Medical ethics experts identify, address key issues in H1N...(known and what is not known about the si...),Health

For citizens to be honest about their own health, the state need to acknowledge that transparency will not be penalized. For example, someone who accepts voluntarily quarantine needs assurance they will not lose their job.

Likewise, at the international level, "countries need to be able to trust each other to be transparent and honest about infectious disease outbreaks.

"Reciprocally, countries that do not trust the international community to be fair and to provide assistance may fear things such as economic loss as a consequence of having open and honest communications about outbreaks. The result may be that they chose not to be transparent with the global community."

"If countries have a moral duty to be transparent, then the global community has reciprocal moral obligations to compensate and support those countries that may suffer economic or health consequences as a result of transparent communication."

Vulnerability

Although the prevalence of chronic and acute diseases is higher among elderly and other certain groups, stakeholders felt that it was important to distinguish between age and disease and noted that age should not be a proxy for disease or provide the basis for allocation decisions.

In places, isolation due to geography may increase vulnerability.

"In Northeastern Ontario alone, the land mass is equivalent of Spain and Portugal combined, so 100,000 square miles, so logistical distribution of emergency supply and stockpile is a huge issue".

A particular challenge noted by many stakeholders: pandemic influenza planning occurs primarily at urban centres, for urban centres, thus not being sensitive to the difficulties that might arise in rural areas. Similarly disadvantaged: those who live in poverty or in crowded housing conditions such as shelters and prisons.

'/>"/>