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Ethical Dilemma

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ETHICAL DILEMMA

CJS/211
September 1, 2014
Michael Raneses

ETHICAL DILEMMA
EBOLA VIRUS

Ebola virus appeared in Sudan, Zaire in 1976. The very first outbreak of the Ebola virus was named Sudan Ebola virus and it infected over 284 people, killing 53% of its victims. Another strain of the infection came infecting 318 people; this strain was called the Zaire Ebola virus. It had the highest mortality rate of 88%, and at this time the researchers were not able to pin point where the Ebola virus had originated from. The third subtype of the virus is known as Reston-Ebola and was identified in1989 when it infected monkeys that were being imported to Reston, Virginia from Philippines. The virus also has infected some of the patients, but the patients did not develop the Ebola hemorrhagic fever. The fourth subtype had occurred during 1994 when an ethnologist was during a necropsy on a dead chimpanzee. The ethnologist accidentally infected herself while she was performing the necropsy on the chimpanzee.

Ebola has become more prevalent in Africa, where there is an outbreak. The Ebola virus is worsening in West Africa and the director of the Center of Disease Control and Prevention urge traveling warning to any person that may be going any of the three West Africa countries that have been hit by the outbreak. Guinea, Liberia, and Sierra Leone the disease have killed all together more than 700 individuals this year alone. This outbreak can become a “global pandemic” if it is not taken care of in a reasonable time. The government has now declared this a human crisis that is above the control of the national government at this point. The Ebola virus is the largest that the African country has seen in the last 40 years. The expert’s says that during this outbreak that 60% of the people have become sick with the Ebola virus have died.

Senegal is the fifth country in the region to become infected with the virus; Senegal closed its border to Guinea over the fear that the Ebola virus outbreak was the deadliest virus that they have ever had. The outbreak is continuing to accelerate in West Africa and has killed 1,552 people. The total number of cases stands at 3,069 right now, with 40% recently occurring in three weeks. The fatality rate is 52%, Sierra Leone to 66% in Guinea. As of August 11, 2014 2,000 people has been infected and 1,000 have died. So far there is no cure for the Ebola virus. The World Health Organization (WHO) are coming together to have a meeting to determine preventive measurements to stop the further spread of the virus.

There have been several emergency assistance agencies that have offered to provide help, and the World Bank has offered to donate $200 m in assistance and the British Red Cross launched an emergency appeal to help those individuals that has been infected with the deadly virus. The WHO panel will also get together with a panel of experts on the ethics, to make decisions about the recommendations use of the experimental treatments. At this particular stage the WHO panel is not certain the individuals that will serve on the ethics panel of what type of recommendations the panel they will have. One thing that the World Health Organization (WHO) knows is that the panelist will have to address certain issues. They are going to want an accurate summary of the scientific evidence that is regarding the safety and the efficacy of any experimental drugs, which have not been tested on humans.

The underlying problem to why the Ebola virus is spreading so rapidly is because countries like Liberia does not have the adequate resources that are needed to deal with the problem at hand. Until the international communities begin to address the issues and eliminate poverty, it is going to be the same type of problems going on reoccurring in West Africa. Treating patients with Ebola can be a difficult ethical decision for doctors and nurses to make. Due to the fact that caring for individuals that have the infectious disease, can become life or death for question for the doctors and nurses to answer for themselves. If s doctor or nurse make one wrong move with one slip of a glove, they can now become infected with the disease their self.

This is an extremely ethical decision for doctors and nurse to make on a daily basis when it comes to the care of those that are infected with the Ebola virus. Dr. David Beyda who is a pediatric critical care specialist at phoenix Children Hospital is the director of the global health program as well at UA College of Medicine of Phoenix. He states that the students go through rigorous training before leaving to serve others that are in need of care, in order to help them raise awareness of the dangers that they come faced with when they are overseas.

Due to the Ebola virus outbreak many hospitals are closing down and many of the medical staff is fleeing from the area. People in the infected areas are in quarantine, and some are disobeying the orders of the government. They are dumping the infected bodies of their loved one in the middle of the streets. Schools are closed, people are not coming to work or some are just too afraid to report in to work. There are four Indian doctors that are being forced to treat individuals that are infected with the deadly virus , and the doctors says that some of their employees have taken their passport , which keeps them from leaving the country. There are many people that are dying every day to the illness and the health care system is beginning to fall apart in this region.

Even after the crisis is long over it is still gone to leave a long-term impact on the country. A number of trained doctors and nurse are already in short supply and shrinking daily as more and more health officials are become infected with the virus, quarantined or just too afraid to come to work. When we look at the situation right now in Nigeria they are dealing with a deadly epidemic that is spreading rapidly every day. Where in Nigeria there are 50 doctors to 4 m individuals. Sierra Leone has one doctor to 45,588 individuals, while in Liberia one doctor for every 86,275 individuals. As we can see this spreads very fast and rapid, so fast that WHO cannot deal with it and has declared a health emergency.
The only hope for the Ebola virus at this time is the ZMAPP which is an experimental drug that is composed of three antibodies that helps he immune system kill the virus. This drug was given to 18 infected monkeys that had the Ebola virus. This drug is the only hope to help fight the outbreak of the deadly raging disease that is taking the life of many individuals in West Africa. In a study the drug was given to monkeys 3 to 5 days after they had been infected with the virus and already showing symptoms. These monkeys’ symptoms improved, the the ZMAPP does its attached its self to the person cells and it helps the immune system kill off the virus. The ZMAPP was given to 7 individuals and two died. There is no more ZMAPP at this time because there was only a limited supply and it was given the 7 individuals. Before any other ZMAPP is made Biopharmaceutics Inc. what to ensure that they have the proper dose for a human and it is safe for people to use.

Ebola virus is a type of RNA virus that causes the disease Ebola hemorrhagic fever. Ebola virus gets is name form the river that runs in the Democratic Republic of the Congo (which was formerly Zaire) in Africa, which is where it was first recognized. Ebola belongs to one of the two RNA virus called Filoviridae. All together there are four subtypes of the virus and three of those are found in humans. They are called Ebola-Ivory, Ebola-Sudan, Ebola-Zaire. The fourth subtype is the Ebola-Reston and it has caused diseases in many nonhumans primates.

Once a person has been infected with the Ebola virus, some of the symptoms may include fever, weakness, severe headache, vomiting, dry cough, and stomach pain. A person usually starts to experience these symptoms four to six days after they have been infected with the virus. Other symptoms can include rash, hiccups, red eye, and internal and external bleeding. Once an individual become infected with the Ebola virus the virus begins to multiply within the body. When an individual has lighter skin the rash is more recognizable than an individual that has darker skin. If pregnant women happen to become infected with the Ebola virus her symptoms will include heavy vaginal bleeding and miscarriage. The Death of the fetus usually occurs during the second week of the symptoms, the women dies from blood loss.

References http://www.ebolavirusdisease.com/history.html http://ebola.emedtv.com/ebola/ebola-virus-symptoms.html http://ebola.emedtv.com/ebola-virus/what-is-the-ebola-virus.html http://atlanta.cbslocal.com/2014/08/01/cdc-the-bottom-line-is-ebola-is-worsening-in-west-africa/ http://www.cnn.com/2014/08/29/health/ebola-outbreak-senegal/index.html http://www.thedailystar.net/resolving-the-ethics-of-the-ebola-dilemma-36666 http://theconversation.com/who-gets-experimental-drugs-and-who-doesnt-the-ethics-of-ebola-treatment-29799 http://www.yumanewsnow.com/index.php/news/health/7549-treating-ebola-patients-is-difficult-ethical-decision-for-doctors-and-nurses http://www.thesangaiexpress.com/page/items/41913/the-ebola-outcomes http://www.cbsnews.com/news/zmapp-cures-monkeys-of-ebola-virus/

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