Bioethics Blogs

Ethics in the Age of Ebola

by Joseph J. Fins, M.D.

It now seems a lifetime ago. The first case of Ebola had come to the Western hemisphere and taken the life of Thomas Eric Duncan at a Dallas, Texas hospital. His death, and other cases in the “developed” world, led to a predictable media deluge, a good bit of hysteria, and predictable political posturing. As the November election approached, fear and ideology took hold, with calls for quarantine and allegations of discrimination coming from predictable precincts.

I waded into this political tempest on October 10, when I published an essay on the Hastings Center’s Bioethics Forum raising questions about the ethical propriety of unilateral do not resuscitate (DNR) orders for patients in extremis with Ebola (Fins 2015). The details of that argument are recounted in the Bioethics Forum and elsewhere (Altman 2014; Fins in press; Rosenblatt 2014a;2014b), but suffice it to say my analysis was predicated upon questions of safety, feasibility, and utility of the resuscitative act, the lack of available treatment, and the broader risk of contagion. These factors coalesced into a question of proportionality, and the balancing of clear burdens and questionable benefits of resuscitation. Realizing that this was an interdisciplinary question, I hoped to catalyze a discussion among experts in medicine, law, and ethics. My goal was to prevent idiosyncratic responses among institutions and across jurisdictions. Such variance in practice would violate due process, treating similarly situated individuals differently.

Although the argument has become truncated over time like an aging telomere, my essay was as much about what care should be provided as withheld.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.