3 - Ethics of Disasters: Planning and Response

World Health Organization (WHO)

disasters occur worldwide and require prevention, preparedness, response, rehabilitation, and reconstruction.

storms, earthquakes, floods, wildfires, hurricanes, tornadoes

Sources for disasters include natural causes such as

fire, war, and acts of terrorism, mass casualties, explosions, chemical release

human causes, including

1. Vulnerability

2. Hazards

3. Trigger Events

Components of disaster

(poverty, illness, disability, limited resources)

Vulnerability

(natural or human-caused)

Hazards

(earthquake, flood)

Trigger Events (e.g.,

o Weak institutions

o Poor education opportunities

o Economic and physical environment

DISASTER IS Influenced by:

RED CROSS/RED CRESCENT DEFINITION

Disasters disrupt communities and overwhelm local capacities

1. Human

2. Economic

3. Environmental

RED CROSS/RED CRESCENT DEFINITION

Losses include:

(Vulnerability + Hazard) / Capacity = Disaster

Disaster formula:

1. Community

2. State

3. Federal levels

Importance of preparation at:

o Rapid

o Compassionate

Response should be:

o Minimize harm

o Respect individual autonomy

Ethical principles:

DISASTERS IN U.S. HISTORY: NATURAL

1. hurricanes: Matthew

2. floods: Johnstown (1889

3. Fires: Chicago (1871)

4. Tornadoes: 2011 outbreaks

Human-Caused Disasters in US

1. 9/11 terrorist attacks

2. Mass shootings and bombings

DEPARTMENT OF HOMELAND SECURITY (DHS)

• Established Post-9/11 to prevent future terrorist attacks

• Expanded Mission includes:

1. Terrorism prevention (domestic & international)

2. Border & immigration enforcement

3. Cybersecurity & infrastructure protection

4. Disaster resilience and response

• Cybersecurity Efforts:

o Launched “Stop.Think.Connect.” to raise public awareness on internet safety

o Annual Budget: $41.2 billion (as of 2016)

Key Agencies Under DHS:

1. FEMA

2. U.S. Immigration and Customs Enforcement (ICE)

3. U.S. Customs and Border Protection (CBP)

4. U.S. Coast Guard

FEDERAL EMERGENCY MANAGEMENT AGENCY (FEMA)

• Part of DHS, with a 39-year history of disaster response

• Mission: Prepare for, respond to, and recover from all types of disasters

• National Reach: Operates through 224 regional offices

Center for Faith and Neighborhood Partnerships

supports disaster prevention and recovery

o Formed after major disasters like Hurricanes Katrina, Rita, and Wilma

o Provides training on human trafficking awareness and prevention to faith-based and neighborhood organizations

CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC)

• Disaster Response Role: Handled by the Office of Public Health Preparedness and Response (PHPR)

• Focus Areas:

o Biological events

o Natural disasters

o Chemical and radiological incidents

• Key Functions:

o Coordinates with local and state public health departments

o Maintains a national stockpile of medicines and emergency supplies

o Provides laboratory support through a network of 150 labs

o Advocates for a well-trained public health workforce to respond to threats

American Red Cross (ARC) Disaster Response Role

• Founded in 1881, inspired by the International Red Cross

• Not a government agency, but a key humanitarian disaster response organization • Relies on trained volunteers from medical and non-medical communities

• Responds to:

o Floods, earthquakes, wildfires, tornadoes, superstorms

• Disaster Relief Services:

o Emergency shelter, food, healthcare, and mental health services

• Support for emergency workers

• Cleanup support, comfort kits, and long-term recovery aid

• Mission: To be present and supportive before, during, and after disasters

Preparedness Education:

o Emergency kit preparation

o Personal and family response planning

o Resources available on the ARC website

Training Programs of RED CROSS:

o First aid and CPR

o Volunteer training

o Certified nursing assistant (CNA) training and Testing

ETHICAL ISSUES IN DISASTER PLANNING & RESPONSE

• Challenges: Despite strong planning, actual disaster response can be chaotic and ethically complex.

• Ethical Planning: Ethics must be embedded in disaster plans, balancing individual vs. community needs.

Utilitarianism

: Focus on the greatest good for the greatest number (e.g., triage strategy)

Triage categories

Immediate, Delayed, Minimal, Expectant, Dead.

Deontological (Kantian) Ethics

: Every human has inherent worth—prioritize duty to vulnerable populations.

Autonomy vs. Public Good

o Individual choices (e.g., ignoring evacuation or building in high-risk areas) vs. community safety needs

Ethical dilemmas: Quarantine during outbreaks, mandatory evacuations..

The Ostrich Paradox

: Explains why individuals ignore warnings (psychological & cognitive biases).

Social Justice in Disaster Response:

o Fair access to resources and protection during disasters.

o Example: Hurricane Katrina revealed ethical failures and lack of coordination.

o Led to A Failure of Initiative report recommending improved ethical and operational disaster responses.

Ethical Duty

: Healthcare professionals and institutions must be ready to respond to both natural and human-made disasters.

Hospitals' Key Role

As central response hubs, hospitals must have adaptable, practiced disaster plans.

• Planning Essentials (Riley & Markenson)

o All-hazards approach

o Community involvement

o Communication, capacity, coordination, equipment, and training

The Joint Commission (TJC)

includes emergency management in accreditation standards.

o Offers frameworks, hazard-specific guides, mental health support, and modern threat responses (e.g., ransomware).

Goal: Ensure readiness, maintain credibility, and uphold ethical responsibility to serve and protect the community.

o Saves lives

o Reduces recovery time

o Upholds ethical duties: beneficence, nonmaleficence, and social justice

Benefits of Proactive Engagement:

The Ostrich Paradox

- A concept and also title of 2017 book by Robert Meyer and Howard Kunreuther, subtitled “Why We Uprepared for Disasters.”

- The paradox refers to the human tendency to ignore or downplay the likelihood of future disasters, even when the risks are well-known and potentially catastrophic like an ostrich supposedly burying its head in the sand to avoid danger.

Robert Meyer and Howard Kunreuther, subtitled “Why We Uprepared for Disasters.”

The Ostrich Paradox

A concept and also title of 2017 book by __________________

Hurricane Katrina (August 2005)

Worst hit: New Orleans, especially due to levee failures

- Over 1, 800 deaths and $125 billion in damage

- Issue: Long-known structural weaknesses in the leave system were not addressed, despite expert warnings.

Hurricane Rita (September 2005)

- Hit: Texas and Louisiana, just weeks after Katrina

- Caused major evacuation chaos over 100 deaths from the evacuation alone

- Highlighted the lack of coordination and preparation for back-to-back disasters.

Hurricane Wilma (October 2005)

- The strongest storm (by pressure) ever recorded in the Atlantic Basin

- Affected Mexico (Yucatan Peninsula), Cuba, and Florida

- Despite warnings, Florida’s power grid and infrastructure proved vulnerable

- Many were unprepared for such an intense late-season storm