title: Caring for the suffering: meeting the Ebola crisis responsibly.
abstract: The current Ebola virus epidemic in Western Africa appears to be spiraling out of control. The worst-case projections suggested that the unchecked spread could result in almost 1.4 million cases by the end of January 2015 with a case fatality rate of at least 50%. The United States and European nations have begun to respond in earnest with promises of supplies, isolation beds, and trained health care personnel in an effort to contain the epidemic and care for the sick. However, there is neither a vaccine nor specific treatment for Ebola infection, and therapy is ideally centered on supportive care. I have previously argued that the provision of palliative care is obligatory during an overwhelming health catastrophe, notably pandemic influenza. Since affected Ebola patients have best outcomes with technologically advanced intensive care--resources in scarce supply in the area--I suggest that the only acceptable approach to large numbers of very sick, dying, and suffering Ebola patients who overwhelm the resources available to successfully manage them is effective palliative care. However, this could hasten death in this vulnerable population and hence, while ethically and medically justifiable, is not without social risk.
authors: a Duke University Medical Center.
authors: Philip M
authors: PM
authors: Rosoff
mesh_terms: D000354:Africa, Western / Q000453:epidemiology; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects*; D019049:Developed Countries; D019142:Hemorrhagic Fever, Ebola / Q000453:epidemiology* / Q000628:therapy*; D006801:Humans; D007391:International Cooperation; D009102:Multiple Organ Failure / Q000628:therapy* / Q000821:virology; D010166:Palliative Care / Q000941:ethics / Q000379:methods / Q000523:psychology; D035502:Trust; D014481:United States; D014766:Viremia / Q000628:therapy / Q000821:virology
chemical_list: D000701:Analgesics, Opioid
keywords: Ebola virus infection; palliative care; palliative sedation; social justice