Nowadays, chaotic situations are no longer hypothesis or virtual but reality on a day to day. We have to learn on how to cope with chaos according to specs for a limited period of time, according to severity.
Whatever crisis are, natural disaster or pandemics or terrorist attacks, living in XXI° century raises security concerns and threats which must be planned. By thinking about the answers to bring on the table, we have to think about the worse case scenario for developing new strategy to legitimate actions plan and prepare management of deviation for Ethics during conflicting situations or extra-ordinary environments (Political or sanitary); one point to be addressed is to carefully implement new decisions for a while and by explaining conditions required and necessary to activate it.
The Pandemic Preparedness Plan done in 2009 during the Flu H1N1 Pandemic was a good opportunity to review the key role of Ethics by launching talks and seminars on this topic, mostly Legal and Philosophy issues, on the best practices to be used during emergency care in a life-threatening environment, close to chaos also called Black Swan.
Recently, famous Patrick LAGADEC, author of “Le Continent des Imprévus”, is the head of new school of risk management teaching how to think the unthinkable by proposing to create a new task force “Quick thinking force”.
Following the terrorist attacks which occurred in Paris on Friday November 13th 2015, French Parliament (National Assembly + Senate), gathered in Versailles for the Congress, is working on a Patriot Act in order to contain terrorism in link with Islamic State. Reinforcement of internal Security, by measuring risks versus impacts of new measures affecting individual human rights and freedom. This is the price to pay for keeping our population safe. Other measures could be voted to prevent individuals identified as High risk of Security threat, labelled “S” for “Special attention” with regards links with terrorism organisations or extremists.
Now and considering Health, mainly Public Health or disaster medicine, there are several situations where Medical Doctor has to deal with medical Ethics and Law in order to treat no longer on an individual practice but on a mass gathering medical care. It is not a first arrived first served but cares are prioritized based on gravity of injuries but also the better chance to survive if the rule “sooner is better” is applied. In a very critical situation, the main objective is to take care and save the highest number of lives. To achieve this objective, Ethics needs sometimes to be relocated backstage and for a while. That was recently the case during Ebola epidemic in West Africa which required to use military forces for helping containing People and villagers, also in custody. That affected human rights but also saved hundred of lives.
Remember what happened in Scandinavian countries during the AIDS and how ill People infected by HIV were isolated/jailed to prevent spread and to contain risk exposure.
For sure there is a risk for abuses; this is why it is so important that national authorities and Public health department have time and work in advance not to be in a hurry and under pressure when elaborating a management of deviation which is impacting Ethics and human rights. To conclude, during extraordinary occasion, it remains of great importance to be able to explain (not to complain) the rationale behind a management of deviation impacting both Ethics and human rights that we normally refer to while in safe and peaceful environment.