Ethics in Biodefense
The threat of disease infection caused by deliberately or naturally released biological agents exposes the society to serious challenges. Biodefense strategies and measures, therefore, should cope with the complexities that arise because the nature of biological threat affects the public health sector, the intelligence agencies, research institutions and the department of defense. The term biodefense is of military origin and is used to denote the plans, procedures, and methods for establishing before implementing defensive measures against bioterrorism attacks. In other words, biodefense refers to policies involved in maintaining biosecurity or the restoration of accidental, deliberate or natural outbreaks of toxins and microorganisms. Since the defensive mechanisms against bioterrorism apply without considering the particular origin of the threat, an active and integrated spectrum of sustainability necessitates bioethical considerations.
Background
In the events preceding the U.S September 11 attack of the anthrax letters being disseminated, and the emergence of foot-and-mouth disease, the threat of infectious and pathogenic organisms resurfaced. The United States Department of Homeland Security highlighted the need to formulate a comprehensive national strategy to prepare, mitigate, and respond to future events of biological attacks. The U.S. government has invested in agencies for biodefense mechanisms for rapid response and preparedness. A significant need, however, arises for appropriate handling of the ethical challenges in the Department of Biodefense. Vital ethical issues relating to bioterrorism and biodefense present grave moral dilemmas in the research and testing of biological agents. Biodefense by extension, presents an ethical dilemma because of the policies related to the allocation of personnel and resources, in that the free rights of the providers of healthcare, self-preservation and a balance of health risks in the research laboratories. Furthermore, complications arise curtailing the publication of the information used to create bioweapons. In the effort to create biodefense measures, harmful technologies develop and the testing of the potential clinical trial therapies or vaccines to the older adults and children.
Countries justify the ethical use of biodefense weapons as a means to ramp up their military capabilities and fight back any enemy attacks. Currently, most of the administration agencies for instance, in the United States of America have taken actions following the anthrax attack way back in 2001. This happened seven days after the assault of the global trade towers in New York City, emails that had anthrax bacteria were sent to various workplaces of the media where senators said to be two were reported to be infected among other five people who lost their lives and another group of seventeen people was affected. Because of the bioterror attack that left Bob Stevens dead the United States offices are occupied with biodefense attentiveness and reaction (Anderson & Bokor, 2012). In this attack, anxiety heightened as well as sorrow for the number of people who lost their lives following the bioterror attack; it seemed that some legislative agencies reacted collectively to reduce security damage by putting into practice effective sanitization as well as sterilization measures. Unluckily, regardless of the effort made by the government, the terrorist who made the attack was not caught. There is great need, on the other hand, to address ethical challenges in biodefense.
The ethical problems regarding biodefense like the use of vaccines by the military, the management of bioterrorism victims, identification and restriction issues and how this has created a moral dilemma in biodefense. Moreover, various bioethical questions regarding health obstructions in awareness for bioterrorism and suggest various proposals on how to deal with these challenges as well as the preparations regarding bioterrorism fronts on fundamental ethical challenges (Katz & Zilinskas 2011). Even though the public medical care principles and developments have gotten concentrated in the current times, medical care morals must be put in considerations too. In times of a disaster or disease outbreaks, the medical care schemes help the community health in three activities: discovery, control, and management. Similarly, control can also fail to be successful if the doctors take themselves like attendees for personal victims, not taking into account their social duty as medical practitioners (Unlu et al., 2012). Furthermore, treatment and management might not be successful if the medical providers are to take their skilled responsibilities of managing patients during the disasters or disease outbreak.
For all these capable, ethical hindrances to awareness should be dealt with by the doctors and the public at large
Moreover, Barnett and Brian (2006) argue that countries should ethically create awareness to their citizens regarding their continued research and use of biodefense systems. The international distribution of the anthrax bacteria in the United States shows the need for awareness of bioterrorism, and the recent epidemic of the Severe Acute Respiratory Syndrome (SARS), which gave signals for naturally happening epidemics. Regarding the reactions to such warnings, the community health scheme has legally gathered much of the concentration after many years of underfunding of community health groups by the government. On the contrary, an effectual reaction also will demand the medical care scheme to adhere to the vital roles. Health care system includes the doctors, nurses as well as the institutions such as the hospitals and the medical plans in place, that are set for diagnosing, managing and treating persons with infectious epidemics. From a precise point of view, the duties of medical care systems in handling communicable ailments may include the medical care schemes should quickly spot threats, aid in protecting the spread of diseases in the community, and caring for the affected victims (Schneider et al., 2011). Even though there are policy issues that have been spelled out by the government to empower health measures to curb communicable diseases, I wish to draw concentration to various challenges regarding health ethics and professionalism that can block identification, restriction, and management that have drawn less attention.
Position
Personally, I do agree that investing and developing biodefense systems is a necessary and critical action to take for any nation. Since the anthrax attack in late 2001 on the United States, the national security experts have invested in the research for infectious diseases. The research, in particular, involves the manufacturing of vaccines that require human test subjects to determine their effectiveness. The introduction of new medicines and drugs from the bioterrorism research activities requires the approval from the human subject protection agencies (Galamas, 2011). The first controversy emerges from informed consent approval where the patient has a life-threatening infection. The informed consent is violated when the person is unable to communicate or if there is inadequate time to get consent from a proper surrogate. From the public context, insufficient attention has been given to informed consent regarding the participation of individuals in research treatment in emerging outbreaks.
According to Muller (2015), adding up bio-defense systems as a military strategy would ensure that the country would have enough stock weapons to win wars. Evidently, during times of wars, both sides do whatever possible to win, even resorting to using bio defense systems that can help in winning the war.
Therefore, Muller proposes for increased research and funding through the state and federal governments to be increased to assist in research and development. Arguably, the resource allocation for such weapons should be done not to provoke confrontations and wars, but rather as defensive mechanisms and as a last result if peaceful talks fail. Geale (2012) notes of the damaging effects bio defensive weapons have, especially after their consequent use by governments on its citizens in conflict states of Libya and Syria. Furthermore, the author concludes that in the wrong hand, such weapons could be used to cause harm through terrorism, mass killings, and extorting the government for money; in hand, suggesting that the knowledge of making them be known to limited people.
Counter Position
However, I do have my concerns over the ethical application of biodefense systems based on various factors. The use of biodefense systems should be limited considering the risks involved. These risks can occur at any moment during the development and use of the system with accidents being prone to happen. Consequently, with such accidents, the dilemmas that would later arise would have adverse effects that would take years to resolve. Moreover, using these systems during wars have the risk factor of affecting civilians and those that are at most risk including children (Epstein, 2012). The forms for informed consent review consumed more time to fine-tune the edit and minimize the avenues of abuse by the bioterrorism researchers. The research documents should aim at improving the understanding of the subject and drawing attention to the importance of overcoming ethical barriers. The authorization of using anthrax vaccine in emergency cases prompted the military to activate an involuntary administration of the anthrax vaccine (Imperiale & Casadevall, 2011). The vaccine did not meet the approval standards of FDA but still the troops in Columbia used the Anthrax Vaccine Immunization Program (AVIP).
Furthermore, Bernett and Brian (2006) conclude that the continued research, development, and use of bio defense systems have adverse effects on the environment. Scientific research by the authors argues that for the effective development and use of such systems, various and continuous testing need to be undertaken, most of which are conducted on an open environment. Therefore, the increased testing of these systems would harm the environment, not only in the short-term but also in the end. Notably, some of these consequences have the tendencies to cause diseases including cancer and abnormal body growth. Additionally, it is not only the people who are at risk of consequences of exposure, but also plants and wildlife that would either die or drastically reduce in numbers (Bush & Perez, 2012). Therefore, according to propositions by Bernett and Brian, the use of such chemical warfare and systems should not exist in the first place, adding that other equally dangerous ones including nuclear and atomic weapons ought to be eradicated completely.
Conclusion
Protection against bioterrorism and physically occurring infectious epidemics needs physically significant medical health schemes. However, the medical health plan cannot work with no effective medical care system to identify, restrain and manage diseases. In this case, the state defense alongside bioterrorism should make sure that there is a widespread and quick availability of knowledge and kindhearted medical care professionals who in return should examine and take care of possible infectious victims. When ethical obstructions in the medical care schemes come along in the way of identification, restriction, and management, they should be dealt with and resolute, since unidentified, unverified and unattended epidemics pretense health hazards to victims and the public at large. Finally, not only the primary doctors who should be enlightened regarding ethical reaction issues concerning bioterrorism but other medical care providers such as nurses and the entire medical fraternity should be included to be taught about the health features of bioterrorism discovery, examination, and control. Similarly, other management officials should also be included.
Recommendations
A commission that comprises government officials, scientists and bioethicists should review, draft, and publicize a set of ethical guidelines to respond to complex ethical issues that arise during a crisis. The topic of ethical issues in biodefense exhibits multifaceted consensus in providing just guidelines and sound policies. The commission should prepare a guide of ethical responses in advance before a bioterrorist attack occurs, from the lesson learned in the natural disasters like the Ebola outbreak in West Africa. Moreover, this commission should be given the mandate to carry out an investigation in regions where there are suspicions of any wrongful misconduct with the use or making of bio defense systems. After conducting their investigations, the commission would, later on, report its findings to the relevant authorities for consequent punishments.
Likewise, the scientists should educate the nurses, the primary physicians and other healthcare providers about bioethical responses to bioterrorism, management, surveillance and detection procedures. The public similarly, should be educated about the threats of bioterrorism and the preparedness of the government to respond to a bio attack. The public should further understand their principles of triage and the ethical responsibilities in the times of disaster. Lastly, the incentive of financial gain for the research professionals in biodefense may prompt the recruited individuals to engage in unethical practices. The society, therefore, should educate the youth about responsible conduct and what should be done.
Consequences may arise in the fight against bioterrorism if stakeholders fail in their efforts to implement the recommendations required. The implications can range from massive public panic and inefficiency in the strategy implementation by the government. The awareness ensures biosafety regarding access to the research facilities for the unauthorized individuals to reduce the susceptibility and the infection circumstances.
Moreover, the paper advocates for education within the public sector regarding the awareness and consequences of biodefense systems. The public deserves to know of any government activities revolving the use and making of such systems, to avoid any consequences that may benefit them. Having such knowledge can enable the citizens to demand accountability in case any wrongdoing is done, or in the case of international punishments such as was the case in Iran after some world governments sanctioned it because of its investments in nuclear-related activities.