There is a lack of clarity about the New York State Task Force guidelines on ventilator allocation. I believe disability rights concerns regarding the recommendations on chronic ventilator users are well-founded. This lack of clarity may cost lives.
Dr. Goold’s post is a commentary on Laurence McCullough’s post, “In Response to COVID-19 Pandemic Physicians Already Know What to Do”
by Susan Dorr Goold, MD, MHSA, MA
Professor McCullough, a distinguished scholar in bioethics and the history of bioethics, wisely exhorts us to learn from past experience as we confront the COVID-19 pandemic. We should not rush to develop brand new criteria for allocating scarce resources in intensive care units (ICUs), says McCullough, but should instead rely on what we have learned over many years. “When every critical care bed is occupied by patients under the condition of medical reasonableness,” says McCullough, “patients in the emergency department or elsewhere in the hospital for whom a trial of critical care management is medically reasonable should be informed that access to critical care clinical management in the hospital will not be offered and the team will attempt transfer or, failing transfer, do the best that it can.” In other words, a patient with a reasonable chance of benefit from ICU care, even if they have more chance of benefit than an existing ICU patient, might be denied admission because of bad timing.…
by Laurence B. McCullough, Ph.D.
The COVID-19 pandemic has prompted multiple responses from bioethicists and bioethics organizations. One prominent response has come from The Hastings Center, “Ethical Framework for Health Care Institutions and Guidelines for Institutional Ethics Services Responding to the Novel Coronavirus Pandemic”:
An ethically sound framework for health care during public health emergencies must balance the patient-centered duty of care—the focus of clinical ethics under normal conditions—with public-focused duties to promote equality of persons and equity in distribution of risks and benefits in society—the focus of public health ethics. Because physicians, nurses, and other clinicians are trained to care for individuals, the shift from patient-centered practice to patient care guided by public health considerations creates great tension, especially for clinicians unaccustomed to working under emergency conditions with scarce resources.
The slow growth in coronavirus cases in North Carolina relative to New York and some other states puts North Carolina in better position to respond to the pandemic, according to a Duke University professor. Economist Mark McClellan, the director of the Duke-Margolis Center for Health Policy, was U.S. Food and Drug Administration commissioner during the […]
The post Expert: NC better positioned than other states to respond to pandemic (WRAL) appeared first on Peter Ubel.
During the past few weeks, New York City has become an epicenter of the recent COVID-19 pandemic. As a result, hospitals are increasingly running short of Personal Protective Devices (PPEs) and there is a concern that there will not be enough ventilators. In the NY Times on 4/2, there was this headline: “New York could deplete its ventilator stockpile in 6 days.”
As such, doctors will need to “choose” who shall receive or not receive a ventilator. This webinar will present an interactive approach to discuss the various ethical frameworks that can justify the allocation of scarce life-saving resources, including a discussion of the 2015 NY Taskforce’s “Ventilators Allocation Guidelines.”
This webinar will include information on creating video messages with residents, securely storing them and accessing them and other advance care planning documents via MyDirectives.com and the ADVault Exchange global repository, both part of Texas-based ADVault, Inc.
With consumer users in over 50 countries, MyDirectives is the world’s first all-digital advance care planning platform with enterprise partners that include Humana and UnitedHealthcare/AARP, EHR integrations via Cerner and Epic, content partnerships with AMDA – The Society for Post-Acute and Long-Term Care Medicine, the Center for Practical Bioethics, and health information exchange relationships that allow over 75% of the hospitals in the USA to access the data in accordance with health technology security, content and data transport standards.
People can create a plan at MyDirectives or upload any paper-based advance directive such as Caring Conversations®, Five Wishes® and Veterans Administration forms, digital advance care plans like the one created at MIDEO® or MyDirectives.com, as well as other audio or video files.
Portable medical orders (for example, POLST and MOLST and their international equivalents) can be uploaded, as well, to help providers and caregivers have confidence there is alignment between the person’s goals of care (the advance care plan) and the medical order’s instructions.