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

[Mamazen]

**NOTE; I bolded two of the criteria because the fact of the matter is that too many of our people suffer from these conditions and will be the ones who will not get treated.** MZ


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

By LINDSEY TANNER,
AP Medical Writer
Mon May 5, 9:47 AM ET
http://news.yahoo.com/s/ap/20080505/...rationing_care


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.

Now, an influential group of physicians has drafted a grimly specific list of recommendations for which patients wouldn't be treated. They include the very elderly, seriously hurt trauma victims, severely burned patients and those with severe dementia.

The suggested list was compiled by a task force whose members come from prestigious universities, medical groups, the military and government agencies. They include the Department of Homeland Security, the Centers for Disease Control and Prevention and the Department of Health and Human Services.

The proposed guidelines are designed to be a blueprint for hospitals "so that everybody will be thinking in the same way" when pandemic flu or another widespread health care disaster hits, said Dr. Asha Devereaux. She is a critical care specialist in San Diego and lead writer of the task force report.

The idea is to try to make sure that scarce resources — including ventilators, medicine and doctors and nurses — are used in a uniform, objective way, task force members said.

Their recommendations appear in a report appearing Monday in the May edition of Chest, the medical journal of the American College of Chest Physicians.

"If a mass casualty critical care event were to occur tomorrow, many people with clinical conditions that are survivable under usual health care system conditions may have to forgo life-sustaining interventions owing to deficiencies in supply or staffing," the report states.

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.

Dr. Kevin Yeskey, director of the preparedness and emergency operations office at the Department of Health and Human Services, was on the task force. He said the report would be among many the agency reviews as part of preparedness efforts.

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."

James Bentley, a senior vice president at American Hospital Association, said the report will give guidance to hospitals in shaping their own preparedness plans even if they don't follow all the suggestions.

He said the proposals resemble a battlefield approach in which limited health care resources are reserved for those most likely to survive.

Bentley said it's not the first time this type of approach has been recommended for a catastrophic pandemic, but that "this is the most detailed one I have seen from a professional group."

While the notion of rationing health care is unpleasant, the report could help the public understand that it will be necessary, Bentley said.

Devereaux said compiling the list "was emotionally difficult for everyone."

That's partly because members believe it's just a matter of time before such a health care disaster hits, she said.

"You never know," Devereaux said. "SARS took a lot of folks by surprise. We didn't even know it existed."

___

[Sourakhata]

Aren't they supposedly responsible of the whole population well-being?
For those naïve enough to put their lives in the hand of such a governement, and who believe they'll be taken care of by the merciful US administration, here the proof that they don't care..!

Instead on working on how to get everyone treated, they're rather working on who they'll let die first, that's to say the weak and those who are 'useless' to them..!

For our Nation, we already know all that, Katrina disaster has swept all remaining illusions, keep on counting on them will be foolish..!

[Jahness]

Greetings Mamazen & Sourakhata!

They are acting as if they are the ones who created life. It is sad to think that they would be doing that to people.

Sourakhata, I agree if we continue to count on them indeed we would be foolish.

Have a blessed day!

[Jalili]

Many doctors are willing to help but then like most jobs are given guidelines to follow. Told what they can and can't do told not to care for some and care for others. This system is based on money as well as what they can do just not to be sued. It stopped me from going further in the medical field because I could take a vow to help people then be told don't help a damn person without the right "requirements" to receive help.

[Im The Truth]

More money = more healthcare
Less money = less healthcare

In ameriKKKa money will be the deciding factor is all cases.

[Im The Truth]

More money = more healthcare
Less money = less healthcare

In ameriKKKa money will be the deciding factor is all cases.