Identifying the scope of ethical challenges caused by the Ebola epidemic 2014-2016 in West Africa: a qualitative study

Saskia Wilhelmy; Regina Müller; Dominik Gross

doi:10.1186/s13010-022-00128-y

Identifying the scope of ethical challenges caused by the Ebola epidemic 2014-2016 in West Africa: a qualitative study

Philos Ethics Humanit Med. 2022 Dec 28;17(1):16. doi: 10.1186/s13010-022-00128-y.

Authors

Saskia Wilhelmy¹, Regina Müller², Dominik Gross³

Affiliations

¹ Institute for History, Theory and Ethics of Medicine, Medical Faculty, RWTH Aachen University, Wendlingweg 2, 52074, Aachen, Germany. swilhelmy@ukaachen.de.
² Institute of Philosophy, University of Bremen, Enrique-Schmidt-Str. 7, 28359, Bremen, Germany.
³ Institute for History, Theory and Ethics of Medicine, Medical Faculty, RWTH Aachen University, Wendlingweg 2, 52074, Aachen, Germany.

Abstract

Background: The West African Ebola virus epidemic from 2014 to 2016 is unprecedented in its scale, surpassing all previous and subsequent Ebola outbreaks since 1976. This epidemic provoked a humanitarian emergency that extended to different spheres of life, making visible ethical challenges in addition to medical, economic, and social ones. The present article aims to identify and differentiate the scope of ethical issues associated with the Ebola epidemic.

Methods: An online media analysis was performed on articles published from March 2014 to September 2015 in ten preselected academic journals (scientific press) and two online newspapers (lay press). Two methodological approaches were combined: a systematic literature search and a qualitative content analysis. An additional keyword search was conducted on the PubMed database for the period after the end of the Ebola epidemic (2016-2020) to obtain an overview of research dealing with medical ethics due to the epidemic and to compare these results with the identified ethical challenges.

Results: A total of 389 articles dealing with the subject fields "Ebola epidemic" and "ethics" were researched. For qualitative content analysis, the time span with the highest article density was selected and a total of 64 articles were included (15 scientific articles, 49 popular articles). Five core ethical challenges of the Ebola epidemic emerged: 1. Responsibility and Accountability, 2. Spillover Effects, 3. Research and Development, 4. Health Communication, and 5. Resource Allocation. Articles in academic journals were dominated by the discussion of normative aspects in the area of "research and development", while newspaper articles focused on aspects of "responsibility and accountability".

Conclusion: An ethical discussion of the Ebola epidemic requires an examination of as many of the ethical dimensions involved as possible. The presented investigation of the two types of media with regard to the Ebola epidemic offers this possibility of a more comprehensive insight into this diversity as a basis for ethical discussions.

Keywords: Bioethics; Ebola; Epidemic; Ethical implications; Media.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Africa, Western / epidemiology
Disease Outbreaks
Epidemics*
Hemorrhagic Fever, Ebola* / diagnosis
Hemorrhagic Fever, Ebola* / epidemiology
Humans
Qualitative Research