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Who should MDs let die in a pandemic? Report offers answers
Zorvan
Member CommonPosts: 8,912
news.yahoo.com/s/ap/20080505/ap_on_he_me/pandemic_rationing_care
By LINDSEY TANNER,
AP Medical Writer Mon May 5, 9:47 AM ET
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.
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."
___
On the Net:
CHEST: http://www.chestjournal.org
U.S. Govt.: http://www.pandemicflu.gov
Comments
I find the rationale behind the plan very well thought out. At least from a survivabiltiy standpoint. That being said its clear we have the resources to handle the situation better. More materials placed in the right places are possible. As if anyone needs to be told WHY we dont have the money there
In anycase Ive survived a extremely deadly form of flu from the philippines twice and its TOUGH! You lose alot of weight and you have no energry. You cant even eat if you wanted to. I survived. 
I suspect I would be allowed a vacinatiion but Im betting Id survive anyways hehe.
Yeah, I've heard how bad those asian "superflus" can be. I remember when the big avian flu scare a few years back came out, I was damn near panicking. Not for myself, hell if it's my time then it's my time. But the elderly and children are the ones really hit hard/killed by these flus. I was trying to figure where to hide my kid if the shit broke out. Luckily, we only had a few cases in California.
I think we should start with the big muscular people where their muscles are superflous. They will take more vacination to cure, and they might be healthy enough to resist the disease.
It's pretty sad...Too bad everyone can't get the shots, no one deserves to die because they are too old or are already sick...it's a shame.
__________________________________________________
In memory of Laura "Taera" Genender. Passed away on Aug/13/08 - Rest In Peace; you will not be forgotten
There are several things that are inevitable, one of them is death... if they only had enough vaccine to innoculate the healthy why would they waste it on those who will inevitably die soon anyways as opposed to those who might have a chance
Unfortunately to most this is a very touchy subject of who "Deserves" to live..
but mother nature chooses who will live and who will die and at what time anyways
Old people should be far at the bottom of the list for innoculations as well as people with terminal illness
HIV/aids(At later stages they will die even with the innoculation) drug dealers
and Creationalists lol
they can go see if people really put saddles on their dinosaurs
Trump 2016
Okay, so what about the poor crackhead, and the homeless wino? What about the prison inmate serving life for the murder and mutilation of his wife? What about the child molester currently out on the street on bond pending trial? What about the Muslim cleric that calls for "Death to Israel, Death to America" in his weekly sermons in Chicago?
What if that elderly person is George Herbert Walker Bush, Jimmy Carter, or Pat Robertson? What if that elderly person is the doctor's father? What if that elderly person is your father?
Do they live, or die?
That was just a rough list i made up in about 5 minutes :P
Poor crackhead made too many poor decisions in his life and his body is probably withered enough anyways..
Homeless wino might as well be a vietnam veteran and I have nothing but sympathy for the veterans our country has forgotten- if not then maybe he's an ex-mental health patient who was booted from the mental hospital and declared fit and wouldn't be at the bottom of the list
the muslim cleric needs to be deported
George HW bush, jimmy carter or pat robertson, dick cheney for that matter are no different from normal elderly people besides their amassed wealth
and I'm more than certain anyone with enough money would be able to get their hands on a vaccination..
though it's still not my position to decide who should or shouldn't live- i was just using a little logic
if my father was 85+ i would see no difference..
Trump 2016
Your right Zorvan, the asian superflu's are amazingly deadly. I honestly was dying when I went to the doctor. I thought I could fight it on my own like I did a American flu. I was wrong.
By the time I went in to see the doctor id went from 210 pounds to 170 in a little less then a week. I literally could feel like life draining from me and thats a scary feeling. I was losing. Anycase they gave me a extremely powerful dose of antibiotics and 2 and a half weeks later I could walk at least. Took a full 2 months to be back to normal. I never did regain all my strength for some reason. Now that is summer I mite. Im feeling better in the warm tempatures. Oh and I had the flu last november.
This is really simple.
You ask them one question: "Did you vote for George W. Bush in 2000 or 2004?"
If they answer in the affirmative, you let them die.
CH, Jedi, Commando, Smuggler, BH, Scout, Doctor, Chef, BE...yeah, lots of SWG time invested.
Once a denizen of Ahazi
LMAO - I agree!
It sickens me to no end. I can not express how much this truly turns my stomach..... I don't care what people view as acceptable or practical. This is not the way America was designed or intended to work. Bah screw it... Not worth a rant.. Americans are so bloody pasive for such a patriotic nation.. Can't believe shit like this fly's... How much more of this are people gonna take. It amazes me.
Um, Cleffy. Vaccinations and antibiotics are not based on body weight/volume.
In a post apocalyptic world, you're faced with some random crisis of whatever you can imagine. What do you do? You can only choose one.
A. save humanity (including yourself)
B. save your friend/lover/parent/someone whom you have a close personal relationship with (but a few mins later you both die anyways but hey, at least your conscience is clear, whoop di doo)
Umm you can be as pissed off as you want, but at the end of the day when there isn't enough vaccines/medical staff to go around you have to follow logic no matter how cold it may seem. Pandemics are extraordinary situations and extraordinary measures have to be taken.
O_o o_O
I just love the idea of the political donor class that controls the United States preparing us for the news that the major drug companies are incapable of changing up production lines and meeting the demands of the entire nation.
My solution is simple, the drug companies do whatever they have to do to meet demand, even if that means switching production from viagra to the innoculation.......
So America has to go without prescription pain killers for a month, unless you're addicted, you shouldn't miss them....pain is a wonderful thing, it's God's way of telling you that you are still alive.
Um, Cleffy. Vaccinations and antibiotics are not based on body weight/volume.
Ya but infection is. They say its how the big mammals died in 40,000 BC.
Um, Cleffy. Vaccinations and antibiotics are not based on body weight/volume.
Ya but infection is. They say its how the big mammals died in 40,000 BC.
Your argument might make sense if the big, muscular people were the size of a wooly mammoth. I say give the vaccines to the muscular folks first and let the blubber butts die. They're a drain on our society's resources anyway and maybe a plan like this will encourage them to put down that Big Mac and start exercising.
A vaccine is not as simple as compressing some stuff in a pill and sealing it into blister packs. It's way more complicated than that and requires special facilities and specially trained people.
Save the good looking women first.
If you are not being responded to directly, you are probably on my ignore list.
As cold as it sounds thats just about the norm in an emergency.
You save those that are more likely to be saved first.
Umm you can be as pissed off as you want, but at the end of the day when there isn't enough vaccines/medical staff to go around you have to follow logic no matter how cold it may seem. Pandemics are extraordinary situations and extraordinary measures have to be taken.
I refer you to olddaddy's post. Lets also hope that you never , ever... fall into the left behind, forgotten. If a old person can make it to a treatment center they dam well deserve as much attention as a 20 year old. How about people in congress or the majority of our Presidents? Oh nm that's right I am sure they have nothing to worry about even though most of those bastards would fall into the left behind category because of their age..
Keep thinking this is acceptable and just hope for the love of whatever you never fall into this category. Not that our country does as good of a job as it could during disasters, unless it involves 2 big buildings coming down in the middle of town.
Common sense, first hand evaluation from the person or persons on the scene should be the deciding factor. Not a blanket protocol that effectively says "no one over this age gets treated." That for all intents and purposes goes against the founding principles of what America was founded on.
That's my whole issue with this garbage.. As I said I am glad to see people being so patriotic but then when shit like this comes up we accept it wtf? One thing this country is in dire need of is a bit more common sense.
A vaccine is not as simple as compressing some stuff in a pill and sealing it into blister packs. It's way more complicated than that and requires special facilities and specially trained people.
Whats funny is it is that simple. So what if production takes 6 months. Your telling me that you can't figure out how they could increase their volume, while people in the government find a way to strip millions of dollars for their personal pet projects? Expansion for a hint..If a private company does not want to do it for whatever reason. Then in an issue like this I would think it would be acceptable for the government to step in a say fuck off we will do it if no one else will. I do realise expanding something like this is probably a big task? But if no one else will then should we just leave it like it is? The population of the world is expanding and yet we still treat things as if it were the size say 100 years ago. What good is technology if we can't get it to those in need?
Common sense, first hand evaluation from the person or persons on the scene should be the deciding factor. Not a blanket protocol that effectively says "no one over this age gets treated." That for all intents and purposes goes against the founding principles of what America was founded on.
That's my whole issue with this garbage.. As I said I am glad to see people being so patriotic but then when shit like this comes up we accept it wtf? One thing this country is in dire need of is a bit more common sense.
I am really curious where you're getting your information about the founding principles of America. If we were basing our decisions today on the same "principles" that America was founded upon then the only people who would receive any treatment from the government would be white males. Remember back then slaves and women had no real rights in our society. Hell, women didn't even gain the right to vote until what 40-50 years ago? I know you'd love to believe that our nation was built on this notion of freedom, justice and equality for all but it wasn't. Those principles have developed over time through a lot of civil unrest and quite a few changes in law.
Common sense, first hand evaluation from the person or persons on the scene should be the deciding factor. Not a blanket protocol that effectively says "no one over this age gets treated." That for all intents and purposes goes against the founding principles of what America was founded on.
That's my whole issue with this garbage.. As I said I am glad to see people being so patriotic but then when shit like this comes up we accept it wtf? One thing this country is in dire need of is a bit more common sense.
I am really curious where you're getting your information about the founding principles of America. If we were basing our decisions today on the same "principles" that America was founded upon then the only people who would receive any treatment from the government would be white males. Remember back then slaves and women had no real rights in our society. Hell, women didn't even gain the right to vote until what 40-50 years ago? I know you'd love to believe that our nation was built on this notion of freedom, justice and equality for all but it wasn't. Those principles have developed over time through a lot of civil unrest and quite a few changes in law.
http://www.ushistory.org/Declaration/document/index.htm
We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness. — That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed, — That whenever any Form of Government becomes destructive of these ends, it is the Right of the People to alter or to abolish it, and to institute new Government, laying its foundation on such principles and organizing its powers in such form, as to them shall seem most likely to effect their Safety and Happiness. Prudence, indeed, will dictate that Governments long established should not be changed for light and transient causes.
So... do I get a cookie?
Edit: So what shoot me my grammar sucks. I used the word wrong the correct word / phrase would have been "in principle".
" —Idioms
I imagine you knew what I ment.