摘要：We assessed the progress since 2005 of state plans for pandemic influenza and found that 7 states had recommended steps to further clarify ethical processes or decisions; 6 states had made some progress but almost exclusively in hospital preparedness. Having a high-level public health leader, such as a health department director, committed to ethics was the key determinant of progress. Some state health departments may be destined to gain an appreciation for ethics through ethical mishaps. In 2005, the World Health Organization exhorted countries to prepare plans for a pandemic of highly pathogenic H5N1 influenza. 1 The United States and its individual states produced plans soon thereafter. 2 Although a pandemic of highly pathogenic influenza will bring states and local communities to many ethical decision points, a review of the US states’ plans found that few addressed ethics in any meaningful detail. 3 Moreover, the review noted the need for states to develop plans for anticipated ethical decisions beyond the allocation of vaccine and antiviral medications. Approximately 3 years after the first review, we revisited the state plans and related materials, such as stand-alone reports intended to supplement the plans, to see what progress had been made toward further ethics preparedness.
