title: Reaching out to Ebola victims: Coercion, persuasion or an appeal for self-sacrifice?
abstract: The 2014-2015 Ebola crisis in West Africa has highlighted the practical limits of upholding human rights and common ethical principles when applying emergency public-health measures. The role of medical teams in the implementation of quarantine and isolation has been equivocal, particularly when such measures are opposed by communities who are coerced by the temporary suspension of civil liberties. In their encounters with Ebola victims, outreach teams face moral dilemmas, where the boundaries are unclear between coercion, persuasion and appeals for self-sacrifice. For those teams, we propose a set of practical recommendations aimed at respecting the autonomy of epidemic victims and easing tensions within communities. We recognize that some of these recommendations are progressively achievable, depending on the specific stage or setting of an outbreak. Yet with the increasing availability of experimental treatments and research interventions, weighing patients' autonomy against the common good will become an even more pressing ethical obligation.
authors.affiliation: Research Unit on Humanitarian Stakes and Practices (UREPH), Médecins Sans Frontières, Rue de Lausanne 78, 1211 Genève 21, Switzerland. Electronic address: philippe_calain@hotmail.com.
authors.forename: Philippe
authors.initials: P
authors.lastname: Calain
authors.affiliation: Research Unit on Humanitarian Stakes and Practices (UREPH), Médecins Sans Frontières, Rue de Lausanne 78, 1211 Genève 21, Switzerland.
authors.forename: Marc
authors.initials: M
authors.lastname: Poncin
mesh_terms: D000354:Africa, Western; D003068:Coercion; D004196:Disease Outbreaks / Q000517:prevention & control; D004992:Ethics, Medical; D019142:Hemorrhagic Fever, Ebola / Q000453:epidemiology / Q000628:therapy* / Q000635:transmission; D006806:Human Rights / Q000331:legislation & jurisprudence; D006801:Humans; D010565:Persuasive Communication; D011634:Public Health; D011790:Quarantine / Q000379:methods
keywords: Autonomy; Ebola; Human rights; Isolation; Public health ethics; Quarantine