Ready and willing? Physicians' sense of preparedness for bioterrorism

Health Affairs

Volumn 22, Issue 5, 2003, Pages 189-197

  Alexander, G Caleb ^a,b   Wynia, Matthew K ^c,d  

^a Division of General Internal Medicine   (Canada)

^b UNIVERSITY OF CHICAGO   (United States)

^c AMERICAN MEDICAL ASSOCIATION   (United States)

^d UNIVERSITY OF CHICAGO MEDICAL CENTER   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; ARTICLE; BIOLOGICAL WARFARE; COMMUNICABLE DISEASE; DISASTER PLANNING; EMPIRICAL APPROACH; EPIDEMIOLOGY; ETHICS; HEALTH CARE AND PUBLIC HEALTH; HEALTH PERSONNEL ATTITUDE; HUMAN; MIDDLE AGED; MORALITY; OCCUPATIONAL HEALTH; PATIENT ABANDONMENT; PHYSICIAN; PSYCHOLOGICAL ASPECT; RISK MANAGEMENT; SOCIAL BEHAVIOR; UNITED STATES; WAR AND HUMAN RIGHTS ABUSES;

EMPIRICAL APPROACH; HEALTH CARE AND PUBLIC HEALTH; WAR AND HUMAN RIGHTS ABUSES;

ADULT; ATTITUDE OF HEALTH PERSONNEL; BIOTERRORISM; COMMUNICABLE DISEASES; DISASTER PLANNING; HEALTH CARE SURVEYS; HUMANS; MIDDLE AGED; MORAL OBLIGATIONS; OCCUPATIONAL HEALTH; PHYSICIANS; REFUSAL TO TREAT; RISK MANAGEMENT; SOCIAL RESPONSIBILITY; UNITED STATES;

EID: 1542680573     PISSN: 02782715     EISSN: 02782715     Source Type: Journal    
DOI: 10.1377/hlthaff.22.5.189     Document Type: Review

References (30)

1. A.S. Khan, S. Morse, and S. Lillibridge, "Public-Health Preparedness for Biological Terrorism in the USA," Lancet (30 September 2000): 1179-1182;
2. and J.F. Waeckerle, "Domestic Preparedness for Events Involving Weapons of Mass Destruction," Journal of the American Medical Association (12 January 2000): 252-254.
3. J.L. Gerbeding, J.M. Hughes, and J.P. Koplan, "Bioterrorism Preparedness and Response: Clinicians and Public Health Agencies as Essential Partners," Journal of the American Medical Association (20 February 2002): 898-900.
4. H.C. Lane and A.S. Fauci, "Bioterrorism on the Home Front: A New Challenge for American Medicine," Journal of the American Medical Association (28 November 2001): 2595-2597.
5. See, for example, A. Zuger and S.H. Miles, "Physicians, AIDS, and Occupational Risk: Historic Traditions and Ethical Obligations," Journal of the American Medical Association (9 October 1987): 1924-1928;
6. and L.K. Altman, "Asian Medics Stay Home, Imperiling Respirator Patients," New York Times (21 March 2003).
7. ANSER Institute for Homeland Security, "Dark Winter," www.homelandsecurity.org/darkwinter/index. cfm (19 June 2003);
8. and T.V. Inglesby, R. Grossman, and T. O'Toole, "A Plague on Your City: Observations from TOPOFF," Clinical Infectious Diseases (1 February 2001): 436-445.
9. G.J. Annas, "Bioterrorism, Public Health, and Civil Liberties," New England Journal of Medicine (25 April 2002): 1337-1342.
10. D.M. Fox, "The Politics of Physicians' Responsibility in Epidemics: A Note on History," Hastings Center Report (April/May 1988): 5-9;
11. American Medical Association, "Declaration of Professional Responsibility," 6 March 2003, www.ama-assn.org/ama/pub/category/7491.html (19 June 2003);
12. and American College of Physicians, "Ethics Manual," 4th ed., 1998, www.acponline.org/ethics/ethicman.htm (19 June 2003).
13. We assumed that approximately twenty-five physicians of this second cohort would respond, providing a 95 percent probability of detecting a true difference of 20 percent or greater with respect to willingness to treat among early-wave responders in the first and second cohorts (power = .80).
14. F.M. Chen et al., "On the Front Lines: Family Physicians' Preparedness for Bioterrorism," Journal of Family Practice (September 2002): 745-750.
15. J.G. Bartlett, "Mobilizing Professional Communities," Public Health Reports (Supplement 2, 2001): 40-44.
16. Chen et al., "On the Front Lines."
17. ANSER Institute, "Dark Winter";
18. and Inglesby et al., "A Plague on Your City."
19. Altman, "Asian Medics Stay Home."
20. R. Bayer, "AIDS and the Duty to Treat: Risk, Responsibility, and Health Care Workers," Bulletin of the New York Academy of Medicine (July/Aug 1988): 498-505.
21. AMA, "Declaration of Professional Responsibility";
22. and ACP, "Ethics Manual."
23. These trends mirror the substantial decrease in physicians' use of online bioterrorism training programs throughout 2002, and they should be followed closely. M. Croasdale, "Doctor Interest in Bioterrorism Is Wearing Off," American Medical News (24 June 2002): 9-10.
24. See, for example, E.J. Emanuel, "Do Physicians Have an Obligation to Treat Patients with AIDS?" New England Journal of Medicine 318, no. 25 (1988): 1686-1690;
25. and Hastings Center Report, April/May 1998 special issue, which was devoted entirely to this debate.
26. See, for example, D. Blumenthal et al., "Preparedness for Clinical Practice: Reports of Graduating Residents at Academic Health Centers," Journal of the American Medical Association (5 September 2001): 1027-1034;
27. and G.C. Wickstrom et al., "Confidence of Graduating Internal Medicine Residents to Perform Ambulatory Procedures," Journal of General Internal Medicine (June 2000): 361-365.
28. D.A. Asch, M.K. Jedrziewski, and N.A. Christakis, "Response Rates to Mail Surveys Published in Medical Journals," Journal of Clinical Epidemiology (October 1997): 1129-1136.
29. E. Fee and T.M. Brown, "Preemptive Biopreparedness: Can We Learn Anything from History?" American Journal of Public Health (May 2001): 721-726;
30. and V.W. Sidel, H.W. Cohen, and R.M. Gould, "Good Intentions and the Road to Bioterrorism Preparedness," American Journal of Public Health (May 2001): 716-718.