Indiana health officials examine state's pandemic influenza ethics planning

Information relevant to Indiana's current pandemic influenza preparedness plan was presented July 16 during a symposium convened by the Indiana State Department of Health and the Indiana University Center for Bioethics, "The Ethics of Pandemic Influenza Planning in Indiana: What Have We Done and Where Are We Going?"

The purpose of the meeting was to involve local health officials, health care providers, and other stakeholders in a discussion on the ethical issues related to an influenza pandemic. The meeting began with an overview of Indiana's Pandemic Influenza Preparedness Plan by Deputy State Health Commissioner Mary Hill, RN, Esq. IU Center for Bioethics Director Eric Meslin, Ph.D., then spoke on "Incorporating Ethics into Planning: Indiana's Approach."

Speakers at the Indiana symposium also included Eleanor D. Kinney, J.D., MPH, the Samuel R. Rosen Professor of Law at the Indiana University School of Law, Indianapolis, and co-director of the Hall Center for Law and Health, and Margaret G. Gaffney, M.D., associate professor of clinical medicine at the IU School of Medicine and a faculty member at the IU Center for Bioethics. Some of the topics covered during the meeting were altered standards of patient care, patient triage, vaccination, and workforce management.

New data from a survey of public opinion regarding the ethics of pandemic influenza preparedness was also presented by James G. Wolf, M.A., director of the Survey Research Center at Indiana University-Purdue University Indianapolis. The purpose of the survey was to estimate public perception of priorities during an influenza pandemic, the likelihood of the public's compliance with public health recommendations, potential barriers to compliance, and what the public perceives as likely sources of assistance and information during an influenza pandemic. Some highlights from the survey are:

• Public generally supports state policies taking firm action in times of medical crisis;
• Most would stay home if requested by state health officials;
• There is a high likelihood of financial problems for 25-30 percent of those surveyed, especially for those with children, if in-home quarantine lasted 7-14 days;
• People overwhelmingly report they would rely on family and friends for help; and
• The public has far more trust in getting information about the pandemic from their doctor or health care provider than from more formal channels.

Today's meeting at the Indiana Government Center South followed a two-day national summit in Indianapolis on July 14-15, where state health officers and other senior public health officials from 35 states and U.S. territories convened to identify key ethical challenges, best practices and possible solutions during an influenza pandemic. The key ethical challenges identified during the national summit included:

• Meeting the obligation to engage communities in planning and response to ensure fairness, transparency and participation.
• Identifying and defining criteria for allocation of scarce health care resources and critical infrastructure.
• Defining criteria and mechanisms for implementing altered standards and places of care.
• Preventing exacerbation of disparities in access to care.
• Balancing the rights and duties of health care workers.
• Providing palliative care.
• Meeting the needs of at-risk populations.
• Selecting effective community containment strategies.
• Respecting cultural and religious practices in the face of mass fatalities.

For information on the national summit or pandemic influenza planning in Indiana, see http://www.bioethics.iu.edu/pandemic_portal.asp.

http://www.iupui.edu