Question

In one recent 2-week summer period, the Fairview County Health Department (FCHD) received 4 reports from local physicians of E. coli infection (a mandatory reportable disease) among child patients. Fearing a more extensive outbreak, the FCHD Director immediately started active case-finding procedures, because the peak summer tourist season was still ahead. By the fifth week, the FCHD had identified five more reports of E. coli infection in children - all of whom had visited the Daisy Farm Petting Zoo. The Petting Zoo was located in Fairview County. Among the thousands of persons who visited there each year, most were preschool-aged or school-aged. Visitors could touch and feed the livestock. Though the Zoo offered eating and drinking facilities for visitors, its restrooms were undersupplied and its hand-washing facilities were hard to reach for small children. The evidence for the Petting Zoo as source of infection was persuasive, but the FCHD's legal authority to publicize this information was ambiguous. The FCHD seemed to have clear statutory authority to protect the public's health against any threat within its county jurisdiction. However, on consultation, the state health department said there were no policies in place for handling an E. coli outbreak; and other state laws seemed designed to protect the Zoo's private information against losses of business. The case-finding process continued through the seventh week. The results showed 51 persons who experienced diarrhea within 10 days of visiting the Petting Zoo, with 15 of them (29%) having laboratory or clinical evidence of E. coli 0157 infection. Based on this evidence, the FCHD finally convinced the Petting Zoo to close and prohibit all public access to its animals. Nevertheless, by that time, 8 children aged 10 or younger had been hospitalized with hemolitic uremic syndrome - a life-threatening condition, which all of these children fortunately survived.

Given the lack of clear legal authority for the FCHD Director to publicize the likely source of the E. coli outbreak, he faces the ethical problem of

a.Whether to minimize the potential harm caused by county-wide disclosure of outbreak information by making the disclosure solely to physicians, healthcare professionals, and healthcare organizations.

b.Whether the county's legal public health authority should outweigh any of the state’s laws or policies that don't address health issues.

c,.Whether to favor the community's interest in having information about public health threats over the Petting Zoo's private economic interests.

d.Whether to involve the county's Chamber of Commerce in gaining support to force the Petting Zoo's temporary closure.

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Answer 1

Answer :

is to minimize the potential harm is caused by country wide disclosure of outbreak information by making the disclosure solely to physicians, health care professionals and health care organizations.