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Monica Schoch-Spana, PhD Speaker Biography | Summary | Audio Transcript
It's a real pleasure to welcome you to "Disease, Disaster, and Democracy." Some people have called it the "3D" conference or the "D-cubed" conference, but our focus specifically is on what we are calling the public's stake in health emergency planning. Thank you very much for coming. May is a month that is chockfull of competing conventions, conferences, and workshops. So, we are very appreciative of the time that you've taken this morning to join us here today. I would like to welcome you on behalf of the Center for Biosecurity of the University of Pittsburgh Medical Center and also our summit co-conveners, the Canadian Policy Research Networks, the Center for Science, Technology, and Security Policy of the American Association for the Advancement of Science, and the National Consortium for the Study of Terrorism and Responses to Terrorism. What I'd like to do in order to open the conference is to say a few words about why we are here. So, why are we here? That's the first issue I want to touch on in the opening remarks. I also want to discuss reasons for which some people may think that we are here, but in actuality, we are not here to discuss or to promote, as you will see very soon. This conference is about collective problem-solving and shared decision-making in relation to a large-scale health emergency. Specifically, we are here to discuss the feasibility and the benefit of actively engaging citizens to help emergency planning in anticipation of-first-ethical dilemmas posed by scarcity of life-saving medical resources and secondly, the practical difficulties of protecting the well and caring for the sick in large numbers. Now, there's something of a historical and conceptual context for this type of meeting. So, I want to speak very briefly to that. As I indicated, the core concept for the conference is shared decision-making and collective problem-solving. What we are advocating and what we assume you are also advocating, because you made time to attend this conference, is an approach to citizens as capable partners in handling the impact of a large-scale health emergency. This is a paradigm shift away from the two predominant modes of thinking about how the public will react to either an intentional outbreak of infectious disease or a naturally occurring one such as the pandemic flu that we are now anticipating. Those two dominant ideas are, first, the notion of an angry mob that has to be contained somehow, and in that context the work of government is one of "crowd control." We are advocating an alternative to the one-dimensional and simplistic way of thinking about how citizens will react when faced with a large outbreak of infectious disease or other kind of health emergency. It's very easy to be caught up in a very spectacular image of people who are consumed by self-interest, whether they are pouring into the hospital and are considered to be the worried well getting in the way of health care workers assisting those "in true need." Or, the image sometimes takes that of a violent mob that is seeking access to a scarce medical good such as vaccine or hospital bed or antibiotics. What we are saying is that this is an inappropriate way or an inappropriate assumption upon which to build preparedness and response systems for large-scale health emergencies. So, that's the first dominant idea that we want to replace with that of the public as a capable partner. The second dominant idea, which is more productive, but still has its limitations, is that of a public as an anxious audience where the work of government is, essentially, to provide credible communications in the midst of a crisis. What was helpful with regard to experience with the tragedies in the fall of 2001, at least in the United States, is that awareness arose that members of the public were not a problem to be managed, but a constituency to be served. Awareness through those tragedies, and self-reflection on the government response, did elicit an interest in improving risk communications and crisis communications. And that is something that the organizers of this event will heartily endorse. But, we do want to underscore that crisis and risk communications-while essential to preparedness, response, and recovery from a health emergency-are insufficient in and of themselves. There is something more that needs to be done and that is why we are convening this meeting, which is to recognize the importance of communications, to recognize the importance of getting away from the captivating yet unfounded image of a panicked public driven by self-interest. And underscoring the need to involve citizens as a capable partner in handling effects of a large-scale health emergency. So, that's why we are here. I did want to make a few remarks regarding what this summit on citizen engagement and health emergencies is not about. Just another way of covering the same grounds that I just did. The first thing that this summit is not about is cynicism or mutual distrust between the government and citizens. The program again is built around the ideas of collaborative problem-solving and implementing solutions. And what do I mean when I say that this summit is not about cynicism? Well, this is a conference not about a survivalist or rugged individualist credo. The organizing question is not, "What do we have to do for ourselves because we know that the government is not going to be there for us?!" That's the cynicism about our governmental and public health and safety institutions that, we would argue, is unfounded, or better yet, is not the kind of foundation for improved preparedness that we would promote. Secondly, this conference is not about techniques of persuasion to garner public compliance with what authorities have already planned. Another form of cynicism, in its extreme measure, is focused on and can be characterized as selling the public a can of goods. Those are the extreme things that we are not here to discuss or to promote or upon which to build a conceptual framework for citizen engagement in public health emergency planning. Apart from cynicism, the summit is also not about scare-mongering around new and emerging threats like bioterrorism or long-standing ones like pandemic flu. I think most of us are suffering from some form of "threat fatigue." So, recognizing that, this summit is built upon a realistic appreciation of what can happen in a large-scale health emergency and what we collectively, as a society, can do about it. So, we are advocating a measure of hopefulness. We are here to talk about getting ready and taking action. We are not here to talk about a fear-driven state of paralysis. We want to stay focused on implementing solutions that all of us can live with if we are faced with a disaster-a health disaster particularly one involving infectious disease. And that's why we put "democracy" up there, in the key title, with "disease" and "disaster." So, thank you again for taking the time to join us here today. I'd like to turn the floor over to my colleague, Dr. Tara O'Toole, who is the executive director and chief executive officer of the Center for Biosecurity. Thanks, Tara. Proceedings of the May 23, 2006 Summit: Disease, Disaster, & Democracy Transcription by CastingWords | 
