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    Carine Mbilia

    1.There were probably many lessons gained
    Hurricane Katrina. She may have learned th value of clear rules and procedures in challenging decision-making circumstances. the confusion that followed the hurricane, medical team faced the difficult decision which patients would receive the generator limited electricity. Dr. Evans may have understood the significance of a fair and open method for allocating limited resources.
    The remaining questions:How to decide? How would hospitals in New York deal with the enormous demand for life support equipment? What are we going to do?
    2.I can give overview of how disaster preparation has changed after Hurricane Katrina.
    Significant gaps in disaster preparedness and response were made clear by Hurricane Katrina.
    Various adjustments to disaster preparedness were made in reaction to future catastrophes like Hurricane Sandy.
    Following Katrina, there was a greater emphasis placed on enhancing coordination and communication amongst the various entities involved in disaster response. Systems for emergency management have been improved, and more efficient methods resources have been implemented.
    The nonprofit parent company had a well-organized local command center and was providing proactive assistance not only to its own hospitals but also to others in the region, which was very different from the support provided by Tenet and Life care headquarters to their hospital during Hurricane Katrina. This was one of the changes that occurred in disaster planning after Katrina.
    What was left unaddressed was that, similar to
    the lead-up to Katrina, some staff members claimed they had never thought about or prepared for what they would do in the event of a complete loss of power, slower-burning medical issues, vulnerabilities beyond our control, our difficulty coping with uncertainty, how we die, or how we prioritize and divide what is most precious, vital, and limited.
    The United States’ federal, state ,health departments failed to make adequate preparations for unforeseeable calamities. The AMA doesn’t have a standard or policy for medical associates on how to handle circumstances in times of tragedy, which is how I feel about them as a result of this story.
    3.Maryland’s approach to disaster planning has several advantages, including the fact that it was the first state to address the issue by creating a framework for decision-making in disaster planning, focuses on people who may have the best chance of surviving their current illness because saving them would be a more effective way to accomplish goals and it is based on the idea that everyone deserves the same right to live through all stages of life.
    I think Fink mean that making difficult decisions when allocating resources and providing care may require medical practitioners to strike a balance between scientific principles and their own values.
    4. This story had a positive effect on my opinion about AMA, my thoughts on whether and how standard medical practices should be altered in disasters, and my plans to vote on a proposed initiative for state laws that would automatically exempt doctors from liability in disasters unless they committed malpractice.
    5. I agree with Roger Bernier statement. Democracy is a individual autonomy and equality. these concepts mean no one should be bound by laws that have been imposed by others. To a reasonable extent, people are in charge of their own life. everyone should be given an equal chance to participate in social decisions.
    These values are naturally appealing, and they contribute to the explanation that democracy is the power of the people.
    6. this story gave me a lesson, nursing care professionals must to think carefully before making a decision or doing anything to patients. because one mistake can ruined you entire
    Dramatic scenes like this do not occur often. But being in New York for Sandy was a reminder that terrible triage conundrums can arise anywhere, at any time, and that they have the power to change lives irrevocably. Across the country many hospitals in flood zones have electrical backup power systems in their basements. Others, in earthquake zones, were constructed before modern building codes and hadn’t been required to retrofit.
    Others are simply situated in Tornado Alley. To the extent that protections and plans have been put in place since Katrina, recent events have often shown them to be inadequate or misguided.
    Life and death in the early aftermath of a disaster frequently depend on the preparedness, effectiveness, performance and decision making of the individuals on the scene.
    In my opinion,The wisdom offer in this book is health care professionals must plan ahead, think through your options, and figure out how to handle challenging situations. People’s lives can be lost due to lack of preparation, as many patients at Memorial did.
    It is difficult for any of us to predict how we might behave in the face of such extreme or terrible pressure.But at least we have the opportunity to plan and decide how we would like to get at the decisions.

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