Doctors to decide who lives and who dies in coming pandemic
Who should MDs let die in a pandemic? Report offers answers
By LINDSEY TANNER
CHICAGO (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.
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.”
5 responses so far ↓
wil // May 5, 2008 at 10:24 am
Except they’re already doing this.
More for the elites–but they have theirs set up anyway.
wil // May 5, 2008 at 4:15 pm
So–a more blatant announcement of eugenics than usual.
I’ve seen the header for the AP article in other sites–makes it sound so casual and matter of fact.
For all the predictions of pandemics–I’ve read the purported death toll would be about the same as the one in 1919, and no martial law or NWO then. But it was just getting started at that time.
I know the war against humanity has been going on for years/decades/millennia–but this declaration is bald faced.
And no one notices.
We were at fairs in South Georgia yesterday. My friend as an experiment was going around asking random people if they’d heard of the North American Union. Nada. Everyone looked at him like he was a freak and wanted to get away.
And in the vicinity but not that close to the local Masonic food stand, I cracked a joke and several guys in black shirts (police/EMTs?) stopped, turned and glared at me–and I’m like thinking to myself–Ok!
There was a table of Fairtax people at one fair–they were a little more together. (though I still don’t quite understand how “fairtax” is supposed to work.)
My friend went to table that was county public health and collected all the Homeland security literature they had for locals–you can imagine the content: pull together and obey. One scary thing was calling for Homeland security youth groups–though they called it something nice.
And people wonder at all the WW2 books on Nazi Germany I’ve collected.
******
My friends grandmother who recently passed away–she had a Living Will/Do Not resuscitate thing. She had pneumonia 5 years ago and heart stopped and had to be shocked or I forget what they call it–and doctors then were trying to do the do not resuscitate–buy my friends relatives were like of course resuscitate. And she had five more good enough years.
Another reason I refuse to be an organ donor.
wil // May 5, 2008 at 5:13 pm
“While the notion of rationing health care is unpleasant, the report could help the public understand that it will be necessary, Bentley said.”
And another slippery slope.
wil // May 5, 2008 at 9:19 pm
Article has so much spin–I forget the exact definition wikipedia has for “weasel words,” but this one uses “influential,” “prestigious,” and “professional” since I guess that’s supposed to impress or convince us?
Says whom? And who works or gets grants from whom?
“so that everybody will be thinking in the same way”
Oh yeah!”
wil // May 7, 2008 at 5:18 pm
I’m sure I’m just being paranoid again–ha–but again the most important news on the noon news hours is offhandedly glossed over in a couple of mumbled sentences.
The UN Secretary General is to be in Atlanta to meet with our globalist Governor Sonny (commerce with China is a separate issue from human rights) Perdue on–cough–health issues. Then meet with mayor Shirley (ok the budget is short–fire the workers not the managers who were responsible for it) Franklin (Earth Hour!), the CDC (cough again), and the Carter (great speech Vicente!) Center.
Might not be able to protest this one since rather hushed over–first I’ve heard of it. But I passed the word and some friends are making calls to the some of the offices mentioned.