Ethical Issues and the Allocation of Scarce Resources During a Public Health Emergency
Authors: Douglas B. White
Journal: Annals of Internal Medicine (2009)

Letters16 June 2009Ethical Issues and the Allocation of Scarce Resources During a Public Health EmergencyDouglas B. White, MD, MAS, Bernard Lo, MD, and Mitch Katz, MD, MPHDouglas B. White, MD, MASFrom University of California, San Francisco, San Francisco, CA 94143, and San Francisco, CA 94102., Bernard Lo, MDFrom University of California, San Francisco, San Francisco, CA 94143, and San Francisco, CA 94102., and Mitch Katz, MD, MPHFrom University of California, San Francisco, San Francisco, CA 94143, and San Francisco, CA 94102.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-150-12-200906160-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciate our colleagues' comments and are heartened to see that our analysis has stimulated further thought among clinicians and policymakers. We agree with Dr. Glass that government has an ethical obligation to carefully plan for foreseeable public health emergencies, such as pandemic influenza. However, because society's resources are limited, it is impossible to fully meet all emergency needs while still allocating adequate resources to competing routine societal needs, such as primary care, education, infrastructure, and defense. Public health emergencies remind us of the inevitable need to balance competing considerations when shaping public policy.Dr. Hansen-Flaschen uses the ...References1. Christian MD, Hawryluck L, Wax RS, Cook T, Lazar NM, Herridge MS, et al. Development of a triage protocol for critical care during an influenza pandemic. CMAJ. 2006;175:1377-81. [PMID: 17116904] CrossrefMedlineGoogle Scholar2. Devereaux AV, Dichter JR, Christian MD, Dubler NN, Sandrock CE, Hick JL, et al; Task Force for Mass Critical Care. Definitive care for the critically ill during a disaster: a framework for allocation of scarce resources in mass critical care: from a Task Force for Mass Critical Care summit meeting, January 26-27, 2007, Chicago, IL. Chest. 2008;133:51S-66S. [PMID: 18460506] CrossrefMedlineGoogle Scholar3. Chelluri L, Mendelsohn AB, Belle SH, Rotondi AJ, Angus DC, Donahoe MP, et al. Hospital costs in patients receiving prolonged mechanical ventilation: does age have an impact? Crit Care Med. 2003;31:1746-51. [PMID: 12794415] CrossrefMedlineGoogle Scholar4. Ely EW, Evans GW, Haponik EF. Mechanical ventilation in a cohort of elderly patients admitted to an intensive care unit. Ann Intern Med. 1999;131:96-104. [PMID: 10419447] LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: Douglas B. White, MD, MAS; Bernard Lo, MD; Mitch Katz, MD, MPHAffiliations: From University of California, San Francisco, San Francisco, CA 94143, and San Francisco, CA 94102.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoMechanical Ventilation in a Cohort of Elderly Patients Admitted to an Intensive Care Unit E. Wesley Ely , Gregory W. Evans , and Edward F. Haponik Who 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 Allan R. Glass Ethical Issues and the Allocation of Scarce Resources During a Public Health Emergency John Hansen-Flaschen Ethical Issues and the Allocation of Scarce Resources During a Public Health Emergency Mark D. Siegel 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 Metrics 16 June 2009Volume 150, Issue 12Page: 891-892KeywordsDisabilitiesElderlyEmotionsIntensive care unitsLife expectancyPoliomyelitisPrevention, policy, and public healthPublic policySocial statusTriage ePublished: 16 June 2009 Issue Published: 16 June 2009 Copyright & PermissionsCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...