Resource allocation on the frontlines of public health preparedness and response: report of a summit on legal and ethical issues

TitleResource allocation on the frontlines of public health preparedness and response: report of a summit on legal and ethical issues
Publication TypeJournal Article
Year of Publication2009
AuthorsBarnett, DJ, Taylor, HA, Hodge, J, Links, JM
JournalPublic health reports (Washington, D.C.: 1974)
Pagination295 - 303
Date Published2009
ISBN Number0033-3549; 0033-3549
KeywordsDecision Making, Organizational, Disaster Planning/legislation & jurisprudence, Health Planning Guidelines, Humans, Public Health Administration/ethics, Public Health Practice/ethics, Residence Characteristics, Resource Allocation/ethics/legislation & jurisprudence, Social Responsibility, Triage/ethics, United States

OBJECTIVES: In the face of all-hazards preparedness challenges, local and state health department personnel have to date lacked a discrete set of legally and ethically informed public health principles to guide the distribution of scarce resources in crisis settings. To help address this gap, we convened a Summit of academic and practice experts to develop a set of principles for legally and ethically sound public health resource triage decision-making in emergencies. METHODS: The invitation-only Summit, held in Washington, D.C., on June 29, 2006, assembled 20 experts from a combination of academic institutions and nonacademic leadership, policy, and practice settings. The Summit featured a tabletop exercise designed to highlight resource scarcity challenges in a public health infectious disease emergency. This exercise served as a springboard for Summit participants' subsequent identification of 10 public health emergency resource allocation principles through an iterative process. RESULTS: The final product of the Summit was a set of 10 principles to guide allocation decisions involving scarce resources in public health emergencies. The principles are grouped into three categories: obligations to community; balancing personal autonomy and community well-being/benefit; and good preparedness practice. CONCLUSIONS: The 10 Summit-derived principles represent an attempt to link law, ethics, and real-world public health emergency resource allocation practices, and can serve as a useful starting framework to guide further systematic approaches and future research on addressing public health resource scarcity in an all-hazards context.


LR: 20110302; GR: U90/CCU324236-04/CC/CDC HHS/United States; JID: 9716844; RF: 27; OID: NLM: PMC2646457; ppublish