Ethics and SARS: lessons from Toronto

doi:10.1136/bmj.327.7427.1342

BMJ 2003;327:1342-1344 (6 December), doi:10.1136/bmj.327.7427.1342

Education and debate

Ethics and SARS: lessons from Toronto

Peter A Singer, Sun Life financial chair and director¹, Solomon R Benatar, visiting professor², Mark Bernstein, professor³, Abdallah S Daar, director, programme in applied ethics and biotechnology¹, Bernard M Dickens, Dr William M Scholl professor of health law and policy⁴, Susan K MacRae, deputy director¹, Ross E G Upshur, director, primary care research unit⁵, Linda Wright, bioethicist¹, Randi Zlotnik Shaul, bioethicist¹

¹ University of Toronto Joint Centre for Bioethics, 88 College St, Toronto, Canada M5G 1L4, ² Department of Public Health Sciences, University of Toronto, ³ Division of Neurosurgery, University of Toronto, ⁴ Faculty of Law, University of Toronto, ⁵ Sunnybrook and Women's College Health Sciences Centre, Toronto

Correspondence to: P A Singer peter.singer@utoronto.ca

The SARS epidemic showed how easy it is for infectious diseasesto spread round the world. Ethical as well as clinical issuesneed to be resolved to improve the response to the next epidemic

The first 150 words of the full text of this article appear below.

The outbreak of severe acute respiratory syndrome (SARS) inthe Toronto area earlier this year forced medical and governmentworkers to make hard choices, often with limited informationand short deadlines. Healthcare providers were on the firingline, and were the people most affected by the disease.¹ Decisionmakers had to balance individual freedoms against the commongood, fear for personal safety against the duty to treat sickpeople, and economic losses against the need to contain thespread of a deadly disease. Such decisions have to be guidedby both scientific knowledge and ethical considerations. TheSARS outbreak showed that Canadian society was not fully preparedto deal with the ethical issues.

Evaluating ethical issues

We formed a working group to identify the key ethical issuesand values most important for an analysis of ethical dimensionsof the SARS epidemic. The final list of issues and values wasagreed by a consensus . . . [Full text of this article]

Ethics of quarantine

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Privacy of personal information and public need to know

Duty of care

Collateral damage

SARS in a globalised world

Next steps

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