Editorials

Ebola and ethics: autopsy of a failure

BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h2105 (Published 23 April 2015) Cite this as: BMJ 2015;350:h2105
  1. Christian A Gericke, chief executive and director of research
  1. 1Wesley Research Institute, Brisbane QLD 4066, Australia
  2. 2University of Queensland Schools of Medicine, Public Health and Queensland Brain Institute, Brisbane, Australia
  3. 3Queensland University of Technology School of Public Health, Brisbane, Australia
  1. c.gericke{at}uq.edu.au

Thousands died while we argued over the wrong questions

The current epidemic of Ebola virus disease has attracted medical ethics commentators like bees to a honey pot. No previous infectious disease epidemic has elicited such a flurry of articles on the ethical challenges associated with infection control and treatment in such a short time. Has this been of any use?

The ethical questions raised by various authors broadly fall into three categories. The first relates to questions of individual medical ethics, in particular surrounding the compassionate use of experimental drugs and vaccines. The second concerns allocation of resources to these experimental treatments versus infection control. And the third centres on how resources should be spent in the long term—on building a public health and clinical infrastructure that can cope in an epidemic instead of propping up a weak infrastructure during a humanitarian crisis.

The tension between these moral challenges can be grouped along two axes: individual versus public health, and short term versus long term (figure).

Tension between moral challenges and possible responses to the Ebola virus epidemic

The short term use of experimental drugs such as ZMapp, first used in a few repatriated health workers from high income countries, attracted far …

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