{"id":116,"date":"2009-04-28T12:13:03","date_gmt":"2009-04-28T11:13:03","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-ethics\/?p=116"},"modified":"2009-04-30T13:00:01","modified_gmt":"2009-04-30T12:00:01","slug":"obligatory-topical-swine-flu-post","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-ethics\/2009\/04\/28\/obligatory-topical-swine-flu-post\/","title":{"rendered":"Obligatory Topical Swine Flu Post"},"content":{"rendered":"

The appearance of Swine Flu over the past couple of days is the sort of thing that provides ample food for thought among ethicists, particularly public health ethicists.\u00a0 One perennial question, for example, concerns exactly what governments ought to do to protect their populations from infection – is spending on flu vaccines a good way to neutralise the risk?\u00a0 Is it efficient?\u00a0 Could the money still be better spent on university lecturers’ pay, bailing out\u00a0the banks, and\u00a0schools?\u00a0 (For what it’s worth: Yes, no, possibly, in that order.)\u00a0 At the same time, we might want to know what liberty-limiting measures might be in order, and what the threshold conditions are for them to become morally acceptable.<\/p>\n

Of course, there are lessons we can learn here.\u00a0 We know, with reasonable certainty, that there will be a public health emergency of some sort at some point in the future that will present a severe threat to a great many people: James Lovelock has predicted that, by the end of the century, the human population will undergo a 90% cull<\/a>\u00a0– and there’s no reason to suppose that disease (as\u00a0opposed to famine or war, as if the three were separable anyway)\u00a0won’t be a part of that.\u00a0 Lovelock is, perhaps, at the extreme end (I don’t think he’s a pessimist: a cull like that wouldn’t necessarily\u00a0be bad for humanity or the planet – it could be good –\u00a0though it would be bad for many particular humans<\/em>).\u00a0 What we don’t know is the form that the cull will take.<\/p>\n

A couple of years ago, there was a lot of fuss about H5N1.\u00a0 The current problem is to do with H1N1 – a different strain of virus.\u00a0 So we got that wrong.\u00a0 In principle, we could be making greater mistakes elsewhere – we got the flu bit right, but, of course, flu of any strain might turn out to be as nothing compared to, say, Ebola or (worse yet) something that is as-yet unknown – remember that, not so long ago, noone knew of HIV, either.<\/p>\n

The point of this isn’t to be gloomy for gloomy’s sake – it’s to point out that predicting and forestalling pandemics is a tricky business, and the correct response will have to take that into account.<\/p>\n

A\u00a0further problem is that governments have to respond to public pressure, and that isn’t always all that well-informed – the death-toll from the current outbreak in Mexico, apparently, has been calculated from deaths in hospital<\/em><\/a> (go to about 3:20 on the clip behind the link) –\u00a0where, of course, we’d only ever see the most seriously ill people to begin with.\u00a0 Looking more widely, H1N1 is not (by some measures at least) nearly as virulent as H5N1.\u00a0 Nevertheless, that’s not likely to make exciting headlines – and, therefore, the public’s demands, which are politically\u00a0important to governments,\u00a0are susceptible to being based on a misapprehension.\u00a0 Implicitly, the worry is that policy responses may not be the best by scientific standards.<\/p>\n

Not, of course, that governments are\u00a0immune from their own brands of foolishness.\u00a0 Take, for example, Yakov Litzman, the Israeli deputy health minister, who has, according to Haaretz<\/a>, decided that<\/p>\n

Israel would call the new potentially deadly disease that has already struck two continents ‘Mexico Flu,’ rather than ‘Swine Flu, as pigs are not kosher.<\/span><\/p><\/blockquote>\n

I can’t help thinking that, perhaps, he has missed the important point in this case, and that his response could have been directed at more pressing concerns.\u00a0 (I’m also intrigued by the implication that Mexican flu would be kosher.\u00a0 Can you\u00a0have a kosher disease?)<\/span><\/p>\n

Not that Litzman is alone in his, um, idiosyncratic approach to the problem.\u00a0 Siti Fadilah Supari, the Indonesian health minister, has reportedly suggested that the virus is man-made<\/a> and designed as a ploy to help Western pharmaceutical companies maximise profits.\u00a0 Meanwhile, Martin Robbins is building up a nice compendium of other flu-conspiracy ravings<\/a> with wry amusement.<\/span><\/p>\n

And, of course, xkcd is on the case<\/a>…<\/span><\/p>\n

\u00a0<\/p>\n

UPDATE: Naturally, Ben Goldacre has something interesting to say<\/a>…<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

The appearance of Swine Flu over the past couple of days is the sort of thing that provides ample food for thought among ethicists, particularly public health ethicists.\u00a0 One perennial question, for example, concerns exactly what governments ought to do to protect their populations from infection – is spending on flu vaccines a good way […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[511,475],"tags":[],"class_list":["post-116","post","type-post","status-publish","format-standard","hentry","category-in-the-news","category-politics"],"yoast_head":"\nObligatory Topical Swine Flu Post - Journal of Medical Ethics blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2009\/04\/28\/obligatory-topical-swine-flu-post\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Obligatory Topical Swine Flu Post - Journal of Medical Ethics blog\" \/>\n<meta property=\"og:description\" content=\"The appearance of Swine Flu over the past couple of days is the sort of thing that provides ample food for thought among ethicists, particularly public health ethicists.\u00a0 One perennial question, for example, concerns exactly what governments ought to do to protect their populations from infection – is spending on flu vaccines a good way [...]Read More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/medical-ethics\/2009\/04\/28\/obligatory-topical-swine-flu-post\/\" \/>\n<meta property=\"og:site_name\" content=\"Journal of Medical Ethics blog\" \/>\n<meta property=\"article:published_time\" content=\"2009-04-28T11:13:03+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2009-04-30T12:00:01+00:00\" \/>\n<meta name=\"author\" content=\"BMJ\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"BMJ\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"3 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2009\\\/04\\\/28\\\/obligatory-topical-swine-flu-post\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2009\\\/04\\\/28\\\/obligatory-topical-swine-flu-post\\\/\"},\"author\":{\"name\":\"BMJ\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#\\\/schema\\\/person\\\/ba3da426ed20e8f1d933ca367d8216fe\"},\"headline\":\"Obligatory Topical Swine Flu Post\",\"datePublished\":\"2009-04-28T11:13:03+00:00\",\"dateModified\":\"2009-04-30T12:00:01+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2009\\\/04\\\/28\\\/obligatory-topical-swine-flu-post\\\/\"},\"wordCount\":698,\"commentCount\":5,\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#organization\"},\"articleSection\":[\"In the News\",\"Politics\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2009\\\/04\\\/28\\\/obligatory-topical-swine-flu-post\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2009\\\/04\\\/28\\\/obligatory-topical-swine-flu-post\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2009\\\/04\\\/28\\\/obligatory-topical-swine-flu-post\\\/\",\"name\":\"Obligatory Topical Swine Flu Post - 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