Correspondence

Avian Influenza and Pandemics

N Engl J Med 2005; 352:1928May 5, 2005

Article

To the Editor:

With an eye to the ominous storm on the horizon that is avian influenza, in his editorial (Jan. 27 issue)1 Stöhr proposes a much-needed research agenda — with one major oversight. In addition to clinical and epidemiologic questions, many ethical issues will undoubtedly be raised by an influenza pandemic. The outbreak of the severe acute respiratory syndrome taught us a number of important lessons, but the first was that we were ill prepared to respond.2 Among the greatest challenges faced were the duty to provide care in the context of unknown risk, the need to balance individual privacy rights and the public's right to know, the use of quarantine and other restrictive measures, and the need to set priorities and use limited resources appropriately. Other issues were related to information sharing, patents, and research ethics.3,4

Avian influenza presents a significant, gathering threat. Although it is indeed prudent to pursue a greater understanding of it and to erect safeguards to protect against pandemic spread, it is no less incumbent on us to ensure that those safeguards are both reasonable and justifiable.

C. Shawn Tracy, M.Sc.
Sunnybrook and Women's College Health Sciences Centre, Toronto, ON M4N 3M5, Canada
shawn.tracy@sw.ca

Ross E.G. Upshur, M.D.
University of Toronto Joint Centre for Bioethics, Toronto, ON M5G 1L4, Canada

Abdallah S. Daar, D.Phil.
McLaughlin Centre for Molecular Medicine, Toronto, ON M5G 2C1, Canada

4 References

1. 1

   Stohr K. Avian influenza and pandemics -- research needs and opportunities. N Engl J Med 2005;352:405-407
   Full Text | Web of Science | Medline

2. 2

   National Advisory Committee on SARS and Public Health. Learning from SARS: renewal of public health in Canada. Ottawa: Health Canada, October 2003. (Accessed April 14, 2005, at http://www.hc-sc.gc.ca/english/protection/warnings/sars/learning.html.)
   

3. 3

   Singer PA, Benatar SR, Bernstein M, et al. Ethics and SARS: lessons from Toronto. BMJ 2003;327:1342-1344
   CrossRef | Web of Science | Medline

4. 4

   Bernstein M, Hawryluck L. Challenging beliefs and ethical concepts: the collateral damage of SARS. Crit Care 2003;7:269-271
   CrossRef | Web of Science | Medline

Citing Articles (1)

Citing Articles

1. 1

   Chih-Cheng Hsu, Ted Chen, Mei Chang, Yu-Kang Chang. (2006) Confidence in controlling a SARS outbreak: Experiences of public health nurses in managing home quarantine measures in Taiwan. American Journal of Infection Control 34:4, 176-181
   CrossRef