Chest. 2015 Mar 12. doi: 10.1378/chest.15-0278. [Epub ahead of print]

Ethical and practical considerations in providing critical care to patients with Ebola virus disease.

Torabi-Parizi P, Davey RT Jr, Suffredini AF, Chertow DS.

Abstract

ABSTRACT:

Infectious disease epidemics in the past have given rise to psychological and emotional responses among health care workers stemming from fear of infection during patient care. Early experiences in the AIDS epidemic provide an example where fear of contagion resulted in differential treatment of human immunodeficiency virus (HIV)-infected patients. However, with a deeper understanding of AIDS pathogenesis and treatment, fear and discrimination diminished. Parallels exist between early experiences with AIDS and the present outbreak of Ebola virus disease (EVD) in West Africa particularly in regards to discussions of medical futility in seriously ill patients. We provide a historical perspective on health care workers' risk of infection during the provision of cardiopulmonary resuscitation, discuss physicians' duty to treat in the face of perceived or actual health care worker risk, and finally present the protocols implemented at the National Institutes of Health (NIH) to reduce health care worker risk while providing life-saving and life-sustaining care.