Ebola Fever and Global Health Responsibilities

This is the authors' abstract. We don't add key points for this paper.

ver the summer and into the fall, the global community grew increasingly alarmed about the outbreak of the Ebola virus in West Africa-and for good reason.By all accounts, the spreading epidemic in Sierra Leone, Guinea, Liberia, and elsewhere constitutes the worst Ebola crisis in recorded history.One of the ethical wrinkles characterizing this public health emergency began in late August when relief and humanitarian organizations urged the doctors, nurses, and other health professionals working for them to flee "the hot zone" and go home.It is hard, if not impossible, to criticize those wanting to escape from such danger, especially when so few of us are willing to go there in the first place.But it does force every doctor (and patient) to reconsider the medical profession's presumed ethical obligation to treat the ill, no matter what the risk.More broadly, it allows for reflection on how population health measures and sound global health policies, backed by sufficient and overdue financial investments, might help us avoid such ethical dilemmas (and severe epidemic outbreaks) in the future.Many people may be surprised to learn that across time and societies, physicians have often abandoned their patients during deadly epidemics.For example, in 166 ce, the famed physician and anatomist Galen fled Rome upon the arrival of bubonic plague.In the 17th century, Thomas Sydenham, one of medicine's most astute observers of infectious disease, quit London for the more salubrious countryside during that city's "great plague."These legendary healers were hardly alone.Some European cities were forced to appoint public plague doctors to attend the ill patients that other physicians refused to treat.A wide range of avoidance responses also was seen in colonial Philadelphia during the yellow fever epidemic of 1793 and the several cholera and smallpox epidemics that broke out across the United States during the early 19th century.Still, many other doctors during these eras did sacrifice their