Preparation for and response to a pandemic, act of bioterrorism, hurricane or other emergency involves extraordinary collaboration among hospitals, public health authorities, law enforcement agencies, emergency management units and others. Among the most challenging issues faced during such preparation and response are isolation and quarantine, triage and rationing, workforce absenteeism and provider liability. There is a growing recognition that these challenges are in large part ethical challenges.

The Miami-Dade County Hospital Preparedness Consortium, created by the Miami-Dade County Health Department, in 2007 established an Ethics Advisory Group to work with other emergency planners to ensure that ethical issues are adequately addressed during the planning and response processes. The Ethics Advisory Group has not been active lately, but it is available on demand in case of a regional emergency.

The Ethics Advisory Group, as initially constituted, comprised the chairs of hospital, hospice, nursing home and community-based ethics committees in Miami-Dade County, with courtesy membership extended to colleagues in Broward County as well as academic experts from around South Florida. The Ethics Advisory Group is chaired by Kenneth W. Goodman, Ph.D., director of the University of Miami Bioethics Program and the Florida Bioethics Network. The committee's inaugural meeting was March 14, 2007, in Miami. The group then helped lead a pandemic preparedness retreat on March 20, 2007. A second meeting was held on June 5, 2007.

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RESOURCES

H1N1 Influenza

Centers for Disease Control and Prevention
H1N1 Resources

Florida Department of Health
H1N1 Updates

NIH Institute of Allergy and Infectious Diseases
H1N1 Resources

Pan American Health Organization
A(H1N1) portal

Regional

Miami-Dade County Hospital Preparedness Consortium
Preparedness is Critical! website

Florida Department of Health
Office of Public Health Preparedness

Florida Department of Health
Curriculum for Workforce Preparedness

State of Florida
Rules for Quarantines and Isolation

National

Agency for Healthcare Research and Quality
Public Health Emergency Preparedness

American Health Lawyers Association
Community Pan-Flu Preparedness: A Checklist of Key Legal Issues for Healthcare Providers

American Hospital Association
Emergency readiness resources

American Public Health Association
APHA Prescription for Pandemic Flu

Baylor College of Medicine
Recommendations for Best Practices in the Management of Elderly Disaster Victims

Centers for Disease Control and Prevention
Ethical Guidelines in Pandemic Influenza
Interim Guidance for Employers for Protection of Migrant and Seasonal Farmworkers from the Novel H1N1 Flu Virus

Department of Health and Human Services overview
PandemicFlu.gov

Department of Homeland Security
Centers of Excellence

Department of Veterans Affairs
Pandemic Influenza Ethics Initiative Resources

General Accounting Office
Hospital Preparedness Report

Institute of Medicine
Ethical and Legal Considerations in Mitigating Pandemic Disease
IOM Guide to Recent Studies and Workshops on Pandemic Flu

State of Minnesota Draft Plan
Ethically Rationing Health Resources in Minnesota in a Severe Influenza Pandemic
Implementing Ethical Frameworks for Rationing Scarce Health Resources During Severe Influenza Pandemic

Police Executive Research Forum
Police Planning for an Influenza Pandemic: Case Studies and Recommendations from the Field

Trust for America's Health
Ready or Not? Protecting the Public's Health from Disease, Disasters, and Bioterrorism

International

University of Toronto Joint Centre for Bioethics, Pandemic Influenza Working Group
Stand on guard for thee: Ethical Considerations in Preparedness Planning for Pandemic Influenza

World Health Organization
Addressing Ethical Issues in Pandemic Influenza Planning
Eleventh Futures Forum on the Ethical Governance of Pandemic Influenza Preparedness

Miscellaneous

Hastings Center
Resources on Pandemic Planning

Blumenshine P, Reingold A, Egerter S, Mockenhaupt R, Braveman P, Marks J.
Pandemic influenza planning in the United States from a health disparities perspective.
Emerg Infect Dis [serial on the Internet]. 2008 May [date cited].
http://www.cdc.gov/EID/content/14/5/709.htm

Mensua A, Mounier-Jack S, Coker R.
Pandemic influenza preparedness in Latin America: analysis of national strategic plans
Health Policy and Planning 2009;1-8 doi:10.1093/heapol/czp019. Available from
http://bit.ly/AsZJI

Educational opportunities / Archive

:: Association for Practical and Professional Ethics, San Antonio, February 23-4, 2008:
Ethics, Public Health and the Environment

:: American College of Epidemiology, Annual Meeting, Fort Lauderdale, September 17, 2007:
Ethics and Pandemiology: Balancing Rights, Managing Resources

:: Florida Bioethics Network, Sarasota, November 9, 2007, FBN Fall Meeting:
"Preparing for the Coming Pandemic"