In a flu epidemic, who decides who lives or dies?
October 26th, 2009From the New York Times:
As the possibility of a flu epidemic looms, public health officials around the country are developing triage plans to address one of medicine’s most troubling questions: Who should receive medical treatment when demands are high and resources are scarce?
The draft plans vary and have attracted little publicity. All involve methods for rationing care and diverting it away from vulnerable and impaired patients during a disaster. Health officials defend formal rationing as the last in a series of steps taken to stretch scarce resources to serve the maximum number of people.
Employees at New York-Presbyterian Hospital were recently asked, in a hypothetical exercise, whether a man with cystic fibrosis who was rushed to a hospital during a flu pandemic could be relieved of his mechanical ventilator so that another healthier patient might have a chance to survive. (The employees couldn’t agree on what to do.)
Earlier posts:
Who should MDs let die in a pandemic? Panel makes a list
Report: People with disabilities left out of disaster planning
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on Monday, October 26th, 2009 at 3:28 pm and is filed under NOT2BEMISSED, emergency preparedness, medicine, public health.
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October 28th, 2009 at 6:48 am
I think the interesting point there was that the originator of one of the plans intended practice to be fluid, constantly re-evaluating patient conditions and rotating equipment.
Current applications of his plan being put into place are rigid and unbending, to the point he himself feels he may have created a monster.
It is best to leave this up to the staff on scene at the time, having had discussions of various scenarios beforehand. Have them follow the war-time example of making best decisions in the moment.
You cannot humanely force staff and patients into rigid roles. Efficiency is totally lost.