Avian Influenza and Pandemics
http://www.100md.com
《新英格兰医药杂志》
To the Editor: With an eye to the ominous storm on the horizon that is avian influenza, in his editorial (Jan. 27 issue)1 St?hr proposes a much-needed research agenda — with one major oversight. In addition to clinical and epidemiologic questions, many ethical issues will undoubtedly be raised by an influenza pandemic. The outbreak of the severe acute respiratory syndrome taught us a number of important lessons, but the first was that we were ill prepared to respond.2 Among the greatest challenges faced were the duty to provide care in the context of unknown risk, the need to balance individual privacy rights and the public's right to know, the use of quarantine and other restrictive measures, and the need to set priorities and use limited resources appropriately. Other issues were related to information sharing, patents, and research ethics.3,4
Avian influenza presents a significant, gathering threat. Although it is indeed prudent to pursue a greater understanding of it and to erect safeguards to protect against pandemic spread, it is no less incumbent on us to ensure that those safeguards are both reasonable and justifiable.
C. Shawn Tracy, M.Sc.
Sunnybrook and Women's College Health Sciences Centre
Toronto, ON M4N 3M5, Canada
shawn.tracy@sw.ca
Ross E.G. Upshur, M.D.
University of Toronto Joint Centre for Bioethics
Toronto, ON M5G 1L4, Canada
Abdallah S. Daar, D.Phil.
McLaughlin Centre for Molecular Medicine
Toronto, ON M5G 2C1, Canada
References
St?hr K. Avian influenza and pandemics -- research needs and opportunities. N Engl J Med 2005;352:405-407.
National Advisory Committee on SARS and Public Health. Learning from SARS: renewal of public health in Canada. Ottawa: Health Canada, October 2003. (Accessed April 14, 2005, at http://www.hc-sc.gc.ca/english/protection/warnings/sars/learning.html.)
Singer PA, Benatar SR, Bernstein M, et al. Ethics and SARS: lessons from Toronto. BMJ 2003;327:1342-1344.
Bernstein M, Hawryluck L. Challenging beliefs and ethical concepts: the collateral damage of SARS. Crit Care 2003;7:269-271.
Avian influenza presents a significant, gathering threat. Although it is indeed prudent to pursue a greater understanding of it and to erect safeguards to protect against pandemic spread, it is no less incumbent on us to ensure that those safeguards are both reasonable and justifiable.
C. Shawn Tracy, M.Sc.
Sunnybrook and Women's College Health Sciences Centre
Toronto, ON M4N 3M5, Canada
shawn.tracy@sw.ca
Ross E.G. Upshur, M.D.
University of Toronto Joint Centre for Bioethics
Toronto, ON M5G 1L4, Canada
Abdallah S. Daar, D.Phil.
McLaughlin Centre for Molecular Medicine
Toronto, ON M5G 2C1, Canada
References
St?hr K. Avian influenza and pandemics -- research needs and opportunities. N Engl J Med 2005;352:405-407.
National Advisory Committee on SARS and Public Health. Learning from SARS: renewal of public health in Canada. Ottawa: Health Canada, October 2003. (Accessed April 14, 2005, at http://www.hc-sc.gc.ca/english/protection/warnings/sars/learning.html.)
Singer PA, Benatar SR, Bernstein M, et al. Ethics and SARS: lessons from Toronto. BMJ 2003;327:1342-1344.
Bernstein M, Hawryluck L. Challenging beliefs and ethical concepts: the collateral damage of SARS. Crit Care 2003;7:269-271.