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A qualitative study of the duty to care in communicable disease outbreaks

Author

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  • Bensimon, Cécile M.
  • Tracy, C. Shawn
  • Bernstein, Mark
  • Shaul, Randi Zlotnik
  • Upshur, Ross E.G.

Abstract

Health care providers' (HCPs') duty to care during communicable disease outbreaks has resurfaced as an important and contentious topic. This renewed interest follows the re-emergence of communicable diseases, largely thought to have disappeared and therefore irrelevant to modern day practitioners. The 2003 SARS outbreak particularly presented propitious circumstances for reconsidering this issue. This study seeks to characterize the views of individuals on the nature and limits of this duty. The authors employed qualitative methods to gather lay and expert perspectives. Individual interviews were conducted with 67 participants consisting of HCPs, spiritual leaders, regulators, and members of the public from the greater Toronto area. Participants' views were analyzed and organized according to three main themes, constituting a framework that combines micro-, meso-, and macro-level structures and processes: the scope of obligations of HCPs, the roles of health care institutions, and the broader social context, respectively. Our data suggest that the duty to care must be placed in a wider context to include considerations that transcend individual provider obligations. It thus follows, based on our data, that the duty to care cannot be left to personal choice or an appeal to morality based on an ethic derived entirely from individual obligations. The micro-meso-macro analytical framework that we have developed can guide the articulation of accepted norms of duty to care during epidemics and the development of policy for public health crises. It can also enhance the focus of our current expectations of HCPs' duty during epidemics. This can be achieved by informing regulatory bodies, collaborating with policy makers and engaging the public.

Suggested Citation

  • Bensimon, Cécile M. & Tracy, C. Shawn & Bernstein, Mark & Shaul, Randi Zlotnik & Upshur, Ross E.G., 2007. "A qualitative study of the duty to care in communicable disease outbreaks," Social Science & Medicine, Elsevier, vol. 65(12), pages 2566-2575, December.
  • Handle: RePEc:eee:socmed:v:65:y:2007:i:12:p:2566-2575
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    References listed on IDEAS

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    1. Loewy, Erich H., 1986. "Duties, fears and physicians," Social Science & Medicine, Elsevier, vol. 22(12), pages 1363-1366, January.
    2. Sohl, P. & Bassford, H. A., 1986. "Codes of medical ethics: Traditional foundations and contemporary practice," Social Science & Medicine, Elsevier, vol. 22(11), pages 1175-1179, January.
    3. Wynia, M.K. & Gostin, L.O., 2004. "Ethical challenges in preparing for bioterrorism: Barriers within the health care system," American Journal of Public Health, American Public Health Association, vol. 94(7), pages 1096-1102.
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    Cited by:

    1. Bensimon, Cécile M. & Smith, Maxwell J. & Pisartchik, Dmitri & Sahni, Sachin & Upshur, Ross E.G., 2012. "The duty to care in an influenza pandemic: A qualitative study of Canadian public perspectives," Social Science & Medicine, Elsevier, vol. 75(12), pages 2425-2430.
    2. Ingrid Gilles & Cédric Mabire & Margaux Perriraz & Isabelle Peytremann-Bridevaux, 2021. "Workplace Well-Being and Intent to Stay by Health Care Workers Reassigned during the First COVID-19 Wave: Results of a Swiss Survey," IJERPH, MDPI, vol. 18(17), pages 1-13, August.
    3. Leanne Burton & Abbie Wall & Elizabeth Perkins, 2022. "Making It Work: The Experiences of Delivering a Community Mental Health Service during the COVID-19 Pandemic," IJERPH, MDPI, vol. 19(19), pages 1-15, September.

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