The Ethics of Infectious Disease Control: Lessons from the Ebola outbreak and an ethical framework

Ebola virus disease (EVD) devastated its way into news headlines in 2014, destroying communities across three West African countries and costing the lives of over 11,000 people. The global health response was widely scrutinised and criticised, and though the outbreak is now over, there are still many lessons that can be learned from the 2014 EVD outbreak. This thesis will use the EVD outbreak in two ways. Firstly, I will use the EVD outbreak as a case study through which I will strive to address the ethical concerns for using experimental treatment during the outbreak, and I will address ethical concerns of the use of quarantine during the outbreak. Second, I will use the EVD outbreak as a launch pad to examine broader and more abstract ethical principles of the ethics of infectious disease control, such as the principles of reciprocity, transparency, proportionality, and the harm principle. This discussion will highlight how physical, biological features of a disease very much impact the application of the above principles when it comes to controlling the disease in an ethical manner. Finally, from this observation, I have created a ‘disease taxonomy’ that categorises infectious diseases based upon, what I argue, are the most ethically relevant biological features of infectious diseases. The taxonomy can aid in preparing for, understanding, and responding to the most pertinent ethical issues that surround various infectious diseases. The thesis should leave the reader with not only a greater understanding of some of the ethical issues raised by the 2014 EVD outbreak, but also a solid framework to utilise in discussing the most pertinent ethical issues of any future outbreak of any infectious disease.