Public Health Preparedness

Pandemic Influenza Ethics Task Force

The Pandemic Influenza Ethics Task Force was formed in November 2008 to review plans and preparations, discuss ethical issues and  make  recommendations on major topics. The Task Force operates under the auspices of the State Pandemic Influenza Coordinating Council,  an advisory body to the S.C. Department of Health and Environmental Control.

The task force will operate  through October 2009 to:

  • Review plans and preparedness measures
  • Identify major ethical issues
  • Discuss ethical issues and principles
  • Gather broad public input
  • Prepare recommendations for guidelines
  • Consider legislative aspects

Since November 2005, a  national effort has been underway to plan for  a severe influenza pandemic. All 50 states and many federal government agencies have done extensive pandemic influenza planning (www.pandemicflu.gov). South Carolina formed its Pandemic Influenza Coordinating Council in November 2005. The council assessed preparedness and called for:

  • Extensive state, regional and local planning
  • Information sharing meetings promoting awareness and preparedness
  • Multi-media public awareness campaign
  • Targeted multi-media campaigns and technical assistance
  • Stockpiles of antivirals, supplies and equipment
  • Detailed planning for medical surge
  • Expansion of disease surveillance and laboratory capabilities

Much progress has been made in planning and preparing for pandemic influenza. Annual reports to the state legislature document pandemic preparedness activities:

Ethical Issues in Pandemic Influenza Planning and Response

In July 2008, a national summit on “Confronting the Ethics of Pandemic Influenza Planning” (pdf) was held in Indianapolis. The summit was hosted by the University of Indiana Center for Bioethics as a national call for action to enhance dialogue and partnering, improve education and training, and address policy issues. 

Among the ethical issues identified were:

  • Engaging communities in planning and response
  • Allocation of scarce resources
  • Altered standards and places of care
  • Rights and duties of health care workers
  • Disparities in access to care
  • Palliative care
  • Needs of at-risk populations
  • Appropriate community mitigation strategies
  • Respecting cultural and religious practices in the face of mass fatalities

Organization of the Pandemic Influenza Ethics Task Force

How will the Pandemic Influenza Ethics Task Force develop its recommendations?
DHEC has  brought together a group of volunteers including physicians, academicians and lay persons with expertise or special interest in ethical issues surrounding our response to a pandemic influenza.  The volunteers of this task force will then focus on one of  four specialized workgroups:

  • Ethical Framework and Principles
  • Ethical Issues in Clinical Practice and Patient Care
  • Ethical Issues in Public Health Practice
  • Legal Issues

The four work groups will identify specific ethical issues within each broad category and develop  policy recommendations  related to these categories.  Their recommendations will be compiled into  a white paper outlining guidance for major ethical issues of concern during a pandemic.  Following the conclusion of these workgroups, a state-level summit will be held to release the  findings in the  summer of 2009.

What kinds of recommendations will this Task Force develop?
The task force will explore all  issues  affecting medical and public health decision-making during a pandemic.  Obviously, critical shortages of medical equipment and medicine and who should receive the available resources will be of primary concern. Among other issues  the task force will  address include absenteeism and shortages in medical personnel, alternate sites for the care of the ill when hospitals are full, use of control measures such as isolation and quarantine, the procedure for the prioritization of vaccine and antiviral allocation.

How can I  offer my opinion on the findings of the Task Force?
The task force recommendations  will be compiled and released in  the Summer of 2009.  Public hearings will be held to receive comments on the findings, as well as DHEC’s Public Health Preparedness emergency plans, including the State Pandemic  Influenza Plan. Please check this website and local news media for dates, locations and times for  public hearings. 

In the meantime, if you have questions, you may contact:

DHEC Contacts:

Resources

South Carolina Pandemic Influenza Reports, Plans, and Procedures:

Learner, R. M. & Beasley, P.  (2006). South Carolina prepares: Pandemic influenza – An assessment of readiness and plan for improvement (pdf). Columbia, SC: Department of Health and Environmental Control.

Learner, R. M. & Beasley, P.  (2007). South Carolina prepares: Pandemic influenza progress report, 2007 (pdf). Columbia, SC: Department of Health and Environmental Control.

Learner, R. M. & Beasley, P.  (2008). South Carolina prepares: Pandemic influenza progress report, 2008 (pdf). Columbia, SC: Department of Health and Environmental Control.

South Carolina Department of Health and Environmental Control. (2008). Mass casualty plan: Appendix 5, South Carolina Emergency Operations Plan. Columbia, SC: State Emergency Management Division.

Strategic National Stockpile Emergency Operations Plan (pdf)

South Carolina Department of Health and Environmental Control. (2008). Pandemic influenza  Annex 2, Mass Casualty Plan (pdf). Columbia, SC: State Emergency Management Division.

South Carolina Department of Health and Environmental Control. (2008). Mass fatality management plan, Annex 4 draft, Mass Casualty Plan (pdf) . Columbia, SC:  State Emergency Management Division.

South Carolina Department of Health and Environmental Control. (2008). Pandemic Influenza antiviral distribution plan: Standard operating procedures. Columbia, SC:  South Carolina Department of Health and Environmental Control.

Antiviral Distribution Plan (pdf)

South Carolina Department of Health and Environmental Control. (2008). Community mitigation plan narrative (pdf) . Columbia, SC:  South Carolina Department of Health and Environmental Control.

South Carolina Department of Health and Environmental Control. (2006). Immunization pandemic influenza mass vaccination policies and procedures (pdf). Columbia, SC:  South Carolina Department of Health and Environmental Control.

State Emergency Management Division. (2008). South Carolina Emergency Operations Plan – Basic Plan. Columbia, SC:  State Emergency Management Division.

State Emergency Management Division. (2008). South Carolina Recovery Plan: Appendix, 6, South Carolina Emergency Operations Plan. Columbia, SC:  State Emergency Management Division

State of South Carolina. (2008). State pandemic influenza plan submission. Columbia, SC: South Carolina Department of Health and Environmental Control.

State of South Carolina. (2007). Template for state pandemic influenza operations plan submission (xls). Columbia, SC: South Carolina Department of Health and Environmental Control.

Bibliography of Ethical Guidelines, State Plans and Resource Materials (pdf)

U.S. Department of Health and Human Services Pandemic Influenza Website

World Health Organization, Ethical considerations in developing a public health response to pandemic influenza

Ethical guidelines in Pandemic Influenza – Recommendations of the Ethics Subcommittee of the Advisory Committee to the Director, Centers for Disease Control and Prevention

Pandemic Influenza Ethics Task Force Working Documents

The following links are to the Task Force presentations, meeting minutes and draft working documents:

For additional information, contact:  (803) 898-3708