[Tina Vaillancourt]

1. I believe one of the key decisions that kept people alive in this chapter was the decision to evacuate the babies in critical condition first, Since the ventilators were not working, nurses also saved lives by dispensing air puffs via ambu-bags to their ventilator-dependent patients. They also made the critical decision to pass patients through the opening in the wall in effort to transport patients to the helipad faster and more efficiently.Perhaps the most difficult decision which resulted in death was the decision not to rescue DNR patients. Those in charge obviously had impossible choices to make during the tragedy but the choice to leave the most vulnerable patients being had to be the most gut-wrenching. Also, the decision to end the airlift due to staff fatigue, while understandable, certainly cost lives. At some point you must consider the well-being of the rescuers but valuable time was lost due to the decision to cease evacuation efforts until morning.

2. The man who was calling for rescue in the middle of the night was a white man in fatigues who seemed to be causing a diversion so that belongs could be robbed and looted. Pets were brought to the hospital because the staff members and other people sheltering there did not want to leave them at home to possibly starve or die in the hurricane. The Cloverleaf was a landing site for helicopters to drop people off. I believe the Cloverleaf is an important part of this story because this was the drop off site, but there was no one to provide food, shelter, transportation or medical needs.

3. Mark Leblanc was clearly taken aback by the tone of resignation among staff when he arrives to save hid mother. He was rightfully shocked to see nurses not attending to patients and seeing his mother lying in a wet bed, messy and thirsty. I believe his perspective was that of an outsider who had not spent the past 48 hours lifting patients to helipad for rescue. No one who hadn’t experienced the trauma that everyone went through could ever really appreciate the toll it would take on staff. However, to some extent, Mr. Leblanc had a point because, as a family member, you would expect your loved one to be cared for regardless of the circumstances.

4. The priority system for evacuating patients did fit within accepted triage practices. The decision to assign numbers based upon the patient’s ambulatory abilities followed the Utilitarian approach because they thought they would be doing the best they could for the greatest number of people. I don’t know if the Utilitarian is the best approach because many of those evacuated may have survived even if they had been placed behind those who were more vulnerable, but there seems to be no perfect solution to these types of dilemmas. Triage medicine is inherently difficult because, regardless of the choices made, lives were going to be lost and the decision to prioritize human life is impossible. The approach to organ sharing is probably one of the most difficult ethical decisions facing medical care providers. If a patient has little to no life expectancy the desire to preserve organs for those in need is understandable. On the other hand, a care providers primary consideration is their patient’s health and well-being. Ultimately a mixture of justice and efficiency is the goal and I think that may be obtained by including doctors, patients and other lay people in the decision making process.

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