A disaster is a situation that overwhelms the local population’s capacity to respond, thus necessitating a request for assistance from outside the impacted area. In these circumstances, needs usually outweigh resources. The objective of response is to do the greatest good for the greatest number of people (the utilitarian principle). As such, some unique ethical considerations will arise that are not seen in day-to-day practice.

The adoption of medical ethics principles is important in such situations, but certain provisions must be accepted. In large-scale, complex disasters, it may be impossible to provide optimal care to each patient. This paper will discuss some of the challenges for healthcare personnel at “ground zero”, how training in preventive ethics may help, and what principles can be applied when working in disaster-affected areas or when responding to disasters.

When an infectious pandemic occurs in the United States, emergency care providers (ECPs) will be on the frontlines caring for infected, potentially infected, and non-infected patients. Logistically, the current emergency care system is not ready for a pandemic, but are the providers ethically ready? Some of the most difficult and challenging issues that will be raised during a pandemic will be ethical in nature. An ECP likely will be confronted with ethical values and value conflicts underlying restriction of liberty, duty to care, and resource allocation.

This report summarizes the ethical concerns and challenges that ECPs face during an infectious pandemic, and raises ethical questions that may arise related to the role of an ECP as a healthcare provider and stakeholder.