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Review

Clinical review: Influenza pandemic – physicians and their obligations

Devanand Anantham1 email, Wendy McHugh2 email, Stephen O'Neill2 email and Lachlan Forrow2 email

1Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Duke-NUS Graduate Medical School, Outram Road, Singapore 169608, Singapore

2Ethics Support Service, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA

author email corresponding author email

Critical Care 2008, 12:217doi:10.1186/cc6918

Published: 24 June 2008


See related commentary by Ehrenstein et al., http://ccforum.com/content/12/4/165

Abstract

An influenza pandemic threatens to be the most lethal public health crisis to confront the world. Physicians will have critical roles in diagnosis, containment and treatment of influenza, and their commitment to treat despite increased personal risks is essential for a successful public health response. The obligations of the medical profession stem from the unique skills of its practitioners, who are able to provide more effective aid than the general public in a medical emergency. The free choice of profession and the societal contract from which doctors derive substantial benefits affirm this commitment. In hospitals, the duty will fall upon specialties that are most qualified to deal with an influenza pandemic, such as critical care, pulmonology, anesthesiology and emergency medicine. It is unrealistic to expect that this obligation to treat should be burdened with unlimited risks. Instead, risks should be minimized and justified against the effectiveness of interventions. Institutional and public cooperation in logistics, remuneration and psychological/legal support may help remove the barriers to the ability to treat. By stepping forward in duty during such a pandemic, physicians will be able to reaffirm the ethical center of the profession and lead the rest of the healthcare team in overcoming the medical crisis.


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