Posted on 04/26/2009 12:14:37 AM PDT by 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.
(Excerpt) Read more at rds.yahoo.com ...
Whatever happened to saving lives—as many as possible? This reminds me of the “Values Clarification” stuff that has been in schol; i.e. if you have to throw someone over from a lifeboat, who would you toss and why?
They are talking about during a pandemic. Sheesh you can’t save everyone and they are being responsible by discussing this now before all hell brakes loose and they don’t know which why to go because of chaos. This is good reasonable preparation. I hate to think that everyone can’t be saved but that is not possible if you have 300 million people dying. However, they will get as many as possible that is for sure.
BS. This was discussed in Bush’s Homeland Security too. This is nothing new.
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.
Marie we are talking about a pandemic. Hell even the doctors and nurses may be sick. We could all die. If this were to happen it would be a mess that we never had before. It would make 9/11 look like a tea party. Remember planning does not make for exact occurance. We could not control a city during a hurricane. How well do you think things will go during a major national incident of this magnitude?????
rdl6989 gets it, and I would add that the list won't be that small or that "reasonable" under socialized medicine. We'll all be forced to "accept" it for the "common good". Good post.
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Obama Says A Baby Is A Punishment
Obama: “If they make a mistake, I don’t want them punished with a baby.”
Is it more compassionate to save twenty people, or a hundred?
Triage assumes that there aren't enough resources to help everyone at once. Someone has to be at the front of the line and someone at the end; it's not a deli, where help is first come, first served.
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?
Probably Christians, right-wing extremists, and beauty pageant contestants who think marriage should be between a man and a woman.
[sarcasm alert tag]
You have two doctors. One sick or wounded, one on duty. If the on-duty doctor helps the other one, then you have two doctors and can save twice as many people. I don't see that as particularly cynical -- or surprising.
In times like that, they have to do what they can to save the most lives possible.
Dems want to cover everyone in the US including illegals under their socialized medicene.
Who would be given priority under a triage system? An older citizen who has paid taxes all their life or a young illegal with their whole life before them?
Such arrogance. The truth of the matter is that triage will be handled by a simple chest X-ray. A young, pretty, affluent, blond haired and blue eyed Wellesley College graduate with shredded lungs will die, and an old, ugly, poor, black, Vietnam vet Republican smoker and drinker will live, and handily, to vote for Jeb Bush for president.
Unless the doctors think that by killing him they will be performing “proactive euthanasia”. But then again, he is armed with a gun, so killing him may not be quite as easy as they’d hoped.
The bottom line is that it’s not going to be as much “their choice” as the little Marcus Welby’s would like. They can speculate until the cows come home about how many “undesirables” they will *allow* to die, but life, and death, is not up to them.
There are essentially two different situations for triage:
1 - there are enough resources (people, supplies, room, etc.) to handle all of the patients. Practical application of triage involves getting the right resources to the right patients at the right time.
2 - there are NOT enough resources to handle all of the patients. This situation sucks. You KNOW that some, probably many, of the patients will die. You fix the ones that you can treat, and you try to make the ones that you cannot save at least comfortable.
While I sincerely hope and pray that none of us face this second situation, as an attending surgeon practicing trauma and critical care medicine for over a decade in the "ivory towers", I can tell you that it is really the "ivory trenches". Our EDs nationwide are already overflowing, and not just from the worried well.
At my institution, our orthopedic surgery team operates around the clock. Several of my recent call nights have involved responding to over 20 major trauma cases a night. A quick glance at the trauma pager over the last 24 hours (a light Saturday night): 6 MVCs, 1 fall, 4 GSWs, 1 burn, 3 blunt assault. These are just the trauma patients that the ED doctors could NOT handle, and does not include the emergent general surgery patients that came in (acute appendicitis, cholecystitis, bowel obstruction, abscesses, etc.)
Despite the volume of trauma climbing (trauma visits alone up over 100% in the past 7 years, going from about 2200/year to over 4400/year), we have FEWER attending surgeons covering the trauma surgery service. The 80-hour work week rules for residents have further reduced the available resources; when gaps in resident doctor coverage occur, the attending has to deal with it. I have to make triage decisions about resources every day.
Just do a Google search on physician work force, much less surgeon work force. The storm is coming - fewer doctors, much fewer general surgeons, increasing population.
Some of my suggestions for what you can do if you are not a doctor/nurse:
1 - learn CPR (in a disaster, this experience will help you identify those who have problems that you can maybe fix with your own hands (e.g. airway), as well as those that you cannot
2 - volunteer at your local hospital, especially the ED.
3 - prepare your own medical supplies kits for home and car - don't need to buy the ready-made kits, but you do need to read what is in them and why in order to make your own decisions about what you need and are prepared to use. If you don't know how to intubate, carrying an endotracheal tube and laryngoscope is not likely to help anyone.
4 - take a disaster preparation course if you can. And be prepared to realize that disasters are NOT pretty. The triage choices that have to be made in the second situation are ones that can haunt you for the rest of your life.
I’m not surprised, nor do I disagree with the policy. However, I frequently work with health care workers and have reason for my cynicism. One of my acquaintances is an emergency room tech who refuses to get flu shots and would not get the small pox boosters being recommended in the days following 9-11. His concern: the miniscule risks. The reason why he wasn’t worried about his chances: he knew, as a hospital worker, he’d be the first to be vaccinated or treated in a pandemic or biological warfare terrorist attack. In other words, he is willing to increase the risk for the rest of society since he knows he’ll be taken care of first.
(okay, maybe I'm being too harsh. Many people don't know about 'Triage'. When I brought it up to a young Doc we once had, it was like I told him his fly was open.)
Yep.
And no it is not pretty.
......Severely burned patients older than 60......
To be denied treatment, must the patient also have the flu?
“Triaging patients in this sort of situation is to ensure that those likeliest to survive get treated.”
I always thought triage meant who gets treated first, not who gets treated and who doesn’t. If the plan is to not treat certain people at all, it isn’t triage.
sure ... unless they sing exceptonally well
Conservatives.
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