Of epidemic proportions: physicians, personal risk, and public trust.

Dr. Carlo Urbani was the first person to recognize Severe Acute Respiratory Syndrome (SARS) in a Hanoi, Vietnam, hospital. On March 29, 2003, only one month after the discovery, Dr. Urbani died from the disease, largely because of his belief that it is a doctor’s duty to “stay close to the victims.” His wife, Giuliani, mother of three, challenged her husband on the point; Dr. Urbani replied, “If I can’t work in such situations, what am I here for?” With the question of avian epidemics (indeed pandemics) looming ahead, we might well consider the extent of risk that is incumbent in the physician’s role when facing such contagious populations. While the level of risk embraced by Dr. Urbani far exceeds what I believe should be expected, I will show, nonetheless, there is a general duty to treat at a professionally appropriate level of risk grounded in natural moral obligations and the medical profession’s reciprocal standing as a public trust.