Learning how to make life-or-death choices about patients and setting policies for ventilator use taught Dr. Evans something that the doctors at Memorial didn’t figure out. Guidelines from experts in public policy, bioethics, and disaster medicine were crucial. Having rules in place before a crisis helped prevent the chaotic decision-making the Memorial Medical Center staff faced after Hurricane Katrina.
Post-Hurricane Katrina, the changes in disaster preparedness included a nonprofit parent company having an organized local command center. It provided proactive help not only to its own hospitals but also to others in the region, unlike the support from Tenet and Lifecare headquarters during Katrina.
Unaddressed issues included the lack of preparation for a complete power loss, slower-burning medical problems, external vulnerabilities, dealing with uncertainty, the process of dying, and prioritizing precious, vital, and limited resources.
The failure of federal, state, and municipal health departments to prepare for unforeseen disasters is the root cause. The AMA lacks guidelines for medical associates in handling calamities, making me question their stance.
Maryland’s disaster planning approach stands out as the first state to create a framework for decision-making in disasters. It focuses on saving those with the best chance of surviving their current illness. Many find it unacceptable for medical professionals to withdraw life-sustaining care, as suggested in pandemic triage plans, fearing it erodes trust in the medical system. Some reluctantly accept it but are concerned about using age as the primary basis for resource allocation, altering societal dynamics.
Fink suggests that triage in a crisis involves allocating resources for the greater good, considering variables like maximizing lives saved, years of lives saved, quality of life, fairness, and social trust. Ideas held by small groups of medical professionals might not align with the wider community.
This story positively influenced my view of the AMA. I started contemplating how traditional medical practices could adapt in emergencies. I also considered supporting a proposed initiative for state laws exempting doctors from liability in disasters unless fraudulent actions were involved.
I agree that democracy relies on people power and decisions made by the people. Respecting and effectively involving the public is crucial for sound public policy decisions.
Describing this experience as an eye-opener, it educated and equipped me to make wise decisions in similar situations. Firstly, criteria for allocating medical supplies during a disaster should involve input from the general population, ensuring fair treatment of patients. Secondly, decisions must be clear, dependable, reasonable, and accountable.