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Preparing for the Usual, Preparing for the Unusual: Ethics in Routine and Emergency Public Health Practice

Etkind, Paul DrPH, MPH; Arias, Donna BS; Bagley, Bobbie BSN, MPH, RN; Nelson, Mary S. BS, MEd

Journal of Public Health Management and Practice: July-August 2008 - Volume 14 - Issue 4 - p 367–371
doi: 10.1097/01.PHH.0000324565.64910.bc

A tremendous amount of resources is being poured into public health agencies for the purpose of planning to prevent, respond to, and/or recover from all manner of emergencies. As planning and practice drills have progressed, many of the shortcomings of our current public health system are being recognized. Many gray areas, particularly legal and ethical, are coming into focus. There are many questions about whether the standards of medical care and public health practice will necessarily remain constant during emergencies. This article examines whether the same might be true of the ethical standards of public health practice. Will they or should they be the same regardless of whether we are working in “usual” times or “unusual” times?

This article examines the purpose of planning to prevent, respond to, and/or recover from all manner of emergencies.

Paul Etkind DrPH, MPH, is Deputy Director and Epidemiologist of the Division of Public Health and Community Services of the City of Nashua, NH and is responsible for the public health emergency preparendess planning for the health department. He developed the concept and was the primary author.

Donna Arias, BS, is the Regional Public Health Preparedness Coordinator for the Division at the time of this work. She provided input from here experience working with the community partners from the 13 communities of the Greater Nashua area to develop regional plans that each community could support and help with the prevent communication that will be essential to the understanding and acceptance that will be needed from the public if the plans are to work in the event of an emergency.

Bobbie Bagley, BSN, MPH, RN, is the Chief Public Health Nurse of the Division and provided her input regarding the issues related to clinical decision marking during emergencies and how to make such decisions transparent prior to and during an emergency.

Mary S. Nelson, BS, MEd, was the Director of a Division at the time of this work and reviewed all of the coauthors' input to be sure that it was coordinated and translatable to the City's and region's policymakers. While Dr Etkind was the primary writer, the other authors reviewed and added to each draft in a significant fashion.

Corresponding Author: Paul Etkind, DrPH, MPH, Division of Public Health and Community, Services 18 Mulberry St, Nashua, NH 03060.

© 2008 Lippincott Williams & Wilkins, Inc.