific phobias; 3) mid Paleolithic and upper Paleolithic circuits ; 4) Neolithic circuits. More importantly, the author presents evolutionary perspectives on warzone-related PTSD, Combat-Stress Reaction, Combat-related Stress, Operational-Stress, and other deployment-stress-induced symptoms. The Neuroevolutionary Time-depth Principle presented in this article may help explain the dissimilar stress-resilience levels following different types of acute threat to survival of oneself or one's progency. PTSD rates following exposure to lethal inter-group violence are usually 5-10 times higher than rates following large-scale natural disasters such as forest fires, floods, hurricanes, volcanic eruptions, and earthquakes. The author predicts that both intentionally-caused large-scale bioevent-disasters, as well as natural bioevents such as SARS and avian flu pandemics will be an exception and are likely to be followed by PTSD rates approaching those that follow warzone exposure. During bioevents, Amygdala-driven and locus-coeruleus-driven epidemic pseudosomatic symptoms may be an order of magnitude more common than infection-caused cytokine-driven symptoms. Implications for the red cross and FEMA are discussed. It is also argued that hospital phobia as well as dog phobia, bird phobia and bat phobia require re-taxonomization in DSM-V in a new "overconsolidational disorders" category anchored around PTSD. The overconsolidational spectrum category may be conceptualized as straddling the fear circuitry spectrum disorders and the affective spectrum disorders categories, and may be a category for which Pitman's secondary prevention propranolol regimen may be specifically indicated as a "morning after pill" intervention. Predictions are presented regarding obsessive-compulsive disorder and "culture-bound" acute anxiety symptoms. Also discussed are insights relevant to pseudoneurological symptoms and to the forthcoming Dissociative-Conversive disorders category in DSM-V, including what the author terms fright-triggered acute pseudo-localized symptoms. Speculations based on studies of the human abnormal-spindle-like, microcephaly-associated gene, the microcephaly primary autosomal recessive gene, and the forkhead box p2 gene are made and incorporated into what is termed "The pre-FOXP2 Hypothesis of Blood-Injection-Injury Phobia." Finally, the author argues for a non-reductionistic fusion of "distal neurobiology" with clinical "proximal neurobiology," utilizing neurological heuristics. It is noted that the value of re-clustering fear traits based on behavioral ethology, human-phylogenomics-derived endophenotypes and on ontogenomics can be confirmed or disconfirmed using epidemiological or twin studies and psychiatric genomics. (shrink)

In 2006, the Indonesian government decided to withhold avian flu samples from the World Health Organization. They argued that even though Indonesian samples were crucial to the development of vaccines, the results of vaccine research would be unaffordable for its citizens. Commentaries on the case varied from alleging blackmail to welcoming this strong stance against alleged exploitation. What is clear is that the concern expressed is related to benefit sharing.Benefit sharing requires resource users to return benefits to resource providers (...) in order to achieve justice. One benefit sharing tool within health research is the duty to provide a health care intervention which has been proven to be beneficial (or alternative benefits) to research participants after a study has been concluded. This duty is generally known as a post-study obligation. It was enshrined in the Declaration of Helsinki in 2000 and re-emphasized in 2008. Yet, there are few, if any, examples of good practice.In this article, we analyse the obstacles to giving more bite to benefit sharing provisions in health research through ethical review. We conclude that the provision of post-study access to healthcare interventions is not a promising mechanism when monitored through research ethics committees. Alternative benefit provision is preferable if one focuses on achieving compliance. However, even the latter faces challenges, which we address in specific recommendations. (shrink)

In 2006, the Indonesian government decided to withhold avian flu samples from the World Health Organization. They argued that even though Indonesian samples were crucial to the development of vaccines, the results of vaccine research would be unaffordable for its citizens. Commentaries on the case varied from alleging blackmail to welcoming this strong stance against alleged exploitation. What is clear is that the concern expressed is related to benefit sharing. Benefit sharing requires resource users to return benefits to resource (...) providers in order to achieve justice. One benefit sharing tool within health research is the duty to provide a health care intervention which has been proven to be beneficial (or alternative benefits) to research participants after a study has been concluded. This duty is generally known as a post-study obligation. It was enshrined in the Declaration of Helsinki in 2000 and re-emphasized in 2008. Yet, there are few, if any, examples of good practice. In this article, we analyse the obstacles to giving more bite to benefit sharing provisions in health research through ethical review. We conclude that the provision of post-study access to healthcare interventions is not a promising mechanism when monitored through research ethics committees. Alternative benefit provision is preferable if one focuses on achieving compliance. However, even the latter faces challenges, which we address in specific recommendations. (shrink)

The threat posed by avian influenza appears to be rising, yet global and national health programs are preparing only fitfully. A lethal form of avian flu has rooted itself deeply into the poultry flocks of poor Asian countries that will have a hard time eradicating it. Every so often a sick bird infects a human, who usually dies from the encounter, and on rare occasions the virus seems to have spread from one person to another before the chain (...) of infection dies out. All it would take to set off a raging global pandemic would be for the virus to mutate into a form that is readily transmissible among humans. Severe Acute Respiratory Syndrome garnered a great deal of public attention because it was novel and its potential for spread was unknown. However, the SARS corona virus is significantly less virulent than pandemic influenza viral infections. (shrink)

The threat posed by avian influenza appears to be rising, yet global and national health programs are preparing only fitfully. A lethal form of avian flu has rooted itself deeply into the poultry flocks of poor Asian countries that will have a hard time eradicating it. Every so often a sick bird infects a human, who usually dies from the encounter, and on rare occasions the virus seems to have spread from one person to another before the chain (...) of infection dies out. All it would take to set off a raging global pandemic would be for the virus to mutate into a form that is readily transmissible among humans.Severe Acute Respiratory Syndrome garnered a great deal of public attention because it was novel and its potential for spread was unknown. However, the SARS corona virus is significantly less virulent than pandemic influenza viral infections. (shrink)

Public concern over major agricultural product safety incidents, such as swine flu and avian flu, can intensify financial losses in the livestock and poultry industries. Crawler technology were applied to reviewed the Weibo social media discussions on the African Swine Fever incident in China that was reported on 3 August 2018, and used content analysis and network analysis to specifically examine the online public opinion network dissemination characteristics of verified individual users, institutional users and ordinary users. It was found (...) that: attention paid to topics related to “epidemic,” “treatment,” “effect” and “prevent” decrease in turn, with the interest in “prevent” increasing significantly when human infections were possible; verified individual users were most concerned about epidemic prevention and control and play a supervisory role, the greatest concern of institutional users and ordinary users were issues related to agricultural industry and agricultural products price fluctuations respectively; among institutional users, media was the main opinion leader, and among non-institutional users, elites from all walks of life, especially the food safety personnel acted as opinion leaders. Based on these findings, some policy suggestions are given: determine the nature of the risk to human health of the safety incident, stabilizing prices of relevant agricultural products, and giving play to the role of information dissemination of relevant institutions. (shrink)

For the past month, the nightly television news has been showing us animals being slaughtered. Governments in 10 Asian countries have killed more than 25 million ducks and chickens to stem the spread of avian flu. China has drowned thousands of civet cats suspected of spreading Sudden Acute Respiratory Syndrome, the often-lethal disease usually abbreviated to SARS. Here in the United States, more than 700 dairy cows, so far, have been killed in order to contain any possible spread of (...) mad cow disease. (shrink)

BackgroundAs a number of commentators have noted, SARS exposed the vulnerabilities of our health care systems and governance structures. Health care professionals (HCPs) and hospital systems that bore the brunt of the SARS outbreak continue to struggle with the aftermath of the crisis. Indeed, HCPs – both in clinical care and in public health – were severely tested by SARS. Unprecedented demands were placed on their skills and expertise, and their personal commitment to their profession was severely tried. Many were (...) exposed to serious risk of morbidity and mortality, as evidenced by the World Health Organization figures showing that approximately 30% of reported cases were among HCPs, some of whom died from the infection. Despite this challenge, professional codes of ethics are silent on the issue of duty to care during communicable disease outbreaks, thus providing no guidance on what is expected of HCPs or how they ought to approach their duty to care in the face of risk.DiscussionIn the aftermath of SARS and with the spectre of a pandemic avian influenza, it is imperative that we (re)consider the obligations of HCPs for patients with severe infectious diseases, particularly diseases that pose risks to those providing care. It is of pressing importance that organizations representing HCPs give clear indication of what standard of care is expected of their members in the event of a pandemic. In this paper, we address the issue of special obligations of HCPs during an infectious disease outbreak. We argue that there is a pressing need to clarify the rights and responsibilities of HCPs in the current context of pandemic flu preparedness, and that these rights and responsibilities ought to be codified in professional codes of ethics. Finally, we present a brief historical accounting of the treatment of the duty to care in professional health care codes of ethics.SummaryAn honest and critical examination of the role of HCPs during communicable disease outbreaks is needed in order to provide guidelines regarding professional rights and responsibilities, as well as ethical duties and obligations. With this paper, we hope to open the social dialogue and advance the public debate on this increasingly urgent issue. (shrink)

In the biomedical field, calls for the generation of new regulations or for the amendment of existing regulations often follow the emergence of apparently new research practices (such as embryonic stem cell research), clinical practices (such as facial transplantation) and entities (such as Avian Influenza/’Bird Flu’). Calls for regulatory responses also arise as a result of controversies which bring to light longstanding practices, such as the call for increased regulation of human tissue collections that followed the discovery of unauthorised (...) post-mortem organ retention. Whilst it seems obvious that new regulations should only be generated if existing regulations are inadequate (a practice referred to in this paper as ‘regulatory syncretism’), this does not always occur in practice. This paper examines the conceptual steps involved in generating regulatory responses to emerging phenomena. Two decision points are identified. First, a stance is taken as to whether the emerging phenomenon raises unique ethical or legal issues (exceptionalism versus non-exceptionalism). Second, the decision is made as to whether new regulation should be generated only for truly unique phenomena (syncretism versus asyncretism). It is argued here that it is important to make a careful assessment of novelty, followed by a reflective and deliberate choice of regulatory syncretism or asyncretism, since each type of regulatory response has advantages which need to be harnessed and disadvantages which need to be managed—something that can only occur if regulators are attentive to the choices they are making. (shrink)

Background As a number of commentators have noted, SARS exposed the vulnerabilities of our health care systems and governance structures. Health care professionals (HCPs) and hospital systems that bore the brunt of the SARS outbreak continue to struggle with the aftermath of the crisis. Indeed, HCPs – both in clinical care and in public health – were severely tested by SARS. Unprecedented demands were placed on their skills and expertise, and their personal commitment to their profession was severely tried. Many (...) were exposed to serious risk of morbidity and mortality, as evidenced by the World Health Organization figures showing that approximately 30% of reported cases were among HCPs, some of whom died from the infection. Despite this challenge, professional codes of ethics are silent on the issue of duty to care during communicable disease outbreaks, thus providing no guidance on what is expected of HCPs or how they ought to approach their duty to care in the face of risk. Discussion In the aftermath of SARS and with the spectre of a pandemic avian influenza, it is imperative that we (re)consider the obligations of HCPs for patients with severe infectious diseases, particularly diseases that pose risks to those providing care. It is of pressing importance that organizations representing HCPs give clear indication of what standard of care is expected of their members in the event of a pandemic. In this paper, we address the issue of special obligations of HCPs during an infectious disease outbreak. We argue that there is a pressing need to clarify the rights and responsibilities of HCPs in the current context of pandemic flu preparedness, and that these rights and responsibilities ought to be codified in professional codes of ethics. Finally, we present a brief historical accounting of the treatment of the duty to care in professional health care codes of ethics. Summary An honest and critical examination of the role of HCPs during communicable disease outbreaks is needed in order to provide guidelines regarding professional rights and responsibilities, as well as ethical duties and obligations. With this paper, we hope to open the social dialogue and advance the public debate on this increasingly urgent issue. (shrink)

Emotions are complex reactions that allow individuals to cope with significant positive and negative events. Research on emotion was pioneered by Darwin’s (1871) work on emotional expressions in humans and animals. But Darwin was concerned mainly with facial and bodily expressions of significance for humans, citing mainly examples from mammals (e.g., apes, dogs, and cats). In birds, emotional expressions are less evident for a human observer, so a different approach is needed. Understanding avian emotions will provide key evolutionary information (...) on the evolution of related behaviors and brain circuitry. Birds and mammals are thought to have evolved from different groups of Mesozoic reptiles, theropod dinosaurs and therapsids, respectively, and therefore their common ancestor is likely to be a basal reptile living about 300 million years ago, during the Carboniferous or Permian. Yet, birds and mammals exhibit extensive convergence in terms of relative brain size, high levels of activity, sleep/wakefulness cycles, endothermy, and social behavior, among others. This article focuses on two basic emotions with negative valence: fear and frustration. Fear is related to the anticipation of dangerous or threatening stimuli (e.g., predators or aggressive conspecifics). Frustration is related to unexpected reward omissions or devaluations (e.g., loss of food or sexual resources). These results have implications for an understanding of the conditions that promote fear and frustration, and for the evolution of supporting brain circuitry. (shrink)

Even as public health ethics was developing as a field, major incidents such as 9/11 and the SARS epidemic propelled discourse around public health emergency preparedness and response. Policy and practice shifted to a multidisciplinary approach, recognizing the broad range of potential threats to public health, including biological, physical, radiological, and chemical threats. This propelled the development of surveillance systems to detect incidents, laboratory capacities to rapidly test for potential threats, and therapeutic and social countermeasures to prepare for and respond (...) to a range of hazards. In bringing public health ethics and emergency preparedness together, Emergency Ethics: Public Health Preparedness and Response adds depth and complexity to both fields. As global threats continue to emerge, the book, edited by Bruce Jennings, John D. Arras, Drue H. Barrett, and Barbara A. Ellis, will offer a vital compass. (shrink)

This is a description of an avian-shaped feature that rests below a network of cellular structures found on a mound within the Argyre Basin of Mars in Mars Global Surveyor image M14-02185, acquired on April 30, 2000, and released to the public on April 4, 2001. The area examined is located near 48.0° South, 55.1° West. The formation is approximately 2,400 meters long from the tip of its beak to the tip of its farthest tail feather. There is a (...) minimum of six different variations in appearance of the surface material over this small area. Utilizing the public targeting request form provided on the Mars Global Surveyor (MGS) website, co-author Miller secured a second image of the area that was obtained on July 3, 2006, showing this feature under different conditions S20-00165. The new image was then released to the public on August 11, 2006. A third image of the formation identified as MGS S13-01480 was acquired on December 15, 2005, and although officially processed on June 20, 2006, it was not made available to the public until August 22, 2009, on NASA’s Planetary Data System (PDS) website. All three of the MGS images reveal defining aspects of this avian feature, including a head, beak, body, eye, leg, foot, toes, wing, and feathers. When taken together, these components induce the visual impression of an avian-shaped formation that exhibits a unique set of proportional features. Adjoining this formation is a composite of complex cellular features that form a compartmentalized infrastructure. The three authors who are veterinarians provide a critical analysis of the avian features, and the geologist and geoscientist authors examine natural mechanisms that could contribute to the formation of this feature. An extensive search of comparable regions within and beyond the area of the Argyre Basin was conducted. A list of these sites is provided, and terrestrial comparisons are also offered. (shrink)

Aboitiz et al. suggest that the mammalian isocortex is derived from the dorsal cortex of reptiles and birds, and that there has been a major divergence in the connectivity patterns (and hence function) of the mammalian and reptilian/avian hippocampus. There is considerable evidence to suggest, however, that the avian hippocampus serves the exact same function as the mammalian hippocampus.

In the mid-nineteenth century, the house sparrow ( Passer domesticus) was introduced to the United States, quickly spreading across the country. For a brief period in the late nineteenth and early twentieth centuries, the observation of sparrow behavior was something of an urban pastime. Traits such as intelligence, reason, persistence, and craftsmanship were conferred onto sparrows by American urbanites. This paper argues that sparrow intelligence was often conflated with domestication: the ability of the birds to adapt to living alongside humans. (...) Praise for the ingenuity of sparrows generally revolved around their nest building, particularly when such structures overcame the challenges posed by urban infrastructure and technology. Sparrows were far less praiseworthy when they caused electricity outages or contaminated water supplies. The sparrow in the United States demonstrates how the relationship between these anecdotes and their implications for animal minds was mediated by the technology and infrastructure of cities. Admirers of sparrows were not measuring the birds’ mental capacity, but rather their ability to adapt to human habitations. Sparrows were only granted intelligence once they had demonstrated their ability to become domesticated. (shrink)

The study of animal behavior, and particularly avian behavior, has advanced significantly in the past 50 years. In the early 1960s, both ethologists and psychologists were likely to see birds as simple automatons, incapable of complex cognitive processing. Indeed, the term “avian cognition“ was considered an oxymoron. Avian social interaction was also seen as based on rigid, if sometimes complicated, patterns. The possible effect of social interaction on cognition, or vice versa, was therefore something almost never discussed. (...) Two paradigm shifts—one concerning animal cognition and one concerning social interaction—began to change perceptions in, respectively, the early 1970s and 1980s, but only more recently have researchers actively investigated how these two areas intersect in the study of avian behavior. The fruits of such intersection can be seen in the various papers for this special issue. I provide some brief background material before addressing the striking findings of current projects. In some cases, researchers have adapted early classic methods and in other cases have devised new paradigms, but in all instances have demonstrated avian capacities that were once thought to be the exclusive domain of humans or at least nonhuman primates. Keywords: avian cognition; avian social learning; avian observational learning; avian communication. (shrink)