Ebola and Learning Lessons from Moral Failures: Who Cares about Ethics?

Area of Science:

• Public Health
• Global Health Security
• Ethics in Public Health

Background:

• Major public health emergencies necessitate "lessons learned" exercises to improve future preparedness and response.
• The Ebola Virus Disease (EVD) outbreak in West Africa highlighted the need for effective post-emergency analysis.
• Current "lessons learned" articulations, especially from organizational reflections, exhibit significant shortcomings.

Purpose of the Study:

• To reframe the understanding of lessons learned from public health emergencies.
• To argue that most "lessons learned" are actually ethical lessons derived from moral failures.
• To emphasize the necessity of acknowledging these moral failures for enhancing global public health emergency preparedness.

Main Methods:

• Critical analysis of existing "lessons learned" literature following major public health emergencies.
• Ethical evaluation of articulated lessons, particularly those from organizational perspectives.
• Conceptual reframing of identified lessons as stemming from moral failings.

Main Results:

• The majority of lessons identified in the post-emergency literature are not technical or logistical, but ethical in nature.
• These ethical lessons predominantly arise from moral failures in preparedness and response efforts.
• Current approaches fail to recognize and address these underlying moral dimensions.

Conclusions:

• Future improvements in global public health emergency preparedness and response depend on acknowledging and addressing repeated moral failings.
• Priorities, policies, and practices must be adjusted to align with values that prevent the recurrence of moral failures.
• An approach embodying solidarity and global justice is essential for navigating future public health emergencies and avoiding new ethical pitfalls.