Who should MDs let die in a pandemic? Report offers answers

May 05, 2008 By LINDSEY TANNER, AP Medical Writer

(AP) -- Doctors know some patients needing lifesaving care won't get it in a flu pandemic or other disaster. The gut-wrenching dilemma will be deciding who to let die.



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DGBEACH
3.5 / 5 (2) May 05, 2008
One thing's for sure; the lawyers will have a field day after one of these unforeseen disasters, and will have the nicest houses afterwards!
Arthur_Dent
3 / 5 (1) May 05, 2008
What about high-cost mental-patients?

Another question, if these humans are to be left without treatment, are they to be given pain-killers?

Or if not, are they to be permitted to die quickly, in *relative* freedom from suffering?
( that might require providing them with suicide pills, though they would obviously have to take the pills themselves, to make certain that the professionals weren't "killing" anyone )

Or are they simply to be stacked somewhere until they expire?

That /would/ cost the least, wouldn't it?

( no this isn't facetious: consider what has happened in the past, throughout this world's wars, particularly in ethnic-wars, and these sorts of questions must be asked, or they get answered in the maximal-suffering way, by default )
ChuckSmith
3 / 5 (4) May 05, 2008
This is where Universal Health Care goes in the end- if you don't meet certain criteria, you die. Tis policy is already in effect in Durham, NC. The EMS/ambulance crews have instructions from the hospital that if you are not within defined limits, they either do not transport, do not revive, do not providecare, or go slow with no lights. I found this out when I recertified on CPR.
mrlewish
3 / 5 (2) May 05, 2008
ChuckSmith stated "Universal Health Care goes in the end"
You've got to be kidding. This is where those without health insurance and insufficient health insurance are now.
Glis
4.5 / 5 (2) May 05, 2008
This title is misleading. It's not like they are going to say FU in a pandemic and NEVER help you, this is a way to prioritize patients, which makes sense when you've got millions needing care and hundreds able to provide. Naturally fellow doctors are at the top of the list, then able bodied/minded citizens, etc. You prioritize based on level of possible contribution. I would wager a diseased doctor would get care over a healthy 18yr old male if said doctor has a reasonable chance of recovering and helping in the crisis. The reason it's horrible to think about is because you are placing one person as 'move valuable' than another, but that potential value is crucial in situations like these.
gromit
3.2 / 5 (6) May 05, 2008
#1:ChuckSmith is not thinking with a fully functional brain, and will therefore be left to perish in the event of a pandemic.
#2:CPR certification (or re-certification) is not a survey course in triage nor could one consider themselves well versed in the shortcomings of a single-payer system after attending a 4 hour Red Cross class. Sorry.
#3:I can assure you that should such a disaster occur, those who need to will be VERY capable of determining who qualifies to receive care, and who should be de-prioritized for care allotment. While it is hard to imagine for most people in the U.S., this is something that occurs every day on a much smaller scale in the form of allocating OR time, ER beds, ventilators, etc. In other words, Physicians are 'practicing' for just such an event every day.
#4: This 'rationing' planning is needed due in large part to a paring down of vital resources and equipment by PRIVATE COMPANIES in order to streamline healthcare delivery. One cannot argue that we have a greater 'surge capacity' as a result of managed care. Trust me, whether our healthcare system is private or government run, in a pandemic, there will NEVER be enough 'stuff' for everyone, but given our current system, we are all gravely underequiped.
paanta
3.3 / 5 (3) May 07, 2008
Just to build on what Gromit said:

Triaging patients has been a key strategy in allocating limited resources since WWI. There's nothing at all shocking here.

At our major public research hospital/medical center (the largest in our region) for the hundred thousand people in the immediate area and the millions within an hour long drive from here, do you know how many beds we have? Well under a thousand. Do you know how many are ALREADY in use at any given time? 85% or more.

Each of those beds costs $1M to $2M to construct. Running a well equipped facility at 50% occupancy isn't an option for _any_ hospital, public or private, in any country, regardless of whether it's a single payer system or not.

This rationing would (will) be needed in any country, in any hospital. Yes, we've got surge capacity in an emergency, but it's simply impossible to equip yourself to treat everyone in a pandemic where >10% of the population needs to be in a million dollar hospital room.

Calling this a failure of the single-payer system is beyond ridiculous.
Fart49
3.7 / 5 (3) May 07, 2008
I recently attended a Emergency Management meeting sponsored by FEMA. Essentially, we were told that incarcerated persons, handicapped (menatlly challenged) and minorities are to receive priority care under FEMA guidelines in the aftermath of a serious emergency such as H5N1 pandemic, nuclear terrorism or other disaster. The reason is that these categories of persons are the most MEDIA SENSITIVE. What I learned is that our government bureaucrats are scared stiff that if they failed to treat prisoners, retarded persons and minorities, especially black people, their jobs will evaporate as a result of being piloried in the media. Consequently, if a minority and a white victim with identical injuries are encountered, the minority gets treated first. You don't believe me? I found it incredible too, yet that's what was telegraphed by our government officials.
TMA
1 / 5 (2) May 08, 2008
Revised list: 1. Felons currently serving time. 2. Felons who served time.
DeeSmith
not rated yet May 08, 2008
Gromit has it rightly; the healthcare system will be so overwhelmed, hospitals and clinics will shut their doors and they will be guarded by police.

It won't matter what your ailment, you won't be treated past a certain stage of critical care demand (easily surpassed in a bad seasonal 'flu year).

Don't sweat the concept of treating incarcerated patients; you get a virus with the case fatality rate like SARS or H5N1, in crowded quarters with various viral diseases and a decided lack of vitamin D - trust me, it won't be an issue.

Mercury_01
not rated yet May 12, 2008
I think the lesson here is that if something major were to happen, dont get hurt. Just covertly make your way to the canadian wilderness and trust that the mouth- breathers, wall martians, rich yuppies, assholes, chronically poor, and the like will be sufficiently weeded out one way or another.
Fart49
not rated yet May 14, 2008
Actually, theree are FEMA policies that authorize euthenasia for older victims as well as other persons, other then "media sensitive" victims of terrorism, nuclear war etc. Agree that the issue of incarcerated persons, etc is moot in a pandemic as the close proximity of such persons will exacerbate to exppsure promblem for both inmates and guard staff. However, FEMA will prioritize assets for such persons and will in most cases treat the minority over the white in cases of injury, wounds etc. They are loath to the possiblility of media labeling them "racist," to the detriment of everyone else. Look at FEMA triage guidelines if you doubt this. FEMA is at core, a liberal organization and this was apparent at the number of regional meetings I've attended since 9/11.
xen_uno
not rated yet May 14, 2008
I think politicians & lawyers should top the article's list. With a pandemic of truly global scale, they won't be needed ... or missed.