Page 105 - Prioridades en salud y salud intercultural

105
Risk: probability and
importance of harm
One of the main dilemmas fac-
ing healthworkers in the field of
public health concerns the tension
between individual rights, societal
needs, and technical proficiency.
Quality of service does not neces-
sarily imply equitable distribution
of benefits or universal access to in-
novative resources.
Epidemics are a case in point. Dur-
ing the SARS crisis, Geneva WHO
officials observed that the usual
procedure for evaluating ethical as-
pects of research proposals might
well take too much time consid-
ering the risks and dangers posed
by a condition rapidly spreading
over wide geographical areas. In
this particular situation, individual
rights to autonomy, confidentiality,
and even denial of treatment would
collide with the common good and
the public interest. Researchers
needed to speed up the process of
ethical review because theirs was
not academic pursuit but need of
knowledge for immediate life-sav-
ing action.
The situation only underscored
what is already common prac-
tice in most countries. Certain
public health actions are compul-
sory. Vaccination is not left to in-
dividual choice but imposed by
public health officials. Notification
of transmisible diseases is manda-
tory when populations are at risk.
Public good, as it is implied in such
practices, has precedence over in-
dividual choice or even individual
rights. This consideration underlies
ETHICS OF PREPAREDNESS IN LATIN
AMERICA. CONSIDERATIONS ON GLOBAL
EPIDEMIC RISKS
Fernando Lolas Stepke