Ethics In Disaster Planning - Deciding What Is Fair

Most of us don't want to think about the terrible choices a disaster or pandemic will force upon all of us. The questions such scenarios present are enormous in scope. How to answer those questions is the focus of the new issue of Practical Bioethics, the quarterly publication of the Center for Practical Bioethics. "Preparedness for catastrophic events forces us to consider our unexamined priorities and values," says Michael Brannigan, the Center's vice president for clinical and organizational ethics. "With diminishing resources and escalating needs and costs, how do we fairly resolve the intractable conflict between self-interest and the good of the group?" Brannigan says planning for a disaster or pandemic forces us to consider how to allocate scarce medical resources. The issues to be resolved are enormous: How do we fairly ration scarce medical treatment such as vaccines and disposable ventilators? -- Who is treated after frontline workers and first responders? Those with high risk conditions or those who are healthier with normal life spans yet to live? -- What is the scope of healthcare workers' duties to patients? How do we resolve duties to patients and duties to family? -- What is the institutions' duty to safeguard and support staff who face disproportionate risks during disasters? Articles in this edition of Practical Bioethics address how to set priorities, how hospitals are planning for the unthinkable, the importance of community input into disaster planning to ensure a moral framework for such planning, and factoring inequalities into pandemic flu planning. Brannigan notes the Center is working with the Mid America Regional Council (MARC) to examine ethical issues in disaster planning and mass-casualty events. An Ethics in Disaster Planning Task Force has been formed comprised of members from hospital ethics committees, MARC hospital representatives and staff from both organizations. "Our first charge as a task force is to establish a protocol for the fair allocation of ventilators, certainly a scarce resource even in the absence of a major crisis," Brannigan says. "Only through such collaborative efforts can evenhanded rationing begin to make sense." Link:

(Author: Making Hard Choices,)

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