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

AP ^ | 05/04/08 | Lindsey Tanner

[TornadoAlley3]

CHICAGO – 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.

[PapaBear3625]

Whatever happened to saving lives—as many as possible?

Triage is all about saving as many lives as possible, in a situation where there are not enough medical resources to go around.

In a grossly oversimplified example, lets say you have 20 units of "medical resource", and 5 patients.

Patients A, B, C, and D each need 5 units and will die if given less than 5. Patient E needs 20 units and will die if given less than 20. How do you allocate your 20 units of medical resources to maximize the number of surviving patients?

In the above example, saving the one who needs the most units of medical resources means that the other four will die, so you save the four who need the least.

[PapaBear3625]

In a triage situation where one has to choose between a normal adult with a 10% chance and a disabled person with a 70% chance of surviving that particular crisis you choose the disabled person. You don't assign a value to each person, as a *person*, then decide if you're going to treat them or not.

They are also thinking about the economy, and assigning more value to the survival of workers who will help prop up the Democrat Welfare State. They are thinking about what happens if federal revenue drops too low due to too many taxpayers dying.

[MaggieCarta]

I ordinarily enjoy splendid health, and I don't want this treatment. I will die at some point anyway with or without it.

Give mine to someone that wants it, thanks.

[Mom MD]

True only God decides if you live or die. But supportive care in an ICU can treat secondary infection and provide temporary mechanical ventilation while the lungs heal. This is life saving and life sustaining in cases of severe influenza. However, we do not have the resources to do this for everyone. In an overwhelming epidemic, unfortunately, decisions about who gets such care will have to be made. The current system of first come first serve may not be the best. All the ICU beds available will be full within the first hours to days of an epidemic, and the rest of us are out of luck.
Actually, making the list gets people thinking about rationing care, but the truth is there is so little reserve in the system in terms of ICU beds and ventilators, that the system would be quickly swamped, and only a very tiny percentage of the critically ill would receive care. I would bet that in a city the size of Denver on any given day during cold and flu season, there are probably not 10 extra ICU beds in the entire city. You see the scope of the problem.

[Clarence]

Unless your doc is a Freeper, too, and carries his own .45 on his hip...

[PapaBear3625]

Of course the elites will be treated to a higher standard of care than us peons, that’s the way the system works, either you are in power or you are subjected to it.

Back in 1993, the 61 year old governor of Pennsylvania needed a heart and liver transplant. There was some discussion at the time as to whether his position caused him to go to the front of the line. In any event, it made me skittish about being in a situation where I was in a hospital and an organ match for a VIP.

[The Great RJ]

In disaster situations such triage is necessary and expedient. However, under Obama’s national health plan such decisions to ration care will be routine.

[PapaBear3625]

Oops, meant to say “NOT be productive”

[PLD]

You don't assign a value to each person, as a *person*, then decide if you're going to treat them or not.

Marie, you are exactly right the only one that can and should decide this is God..He can do miracles that so many will never know he can do because they won't trust..Don't choose who will die or live that sounds like something the Nazi’s did when they decided that the Jews were not good enough..

[Dr.Zoidberg]

One of the reasons I’m not a donor and likely never will be.

Should a family member require something I have, they get it, but that’s as far as it goes.

[Marie]

I guess the only thing you can do is get off your butt and help the 50 thousand doctors and nurses help 300 million people. That is seriously what it will take. the healthier people will suddenly become doctors and nurses to help the 300 million people.

You're thinking like a human being. :-)

[Marie]

Priority goes to those people who are in most urgent need of care. If resources are strained, the next priority is those who are most likely to be savable. Is it "compassionate" for a team of doctors to spend hours working on one patient who's likely to die anyway, while a dozen patients who could be saved die waiting for a doctor?

You just said it - those who are savable. These guidelines go *beyond* that and decide who's worth saving. They aren't saying "who's sickest - who has the greatest possibility of surviving this disease". They're saying, "We aren't even going to ask that. Certain groups of people won't even be considered."

Please try to understand, it’s not this flu that bothers me. I have every confidence that it’s weird, but not even close to as serious as the media is letting on. I’m sure we’ll all be fine.

What bothers me is that you guys can’t realize that this is a policy change that signals a fundamental shift of *morality* within our medical system. In the event of serious pandemic, this can go to the point where they cut off life-saving medicine to healthy, non-infected disabled people. (IE: Not giving my kid his insulin or denying an asthmatic an inhaler.)

[xone]

I remember a war movie in which a doctor declined to treat an seemingly mortally wounded soldier, only to reconsider when he found himself staring down the barrel of the soldier’s buddy’s pistol.

That doctor had no patients that he was working on at the time James Caan brought in his captain. The doc refused to examine the captain because he thought he was dead already. Different situation because he wasn't denying treatment in a triage situation, he thought he was smarter than Caan. After being convinced by the .45 to examine the captain, the doc realized he was wrong about his casual death diagnosis. Which is why when presented with the opportunity to have Caan arrested, he declined. He understood that Caan had provided him an opportunity to return to his profession.

[Salvation]

 

At any age!!!

From natural birth to natural death!

 

 

[Salvation]

Thanks, Blogger. Appreciate your pro-life stance.

[Salvation]

Pro-life bump!

[Salvation]

Good God, that link reads like an American Auschwitz.

May God have mercy on us!
May Christ have mercy on us!
May God have mercy on us!

And the whole world, of course!

[Salvation]

Regardless of anyone's faith or religion!

Prayer for Those Who Are Terminally Ill

 

Lord Jesus, you healed so many people during your public ministry. I bring before you now, in prayer, all those who are terminally ill -- those afflicted with cancer, AIDS, and other illnesses.

 

Look lovingly and compassionately upon them. Let them feel the strength of your consolation. Help them and their families to accept this cross they are asked to carry.  Protect them from euthanasia, Lord.

 

Let them see you carrying their cross with them, at their side, as you once carried yours to Calvary. May Mary be there, too, to comfort them. 

 

Lord Jesus, I know and believe that, if it is your will, you can cure those I pray for (especially N.). I place my trust in you. I pray with faith, but I also pray as you did in Gethsemane: your will be done. 

 

Bless us, Lord, and hear my prayer. Amen.

 

Reprinted from "Queen of Apostles Prayerbook" with permission of copyright holder, Pauline Books & Media,

[muawiyah]

Only federal employees at Department of Education, etc. You want to keep the postal employees around. They have trucks.