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Physicians Create List of
Who Will Live and
Who Will Die in Pandemic / Disaster Scenario
by www.SixWise.com
In a move that sounds eerily like a disaster-based science
fiction movie, doctors have created a list of who to let die
should a pandemic
or other widespread disaster hit.
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A task force of prestigious physicians has done the
unthinkable: decided who will receive lifesaving medical
care -- and who will not -- if and when disaster strikes.
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The theory is that, should a mass disaster occur, medical
care -- including everything from vaccines to respirators
to doctors and nurses themselves -- could become scarce. So
a task force of members from prestigious universities, medical
groups, and government agencies (the Department of Homeland
Security, the Centers for Disease Control and Prevention,
and the Department of Health and Human Services) has compiled
a list of people who would not be treated.
While some are calling the list an attempt to "play
God," Dr. Asha Devereaux, a critical care specialist
and lead writer of the task force report, called the guidelines
a "blueprint for hospitals so that everybody will be
thinking in the same way."
"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," according to the report.
Who is Out of Luck?
It's being recommended that every hospital choose a triage
team to decide who will get lifesaving treatment and who will
not, but the guidelines already spell out some people who
are supposed to be denied care. They include:
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People older than 85
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People with severe trauma, such as critical injuries
from car crashes and shootings
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Severely burned patients older than 60
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People with severe mental impairment, such as advanced
Alzheimer's disease
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People with severe chronic disease, such as advanced heart failure, lung disease
or poorly controlled diabetes
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No one over the age of 85 would receive medical care,
according to the task force report.
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Others who are at a high risk of death or have a low chance
of long-term survival would also be unlikely to receive medical
care.
An Ethical Dilemma
The guidelines could clearly violate laws against age discrimination
and disability discrimination, according to public health
law expert Lawrence Gostin of Georgetown University. Gostin
also called the report "a political minefield and a legal
minefield."
Though most experts acknowledge that health care would, in
fact, need to be rationed in the event of a mass disaster,
the current list could single out the poor, who often suffer
the most from chronic disease and disability.
"There are some real ethical concerns here," Gostin
said.
As for when the guidelines may need to be enforced, members
of the task force said it's only a matter of time.
Said Secretary Michael O. Leavitt, Department of Health and
Human Services, of the potential for another flu pandemic:
"Forty million people died when the last major influenza
pandemic swept around the world in 1918. We have seen two
less severe pandemics since then. We will no doubt see another
sometime in the future.
We don't know when, and we don't know how bad it will be.
But we know it will happen sooner or later and that what we
do now will save lives - maybe millions of lives - in the
future."
Recommended Reading
The
Rise of Contagious Disease & How to Minimize Your Risk
of Contagious Disease Exposure
Norovirus:
The Symptoms and Prevention of This All-Too-Popular "Stomach
Flu Virus"
Sources
Chest
May 2008
WashingtonPost.com
May 5, 2008
PandemicFlu.gov
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