Ethical Issues and the Allocation of Scarce Resources During a Public Health Emergency
Authors: Mark D. Siegel
Journal: Annals of Internal Medicine (2009)

Letters16 June 2009Ethical Issues and the Allocation of Scarce Resources During a Public Health EmergencyMark D. Siegel, MDMark D. Siegel, MDFrom Yale School of Medicine, New Haven, CT 06510.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-150-12-200906160-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:White and colleagues (1) have proposed a carefully considered algorithm to ensure appropriate use of resources during a public health disaster. Their system should be widely applicable and reflects commonly held values.White and colleagues acknowledge the difficulty in denying access to specific patient groups. Therefore, their system does not address conditions associated with diminished functional (particularly cognitive) status. However, a just system cannot avoid taking these conditions into account.Permanent unconsciousness is an example. Consider 2 women age 42 years with septic shock and respiratory failure, neither with significant comorbid conditions that would limit long-term survival. ...References1. White DB, Katz MH, Luce JM, Lo B. Who should receive life support during a public health emergency? Using ethical principles to improve allocation decisions. Ann Intern Med. 2009;150:132-8. [PMID: 19153413] LinkGoogle Scholar2. Annas GJ. “Culture of life” politics at the bedside—the case of Terri Schiavo. N Engl J Med. 2005;352:1710-5. [PMID: 15784657] CrossrefMedlineGoogle Scholar3. American Thoracic Society. Withholding and withdrawing life-sustaining therapy. Ann Intern Med. 1991;115:478-85. [PMID: 11642893] LinkGoogle Scholar4. Schneiderman LJ, Jecker NS, Jonsen AR. Medical futility: its meaning and ethical implications. Ann Intern Med. 1990;112:949-54. [PMID: 2187394] LinkGoogle Scholar5. Burns JP, Truog RD. Futility: a concept in evolution. Chest. 2007;132:1987-93. [PMID: 18079232] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Yale School of Medicine, New Haven, CT 06510.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoWho Should Receive Life Support During a Public Health Emergency? Using Ethical Principles to Improve Allocation Decisions Douglas B. White , Mitchell H. Katz , John M. Luce , and Bernard Lo Ethical Issues and the Allocation of Scarce Resources During a Public Health Emergency Tia Powell , Guthrie Birkhead , and Kelly Christ Ethical Issues and the Allocation of Scarce Resources During a Public Health Emergency Michael D. Christian , Christian E. Sandrock , Asha Devereaux , James Geiling , CAPT Dennis E. Amundson , and Lewis Rubinson Ethical Issues and the Allocation of Scarce Resources During a Public Health Emergency Douglas B. White , Bernard Lo , and Mitch Katz Ethical Issues and the Allocation of Scarce Resources During a Public Health Emergency Allan R. Glass Ethical Issues and the Allocation of Scarce Resources During a Public Health Emergency John Hansen-Flaschen Metrics 16 June 2009Volume 150, Issue 12Page: 889-890KeywordsAlgorithmsConflicts of interestDecision makingEmotionsPrevention, policy, and public healthRespiratory failureTraumatic brain injury ePublished: 16 June 2009 Issue Published: 16 June 2009 Copyright & PermissionsCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...