Heidi Malm talks with
ScienceWatch.com and answers a few questions about
this month's New Hot Paper in the field of Social Sciences,
Article Title: Ethics, pandemics, and the duty to
H;May, T;Francis, LP;Omer, SB;Salmon, DA;Hood,
Journal: AM J BIOETH
* Loyola Univ, Dept Philosophy, 6525 N Sheridan Rd,
Chicago, IL 60626 USA.
* Loyola Univ, Dept Philosophy, Chicago, IL 60626
(addresses have been truncated)
Why do you think your paper is highly
The American Journal of Bioethics has broad appeal, an extensive
and diverse readership, and excellent of methods of making manuscripts
available online for comments before they come into print. Further, the
article itself addresses a very timely topic—healthcare workers' duty
to treat in times of pandemics—that is of interest to academicians
and practitioners in medicine, law, philosophy, public health, and
government, both nationally and internationally.
Does it describe a new discovery, methodology, or
synthesis of knowledge?
The article provides a very detailed philosophical/logical critique of five
arguments that have been commonly proffered in favor of healthcare workers'
duty to treat, but which, surprisingly, had not been subject to the kind of
critique needed to determine (a) the range of any such duty across the
various fields of healthcare work and (b) the applicability of the
arguments in times of fast-moving, infectious diseases (e.g., avian flu,
SARS, Ebola) which increase the health risk to the workers themselves and
alter the conditions under which the care is provided.
"...there are huge social and
political implications related to this issue
and this general subject area, and I trust
many, many scholars and practitioners will
continue to address it."
To put it in another way, it is easy to proclaim that, "Yes, they do have a
duty to treat even at increased risk to themselves," or that "No they
don't," when what was really needed was careful attention to such things as
(a) the referent of "they," (b) the moral/ethical grounds for the duty, c)
the professions' respective codes of ethics, (d) the social contracts
between society and the professions, etc., etc. The article provides that
Would you summarize the significance of your paper
in layman's terms?
I intended the whole article to be presented in layman's terms, although it
does include a section on moral theory. More to the point, the article
examines five commonly offered grounds for claiming that healthcare workers
have a "duty to treat" even at increased risk to themselves, and it
maintains that none of the arguments is currently sufficient to ground the
kind of duty that society would need were society to be hit with a
fast-moving, deadly, infectious disease, such as a humanly transmissible
avian flu. The article also offers, though less centrally so, some
suggestions to help rectify the problem.
Any given reader may not like the conclusions of the particular arguments:
I, too, wish some were different. But the logical reasoning is sound. And
its implications for pandemic planning are clear. A conclusion
(e.g., that healthcare workers have a duty to treat) isn't true
just because someone wants it to be true or because it would be good for
society if it were to be true.
As a personal aside, I think anyone reading the article who is not already
involved in the issue will likely become depressed at how under-prepared we
are as a nation/world to address an avian flu pandemic. We can all assert
broad claims that we ought to do X or Y, prioritize this or that, but the
nitty-gritty details have been barely touched. And they do need to be
touched; deeply massaged, in fact. My own view is that consent-related
methods are the most viable, though nothing will address all the challenges
on the pragmatic front.
How did you become involved in this research, and
were there any particular problems encountered along the way?
I became involved in this topic when a colleague, one of the co-authors,
asked me to join a "working group" on pandemic planning. I believe I was
initially asked to join because of my background in moral and legal theory
as they relate to the duty to prevent harm. The group received funding and
started researching several issues related to pandemic planning.
Where do you see your research leading in the
Members of the group are currently finishing manuscripts on allocation
strategies for flu vaccines and the need for compensation for
quarantine-induced harms. I'm back to working on other issues related to
ethics and preventive medicine, in particular, ethical issues related to
medical screening for diseases such as cancer, as well as the furthering of
Do you foresee any social or political implications
for your research?
Well, there are huge social and political implications related to this
issue and this general subject area, and I trust many, many scholars and
practitioners will continue to address it. But, as for this particular
article or my research—I can’t be so arrogant as to claim such
Heidi Malm, Ph.D.
Chicago, IL, USA Web