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Ethical Considerations in Emergency Planning, Preparedness, and Response to Acts of Terrorism

Published online by Cambridge University Press:  28 June 2012

Gregory Luke Larkin  and
Jeffrey Arnold
Gregory Luke Larkin*
Affiliation:
Professor of Surgery, Director of Academic Development, Division of Emergency Medicine, UT Southwestern Medical Center, Dallas, Texas, USA
Jeffrey Arnold
Affiliation:
Medical Director, Yale New Haven Center for Emergency and Terrorism Preparedness, New Haven, Connecticut, USA
*
Director of Academic Development, Division of Emergency Medicine, UT Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390–8579 USA, E-mail: [email protected]
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Abstract

Throughout the globe, healthcare providers are increasingly challenged with the specter of terrorism and the fallout from weapons of mass destruction. Preparing for and responding to such manmade emergencies, however, threatens the ethical underpinnings of routine, individualized, patient-centered, emergency healthcare. The exigency of a critical incident can instantly transform resource rich environs, to those of austerity. Healthcare workers, who only moments earlier may have been seeing two to three patients per hour, are instantly thrust into a sea of casualties and more basic lifeboat issues of quarantine, system overload and the thornier determinations of who will be given every chance to live and who will be allowed to die. Beyond the tribulations of triage, surge capacity, and the allocation of scarce resources, terrorism creates a parallel need for a host of virtues not commonly required in daily medical practice, including prudence, courage, justice, stewardship, vigilance, resilience, and charity. As a polyvalent counterpoint to the vices of apathy, cowardice, profligacy, recklessness, inflexibility, and narcissism, the virtues empower providers at all levels to vertically integrate principles of safety, public health, utility, and medical ethics at the micro, meso, and macro levels. Over time, virtuous behavior can be modeled, mentored, practiced, and institutionalized to become one of our more useful vaccines against the threat of terrorism in the new millennium.

Keywords

disasteremergencyemergency managementethicsterrorismweapons of mass destruction
Type
Special Reports
Information
Prehospital and Disaster Medicine , Volume 18 , Issue 3: Terrorism-II: Special Reports , September 2003 , pp. 170 - 178
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2003

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