Public Health Ethics for Biocontainment Care

Abstract: Biocontainment (BCU) are purpose built to provide medical care for patients with high consequence infectious diseases (e.g., viral hemorrhagic fevers, Middle East respiratory syndrome) and to contain the risk of disease spread. In the US, high consequence infectious diseases (HCID) are often quarantinable diseases designated by the Centers for Disease Control and Prevention and state and local health departments, and BCUs play a prominent role when public health faces an HCID threat. Containment care involves preparedness efforts that attend to not only the risk of infection, but to the ethical, social, and psychological considerations for patients, healthcare personnel, and the local community. While the clinical standard of care in a BCU should deviate very little from any other medical unit within the hospital, the public health function of containing a HCID presents BCU teams with challenges in upholding public health goals while safeguarding individual patient interests. This presentation will start with an introduction to BCUs and the preparedness activities that ensure the units are ready to activate. Next, it explores the significance of public health ethics for BCUs concerning quarantine and isolation care, family considerations, and diagnostic testing for discharge. Finally, we emphasize the importance of preparedness activities to ensure the effectiveness of BCU operations and highlight when integrating ethical considerations in preparedness activities are critical for developing policies and protocols formulated and justified before the need to implement them in a BCUs.