This article is written by Tanya Singh a 1st year student of Amity University, Chhattisgarh.
The health sector (including public health and both public and private health-care services), has a natural leadership and advocacy role in pandemic influenza preparedness and response efforts. In cooperation with other sectors and in support of national intersectoral leadership, the health sector must provide leadership and guidance on the actions needed, in addition to raising awareness of the risk and potential health consequences of an influenza pandemic. To fulfil this role, the health sector should be ready to:
- provide reliable information on the risk, severity, and progression of a pandemic and the effectiveness of interventions used during a pandemic;
- prioritize and continue the provision of health-care during an influenza pandemic;
- enact steps to reduce the spread of influenza in the community and in health-care facilities; and
- protect and support health-care workers during a pandemic.
FIVE GROUNDS FOR A DUTY TO TREAT :
Numerous grounds have been offered for the view that healthcare workers have a duty to treat. Those ground include express consent, implied consent, special training, reciprocity, and professional oaths and codes. In this section, each ground and its supporting arguments will be discussed and then critically evaluated with an eye to determining whether it can ground the kind of duty that is needed to respond to an infectious disease pandemic.
Virtually all proponents of a duty to treat would agree that the consent of the healthcare worker provides a strong ground—and likely the strongest ground—for asserting the existence of the duty. However, there is room for disagreement about the types of consent that matter (e.g., expressed or implied), about what counts as adequate signs of expressing consent, and about the conditions that need to be met for that consent to count as sufficiently informed and voluntary.
- SPECIAL TRAINING:
One such defense attempts to ground the duty to treat in the special training that professionals receive. This training increases the general obligation to render aid to others in need because it “not only increases the value of the aid, it may also reduce the risk associated with providing it . In other words, given that healthcare professionals know how to aid others, they can provide that aid more efficiently, perhaps by doing more with fewer resources or doing more in less time, than nonprofessionals can. They will also know how to minimize the risks of transferring the disease to themselves and they are likely to have access to the necessary materials such as gloves, masks, and vaccines that will help limit that transmission.
However, if the special abilities are the result of special training that was subsidized by the public or even an employer, or if the special abilities give one a right to special benefits or privileges, then we have a more promising basis for defending a duty to treat. Let us call this the reciprocity view. (It has also been called a social contract view.) It asserts that many healthcare professionals had their field-specific training subsidized by the public. They may have gone to public universities or received scholarships tied to entering certain fields. The information and training they received may also have been subsidized by the public.
- OATHS AND CODES:
One last defense of the duty to treat relies not on the benefits that healthcare professionals receive but on the oaths they take or the codes of ethics to which they submit when they enter a profession. For example, the AMA’s “social contract with humanity”, which was adopted in 2001 and is in the form of an oath, states, among other things, “We, the members of the world community of physicians, solemnly commit ourselves to… apply our knowledge and skills when needed, though doing so may put us at risk” , According to at least some proponents of this defense, reciting the oath is a speech-act akin to promising. As such, it is similar to expressing consent, making this defense of the duty to treat seem at least as strong as contract-based consent. Some argue that it is even stronger.
A whole-of-society approach to pandemic influenza preparedness emphasizes the significant roles played not only by the health sector, but also by all other sectors, individuals, families, and communities, in mitigating the effects of a pandemic. Developing capacities for mitigating the effects of a pandemic, including robust contingency and business continuity plans is at the heart of preparing the whole of society for a pandemic. Activities such as capacity development, planning, coordination, and communication are cross-cutting and require action by all parties.
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