Ethics in a pandemic

ctures of developing countries.

The WHO recommends that ethical issues be a consideration in the planning process for an influenza pandemic. Canada's province of Ontario has incorporated this framework into its plan.

"Other jurisdictions and nations should assess their pandemic plan against this ethical framework and these recommendations," says Dr. Singer.

"Looking ahead, we can say that if the pandemic strikes it will cause great hardship, but societies will struggle through. They will be better able to do so if they have general agreement on an ethical approach. Afterwards, history will judge today's leaders on how well they took decision on the ethical challenges they faced in the midst of the crisis."

Ten substantive values to guide ethical decision-making for a pandemic influenza outbreak

Individual liberty

In a public health crisis, restrictions to individual liberty may be necessary to protect the public from serious harm. Restrictions to individual liberty should:

  • Be proportional, necessary and relevant.
  • Employ the least restrictive means.
  • Be applied equitably.

    Protection of the public from harm

    To protect the public from harm, health care organizations and public health authorities may be required to take actions that impinge on individual liberty.

    Decision makers should:

  • Weigh the imperative for compliance.
  • Provide reasons for public health measures to encourage compliance.
  • Establish mechanisms to review decisions.

    Proportionality requires that restrictions to individual liberty and measures taken to protect the public from harm should not exceed what is necessary to address the actual level of risk to or critical needs of the community.


    Individuals have a right to privacy in health care. In a public health crisis, it may be necessary to ov

  • Contact: Terry Collins
    University of Toronto Joint Center for Bioethics

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