Dont Get Old or Sick

[TexasRed]

or sick or anything else. I'm sure it will be taken to the Supreme Court before its official.

Docs list who would be allowed to die in a catastrophe

CHICAGO, Illinois -- 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 whom 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, California, 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."

[speed]

Scary stuff.

SM

[curley725]

My father was a medic in WWll and from what he told me it kinda remindes me of this... The least injured and most surviveable were treated first...Sad but true

Curley

[Mominatrix]

Originally Posted by curley725

My father was a medic in WWll and from what he told me it kinda remindes me of this... The least injured and most surviveable were treated first...Sad but true

Curley

The difference is in WWII people had a little firmer grip on the realities of life.

This is a plan for pandemic type emergency not day to day life. If you have never been in a hospital emergency room when disater strikes then its hard to imagine. I have. I worked the day of the disaster on I-75 with approx 90 something cars smashed and burning on the interstate beside our hospital. We were overwhelmed with patients and stressed our resources to maximum operating capacity. It was a nightmare. I know a large scale disaster will occur it's only a matter of time. During that disaster there will be too many sick people for too few resources and tough choices will need to be made by those giving care. Would it be better to do first come first serve and the rest of the sick sit outside and die? Those will be our options. People need to realize this is a plan or guidline to help healthcare providers have someway to function when they are swimming in a sea of dead and dying not a plan for daily living.

These are horrible decisions to have to be made but rest assured the day will come when we may face these tough decisions.

[mrpiff]

It makes sense to me :neutral:
It's scary sure, but like Moms said, it's pretty inevitable and it's better to have a plan that makes sense than to be handcuffed and ineffective due to political correctness. The limited resources are used to save the ones with the best chance of recovery, pretty simple.

[mikedetejas]

Could we put Rosie O'donnel at the top of the list???

[Kate]

It does make sense though...
At least until I become one of those on that list!

[TexasRed]

Originally Posted by Mominatrix

These are horrible decisions to have to be made but rest assured the day will come when we may face these tough decisions.

I totally agree with that .. I just dont want to be old or sick when it happens :lol:

Rough call for all medical personnel all the way around I'm sure.

[firestarter]

Hey afterall they do evacuation drills for hurricanes. This makes just about as much sense. Better to be trained or partially prepared for this senario, sad as it is one day it will happen, maybe not in our lifetime, but it will come.

[mrpiff]

Originally Posted by mikedetejas

Could we put Rosie O'donnel at the top of the list???

As long as Nancy Pelosi is in line in front of her, I'm all for it!