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Commentary: Ahead of the Curve |

Ethical and Practical Considerations in Providing Critical Care to Patients With Ebola Virus DiseaseProviding Critical Care to Patients With Ebola

Parizad Torabi-Parizi, MD; Richard T. Davey, Jr, MD; Anthony F. Suffredini, MD; Daniel S. Chertow, MD
Author and Funding Information

From the Critical Care Medicine Department (Drs Torabi-Parizi, Suffredini, and Chertow), Clinical Center, National Institutes of Health, Bethesda, MD; and Clinical Research Section (Dr Davey), Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD.

CORRESPONDENCE TO: Parizad Torabi-Parizi, MD, Critical Care Medicine Department, National Institutes of Health, 10 Center Dr, 2C145, Bethesda, MD 20892; e-mail: torabiparizip@cc.nih.gov


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;147(6):1460-1466. doi:10.1378/chest.15-0278
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Infectious disease epidemics in the past have given rise to psychologic and emotional responses among health-care workers (HCWs), stemming from fear of infection during patient care. Early experiences in the AIDS epidemic provide an example where fear of contagion resulted in differential treatment of patients infected with HIV. However, with a deeper understanding of AIDS pathogenesis and treatment, fear and discrimination diminished. Parallels exist between early experiences with AIDS and the present outbreak of Ebola virus disease in West Africa, particularly regarding discussions of medical futility in seriously ill patients. We provide a historical perspective on HCWs’ risk of infection during the provision of CPR, discuss physicians’ duty to treat in the face of perceived or actual HCW risk, and, finally, present the protocols implemented at the National Institutes of Health to reduce HCW risk while providing lifesaving and life-sustaining care.


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