<p>Comments, thoughts?
This is a discussion that our society needs to have. Withholding therapy will be necessary during a real pandemic or other health care catastrophe, the question is who will get scarce resources.
After the post-Katrina debacle (realizing that concerned alleged euthanasia, not triage), I think MDs and nurses are going to want to have some guidelines established upfront, and the medical profession’s defult will be for battlefield triage - those most likely to survive will get first treatment. I thought the idea that we will be worried about age discrimination or disability discrimination against patients with severe dementia during a full blown epidemic was somewhat disingenuous for a medical professionalhttp://<a href=“http://www.foxnews.com/story/0,2933,354135,00.html”>www.foxnews.com/story/0,2933,354135,00.html</a></p>
<p>H is a physician who went through two “disaster simulations” recently.
There are plans in place in most areas, I would think. Hard decisions will have to be made should such situations occur; I try not to think about it
since it’s unlikely that I’d ever be in a decision-making position. (Anyone remember that “who do we let in/kick out of the lifeboat” exercise from school? I hated that. I could never decide. I wanted everyone in–I probably wouldn’t make it as a college admissions officer).</p>
<p>BTW, H’s blind, wheelchair-bound, 94yo aunt who was then a hospice patient, was “lost” for several days during Katrina (in the panic/confusion some patients were flown out without records or ID, doctor tried to go with them–but wasn’t permitted, etc). H finally located her in a Houston hospital. His aunt actually survived more than 2 years after that experience. We were impressed that she did receive good care in spite of her vulnerability.</p>
<p>Nothing would scare me more than triage plans drawn up by Homeland Security…</p>
<p>Rich republicans at the front of the line…but which line???</p>
<p>Just kidding, of course. Within a few years, I’m sure that I will have a lot of those factors that will make the doctors move on to the next younger, healthier patient. I’ve lived a great life so far…</p>
<p>I posted this yesterday, then, interestingly, the report was mentioned at Med Exec last night because someone had read it in the media.
The CEO of our hospital and a doc who is on the board of the county medical society said that the Dept of Homeland Security had sponsored seminars and planning sessions involving state and local public health officials, hospitals and medical societies to come up with disaster plans. The largest private insurer had also run some disaster scenarios trying to plan how to keep their finance and computer systems up and running during a pandemic, and found the reults so sobering that they shared them with the hospitals around the state.
Truth is, if these doomsday scenarios came to pass, we would be way beyond any previous plans, with totally overwhelmed resources - the care offered would be little different from the level of care offered in 1918. even if the flu came in waves, which is typical for an epidemic, hospitals run in a “just in time” delivery mode, and they don’t think the drugs can be delivered or food or supplies, and much of the staff would be sick or home caring for sick families.</p>
<p>I think the medical community is hoping for affirmation from society at large for the ethical basis of making these tough choices. I could see it happen to us after a hurricane - the hospital started running low on food after a storm a few years ago, and that was with very little damage, just too many squatters.</p>