One Health approaches to emerging infectious diseases: Considering the ethical issues

Dr Chris Degeling1,2, Dr Jane Johnson1, Prof Gwendolyn (Lyn) Gilbert1,2, Ass Prof Tamra Lysaght3

1 Centre for Values, Ethics and the Law in Medicine, School of Public Health, Level 1, Medical Foundation Building K25, The University of Sydney, NSW, 2006. E: chris.degeling@sydney.edu.au
2 Marie Bashir Institute for Infectious Disease and Biosecurity, The University of Sydney, NSW, 2006.

3 Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Level 2 Block MD11, Clinical Research Centre, 10 Medical Drive Singapore 117576.

Emerging and re-emerging infectious diseases (EIDs) continue to represent a significant threat to human health. A management approach grounded in ‘One Health’ is increasingly viewed as the most effective way of responding to these threats since it organizes action around the reality that human, animal and environmental health are interdependent. We argue, however, that in spite of the scientific consensus about adopting a One Health approach, such an approach will not be effective if it fails to engage with the values and ethical issues at stake. In this workshop we will present a number of hypothetical case studies to tease out the ethical issues generated by One Health responses to EIDs.

The format of this workshop will be highly interactive. We will begin by providing background on One Health and EIDs, before dividing the audience into groups to consider a number of case studies. Each group will be assigned one case and asked to identify the ethical issues it raises and to discuss and justify what action should follow from the scenario. Groups will then report back their findings to all workshop participants.

These cases have been used as the basis for online Delphi panels (questionnaires involving experts over multiple rounds) run in Australia and Singapore by the workshop authors. Insights from these panels will be used to inform and enrich workshop discussions. We will take the opportunity to highlight, amongst other things, similarities and differences between the Australian and Singaporean experiences.

We will conclude the workshop with a summary of the common themes and issues raised by the cases and how this work on ethical issues can be used to inform improved strategies and policies for implementing One Health responses to EIDs.


Biographies

Chris is a Research Fellow at the Centre for Values, Ethics and the Law in Medicine at Sydney School of Public Health and a practicing veterinarian. His research and teaching interests revolve around the ethics and politics of human interactions with nonhuman animals, and the social and cultural dimensions of public health. Current projects include the NHMRC funded study: Can One Health strategies be more effectively implemented through prior identification of public values?

Jane is a Research Fellow at the Centre for Values, Ethics and the Law in Medicine. From 2009 until the end of 2014 she was a postdoctoral research fellow at Macquarie University where she worked on projects regarding the ethics of innovative surgery, and the ethical and epistemological implications of reconceptualizing the use of nonhuman animals in biomedical research. Jane has research interests in applied ethics, interdisciplinary research and philosophical pedagogy; her distinctive expertise involves the philosophical and normative analysis of empirical problems.

Lyn is an infectious diseases physician and clinical microbiologist. She is a professor of infectious diseases and senior researcher at the Marie Bashir Institute for Infectious Diseases and Biosecurity and the Centre for Values, Ethics and the Law in Medicine and, until recently, was a senior staff specialist in Microbiology and Infectious Diseases at Westmead Hospital. She has had longstanding research and clinical interests in: communicable diseases of public health importance and ethical implications of infectious diseases and antimicrobial resistance.

Tamra researches ethical and regulatory issues in stem cell science and clinical translation of regenerative medicines and genomics. She has expertise in empirical ethics and experience using qualitative and quantitative research methods. Tamra has worked on policy with the Committee for Ethics Law and Society of the Human Genome Organisation, the Technical Working Group on Ethics at the World Health Organization, the Translational Clinical Research Programme of the Institute of Mental Health in Singapore, and the Human Health Division of the International Atomic Energy Agency. Tamra is an Assistant Professor, Centre for Biomedical Ethics, National University of Singapore.