title: Using typing techniques in a specific outbreak: the ethical reflection of public health professionals.
abstract: Typing techniques are laboratory methods used in outbreak management to investigate the degree to which microbes found within an outbreak are related. Knowledge about relational patterns between microbes benefits outbreak management, but inevitably also tells us something about the relational patterns of the people hosting them. Since the technique is often used without explicit consent of all individuals involved, this may raise ethical questions. The aim of this study was to unravel the complex ethical deliberation of professionals over the use of such techniques. We organised group discussions (n = 3) with Dutch outbreak managers (n = 23). The topic list was based on previously identified ethical issues and discussions were analysed for recurrent themes. We found that outbreak managers first and foremost reflect on the balance of individual harm with public health benefit. This key question was approached by way of discussing four more specific ethical themes: (1) justification of governmental intervention, (2) responsibility to prevent infections, (3) scientific uncertainty and (4) legal consequences. The themes found in this study, rephrased into accessible questions, represent the shared ethical understanding of professionals and can help to articulate the ethical dimensions of using molecular science in response to infectious disease outbreaks.
authors.affiliation: Regional Health Service Utrecht region (GGDrU),Zeist,The Netherlands.
authors.forename: B
authors.initials: B
authors.lastname: Rump
authors.affiliation: Ethics Institute, Utrecht University,Utrecht,The Netherlands.
authors.forename: C
authors.initials: C
authors.lastname: Cornelis
authors.affiliation: Regional Health Service Utrecht region (GGDrU),Zeist,The Netherlands.
authors.forename: F
authors.initials: F
authors.lastname: Woonink
authors.affiliation: Centre for Infectious Disease Control, National Institute of Public Health and the Environment (RIVM),Bilthoven,The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: VAN Steenbergen
authors.affiliation: Section Communication, Philosophy and Technology, Wageningen University,Wageningen,The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Verweij
authors.affiliation: Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboud University Medical Centre,Nijmegen,The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Hulscher
mesh_terms: D001291:Attitude of Health Personnel; D026688:Bioethical Issues; D004196:Disease Outbreaks / Q000941:ethics* / Q000517:prevention & control*; D006801:Humans; D058889:Molecular Typing / Q000941:ethics* / Q000592:standards; D028681:Moral Obligations; D009426:Netherlands; D011634:Public Health / Q000941:ethics*
keywords: Ethics; molecular epidemiology; outbreaks; public health ethics; typing