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Mon 5 May, 2008 06:04 am
No one wants to think about a pandemic, but it certainly is a possibility in today's world. A task force has come up with a list of guidelines concerning how limited resources should be allocated in a medical disaster.
Quote:To prepare, hospitals should designate a triage team with the Godlike task of deciding who will and who won't get lifesaving care, the task force wrote. Those out of luck are the people at high risk of death and a slim chance of long-term survival. But the recommendations get much more specific, and include:
_People older than 85.
_Those with severe trauma, which could include critical injuries from car crashes and shootings.
_Severely burned patients older than 60.
_Those with severe mental impairment, which could include advanced Alzheimer's disease.
_Those with a severe chronic disease, such as advanced heart failure, lung disease or poorly controlled diabetes.
Quote:Public health law expert Lawrence Gostin of Georgetown University called the report an important initiative but also "a political minefield and a legal minefield."
The recommendations would probably violate federal laws against age discrimination and disability discrimination, said Gostin, who was not on the task force.
If followed to a tee, such rules could exclude care for the poorest, most disadvantaged citizens who suffer disproportionately from chronic disease and disability, he said. While health care rationing will be necessary in a mass disaster, "there are some real ethical concerns here."
http://www.breitbart.com/article.php?id=2008-05-05_D90FF38G0&show_article=1&cat=breaking
What do you think?
Well, not sure what to think but it is good that someone is. Survival of the fittest?
Re: Who Should MDs Let Die in a Pandemic? Report Offers Answ
Phoenix32890 wrote: Quote:To prepare, hospitals should designate a triage team with the Godlike task of deciding who will and who won't get lifesaving care, the task force wrote. Those out of luck are the people at high risk of death and a slim chance of long-term survival. But the recommendations get much more specific, and include:
_People older than 85.
_Those with severe trauma, which could include critical injuries from car crashes and shootings.
_Severely burned patients older than 60.
_Those with severe mental impairment, which could include advanced Alzheimer's disease.
_Those with a severe chronic disease, such as advanced heart failure, lung disease or poorly controlled diabetes.
I think it depends on whether you accept the part that I've emphasized.
Phoenix
The criteria appears to relate to standard triage decisions.
Triage is a process of prioritizing patients based on the severity of their condition so as to treat as many as possible when resources are insufficient for all to be treated immediately. The term comes from the French verb trier, meaning "to sort, sift or select." There are two types of triage: simple triage and advanced triage.
BBB
Re: Who Should MDs Let Die in a Pandemic? Report Offers Answ
Phoenix32890 wrote:No one wants to think about a pandemic, but it certainly is a possibility in today's world. A task force has come up with a list of guidelines concerning how limited resources should be allocated in a medical disaster.
Quote:To prepare, hospitals should designate a triage team with the Godlike task of deciding who will and who won't get lifesaving care, the task force wrote. Those out of luck are the people at high risk of death and a slim chance of long-term survival. But the recommendations get much more specific, and include:
_People older than 85.
_Those with severe trauma, which could include critical injuries from car crashes and shootings.
_Severely burned patients older than 60.
_Those with severe mental impairment, which could include advanced Alzheimer's disease.
_Those with a severe chronic disease, such as advanced heart failure, lung disease or poorly controlled diabetes.
Quote:Public health law expert Lawrence Gostin of Georgetown University called the report an important initiative but also "a political minefield and a legal minefield."
The recommendations would probably violate federal laws against age discrimination and disability discrimination, said Gostin, who was not on the task force.
If followed to a tee, such rules could exclude care for the poorest, most disadvantaged citizens who suffer disproportionately from chronic disease and disability, he said. While health care rationing will be necessary in a mass disaster, "there are some real ethical concerns here."
http://www.breitbart.com/article.php?id=2008-05-05_D90FF38G0&show_article=1&cat=breaking
What do you think?
Who was the "TASK FORCE"?
Quote:Those with severe mental impairment
Based on IQ?
Based on MDs evalutation?
Based on list of Rxs?
Based on what?
Miller wrote:Quote:Those with severe mental impairment
Based on IQ?
Based on MDs evalutation?
Based on list of Rxs?
Based on what?
One should excuse
Miller's insistence here, given her direct personal interest in the answers to these questions.
Pretty standard stuff.
Mind you, DOING the triage in a pandemic situation would be hard.
I would imagine many of us will cark it at home.
Re: Who Should MDs Let Die in a Pandemic? Report Offers Answ
Phoenix32890 wrote:No one wants to think about a pandemic, but it certainly is a possibility in today's world. A task force has come up with a list of guidelines concerning how limited resources should be allocated in a medical disaster.
Quote:To prepare, hospitals should designate a triage team with the Godlike task of deciding who will and who won't get lifesaving care, the task force wrote. Those out of luck are the people at high risk of death and a slim chance of long-term survival. But the recommendations get much more specific, and include:
_People older than 85.
_Those with severe trauma, which could include critical injuries from car crashes and shootings.
_Severely burned patients older than 60.
_Those with severe mental impairment, which could include advanced Alzheimer's disease.
_Those with a severe chronic disease, such as advanced heart failure, lung disease or poorly controlled diabetes.
Quote:Public health law expert Lawrence Gostin of Georgetown University called the report an important initiative but also "a political minefield and a legal minefield."
The recommendations would probably violate federal laws against age discrimination and disability discrimination, said Gostin, who was not on the task force.
If followed to a tee, such rules could exclude care for the poorest, most disadvantaged citizens who suffer disproportionately from chronic disease and disability, he said. While health care rationing will be necessary in a mass disaster, "there are some real ethical concerns here."
http://www.breitbart.com/article.php?id=2008-05-05_D90FF38G0&show_article=1&cat=breaking
What do you think?
i think life is merely survival f the fittest, death isnt scary and it shouldnt be.
its amazing how much stock people put on being conscious.
joefromchicago wrote:Miller wrote:Quote:Those with severe mental impairment
Based on IQ?
Based on MDs evalutation?
Based on list of Rxs?
Based on what?
One should excuse
Miller's insistence here, given her direct personal interest in the answers to these questions.
It probably hasn't come up in her lesson to become a nurse's aid.
Miller, "mental impairment" is a common terminology in the medical
field. Here an explanation for you:
A disorder characterised by the display of an intellectual defect, as manifested by diminished cognitive, interpersonal, social, and vocational effectiveness and quantitatively evaluated by psychological examination and assessment.
Re: Who Should MDs Let Die in a Pandemic? Report Offers Answ
Phoenix32890 wrote:No one wants to think about a pandemic, but it certainly is a possibility in today's world. A task force has come up with a list of guidelines concerning how limited resources should be allocated in a medical disaster.
You know, I'm thinking (with what?) the thing we want healthcare for, if we're not superstitious or emotional, is dignity, right? I mean, if someone's 95 with leukemia and missing a leg, it does no good to work out a prosthetic that would allow them to play golf - just makes a johnny banana out of 'em. So then triage is one thing, and taking care of our own is another, but if it came down to making the call on what folk are about, what good they are to the rest - it makes sense, but we must be calculating in a different set of units...
Why are cancer patients on DeathRow given chemotherapy ?
Quote:Those out of luck are the people at high risk of death and a slim chance of long-term survival
This is nothing new in medicine.
If I have several wounded soldiers, and one of them is so severly wounded that there is no way I can save them, I will administer enough pain reliever to allow them to die comfortably, so that I can save the others.
Save two of every type of person. Then build an ark...
There are always ethical concerns involved with triage. It is, by definition, to be used in emergency situations, where there are not enough resources to deal with all critical cases. If you have enough medical resources to ensure that nobody dies, that's not a triage situation.
The goal of triage is to ensure that as few people die as possible. The worst-case scenario is this: the hospital chooses to attempt to save only the most badly injured, and fails in every case, so all the people they treat die. In addition, they could have treated an additional amount of people who were less badly injured but still suffering life-threatening injuries; all those people die too. That hospital's total contribution to saving lives in the emergency becomes zero - maybe even negative, if it's drawing resources away from other medical units who are actually saving people's lives. The only patients who survive are the ones who weren't suffering from life-threatening injuries - i.e. they lived without treatment.
It's easy to say "there's an ethical concern here", but in this sort of medical emergency, decisions on how to allocate care are unavoidable; even saying "you are not allowed to make that kind of decision" is a kind of decision in itself (and likely to cause even greater problems - if you have a "first-come, first-served" policy instead, you'd better have the national guard at the doors...)
It's not enough to express alarm over the prospect. If you aren't happy with the cold reality, you'd better offer a more-palatable alternative.
As in most things the determining factor would be money or the lack of.
Quote:Those out of luck are the people at high risk of death and a slim chance of long-term survival. But the recommendations get much more specific, and include:
_People older than 85.
guess it wasn't a congressional tax force...unless it made an exception for Senator Byrd.
Quote:Those with severe mental impairment
i wonder what severe mental impairments entail sifficiently high risk of death. for example, does severe depression or alcohol dependence pose enough risk?
It makes sense.
What's scary to me isn't the prioritizing - which makes sense, as others have explained. It's rooted in a system that has been practiced and has 'worked' to the degree that it can 'work'.
The scary thing is that when "the **** hits the fan" - we have already seen how in theory, and in practice, can be two drastically different things.
My belief is that is very important not to put too much "stock" or safety relying on what others will have organized, or done, when/if such a thing happens.
We'll be dealing with a lot of immediate, personal, individual decisions more than anything.
The orders may be to do one thing, but we've already seen how 'orders' and priorities soon come into question and dropped on the spot when the real **** is in your face.
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