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Duty to provide care to Ebola patients: the perspectives of Guinean lay people and healthcare providers
  1. Lonzozou Kpanake1,
  2. Tamba Kallas Tonguino2,
  3. Paul Clay Sorum3,
  4. Etienne Mullet4
  1. 1 Department of Psychology, University of Québec-TELUQ, Montréal, Quebec, Canada
  2. 2 Department of Infectious Diseases, University of Conakry Teaching Hospital, Conakry, Guinea
  3. 3 Departments of Internal Medicine and Pediatrics, Albany Medical College, Albany, New York, USA
  4. 4 Ethics and Work Research Unit, Institute of Advanced Studies (EPHE), Paris, France
  1. Correspondence to Dr Lonzozou Kpanake, Department of Psychology, University of Québec-TELUQ, Montreal, QC H2S 3L5, Canada; lonzozou.kpanake{at}


Aim To examine the views of Guinean lay people and healthcare providers (HCPs) regarding the acceptability of HCPs’ refusal to provide care to Ebola patients.

Method From October to December 2015, lay people (n=252) and HCPs (n=220) in Conakry, Guinea, were presented with 54 sample case scenarios depicting a HCP who refuses to provide care to Ebola patients and were instructed to rate the extent to which this HCP’s decision is morally acceptable. The scenarios were composed by systematically varying the levels of four factors: (1) the risk of getting infected, (2) the HCP’s working conditions, (3) the HCP’s family responsibilities and (4) the HCP’s professional status.

Results Five clusters were identified: (1) 18% of the participants expressed the view that HCPs have an unlimited obligation to provide care to Ebola patients; (2) 38% held that HCPs’ duty to care is a function of HCPs’ working conditions; (3) 9% based their judgments on a combination of risk level, family responsibilities and working conditions; (4) 23% considered that HCPs do not have an obligation to provide care and (5) 12% did not take a position.

Conclusion Only a small minority of Guinean lay people and HCPs consider that HCPs’ refusal to provide care to Ebola patients is always unacceptable. The most commonly endorsed position is that HCPs’ duty to provide care to Ebola patients is linked to society’s reciprocal duty to provide them with the working conditions needed to fulfil their professional duty.

  • duty to care
  • ebola patients
  • attitudes
  • perception
  • Africa

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  • Contributors LK, TKT, PCS and EM designed the study and research material, conducted the statistical analyses and contributed to interpretation of the data. LK and TKT supervised the data collection. LK devised the paper and wrote the first draft. All authors contributed to subsequent drafts and approved the final version of the manuscript.

  • Funding This study was funded by a grant from Canada Research Chairs program awarded to LK. Grant number: 950-230745.

  • Disclaimer The funding body had no role in the study or the decision to submit the paper for publication.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval The Guinean National Review Board for Health Research, the Guinean National Review Board for Research on Ebola and the Institutional Review Board of the University of Quebec (TELUQ).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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