Download or read book Allocation of Scarce Medical Resources and Crisis Standards of Care written by Lance Gable and published by . This book was released on 2020 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Potential shortages of medical resources and services related to COVID-19 present government officials and emergency planners with difficult choices. If resources become too scarce, health care professionals and institutions may need to implement triage protocols adopting crisis standards of care. COVID-19 patient surges tested the health care system in March and April 2020, and highlighted the need to prepare to accommodate larger patient capacity in the near future. As a primary consideration, governments and health care institutions should utilize existing powers and resources to avoid shortages and mitigate their severity. If shortages do occur, most states have begun to develop crisis standards of care protocols to assist in making decisions about allocating scarce resources. These protocols attempt to maximize the number of lives saved. Many protocols give priority access to health care and other essential workers. These protocols should be structured to facilitate fair and equitable access, although several have been found to be inconsistent with federal anti-discrimination law. Legal issues that may arise in this context include liability for health care professionals and institutions who decide to not allocate resources to patients who later suffer harm, and civil rights concerns over discrimination in the protocols or their implementation. Liability shields have been put in place by many states to protect health care professionals from lawsuits based on allocation decisions. Federal and state officials should support efforts to clarify and incorporate protections into crisis standards of care plans that prioritize anti-discrimination, fairness, and equity in allocation decision making.This paper was prepared as part of Assessing Legal Responses to COVID-19, a comprehensive report published by Public Health Law Watch in partnership with the de Beaumont Foundation and the American Public Health Association.
Download or read book Crisis Standards of Care written by Institute of Medicine and published by National Academies Press. This book was released on 2012-08-26 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Catastrophic disasters occurring in 2011 in the United States and worldwide-from the tornado in Joplin, Missouri, to the earthquake and tsunami in Japan, to the earthquake in New Zealand-have demonstrated that even prepared communities can be overwhelmed. In 2009, at the height of the influenza A (H1N1) pandemic, the Assistant Secretary for Preparedness and Response at the Department of Health and Human Services, along with the Department of Veterans Affairs and the National Highway Traffic Safety Administration, asked the Institute of Medicine (IOM) to convene a committee of experts to develop national guidance for use by state and local public health officials and health-sector agencies and institutions in establishing and implementing standards of care that should apply in disaster situations-both naturally occurring and man-made-under conditions of scarce resources. Building on the work of phase one (which is described in IOM's 2009 letter report, Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations), the committee developed detailed templates enumerating the functions and tasks of the key stakeholder groups involved in crisis standards of care (CSC) planning, implementation, and public engagement-state and local governments, emergency medical services (EMS), hospitals and acute care facilities, and out-of-hospital and alternate care systems. Crisis Standards of Care provides a framework for a systems approach to the development and implementation of CSC plans, and addresses the legal issues and the ethical, palliative care, and mental health issues that agencies and organizations at each level of a disaster response should address. Please note: this report is not intended to be a detailed guide to emergency preparedness or disaster response. What is described in this report is an extrapolation of existing incident management practices and principles. Crisis Standards of Care is a seven-volume set: Volume 1 provides an overview; Volume 2 pertains to state and local governments; Volume 3 pertains to emergency medical services; Volume 4 pertains to hospitals and acute care facilities; Volume 5 pertains to out-of-hospital care and alternate care systems; Volume 6 contains a public engagement toolkit; and Volume 7 contains appendixes with additional resources.
Download or read book Allocating Scarce Medical Resources written by H. Tristram Engelhardt Jr. MD, PhD and published by Georgetown University Press. This book was released on 2002-05-20 with total page 346 pages. Available in PDF, EPUB and Kindle. Book excerpt: Roman Catholic moral theology is the point of departure for this multifaceted exploration of the challenge of allocating scarce medical resources. The volume begins its exploration of discerning moral limits to modern high-technology medicine with a consensus statement born of the conversations among its contributors. The seventeen essays use the example of critical care, because it offers one of the few areas in medicine where there are good clinical predictive measures regarding the likelihood of survival. As a result, the health care industry can with increasing accuracy predict the probability of saving lives—and at what cost. Because critical care involves hard choices in the face of finitude, it invites profound questions about the meaning of life, the nature of a good death, and distributive justice. For those who identify the prize of human life as immortality, the question arises as to how much effort should be invested in marginally postponing death. In a secular culture that presumes that individuals live only once, and briefly, there is an often-unacknowledged moral imperative to employ any means necessary to postpone death. The conflict between the free choice of individuals and various aspirations to equality compounds the challenge of controlling medical costs while also offering high-tech care to those who want its possible benefits. It forces society to confront anew notions of ordinary versus extraordinary, and proportionate versus disproportionate, treatment in a highly technologically structured social context. This cluster of discussions is enriched by five essays from Jewish, Orthodox Christian, and Protestant perspectives. Written by premier scholars from the United States and abroad, these essays will be valuable reading for students and scholars of bioethics and Christian moral theology.
Download or read book Disability Health Law and Bioethics written by I. Glenn Cohen and published by Cambridge University Press. This book was released on 2020-04-23 with total page 313 pages. Available in PDF, EPUB and Kindle. Book excerpt: Examines how the framing of disability has serious implications for legal, medical, and policy treatments of disability.
Download or read book Crisis Standards of Care written by Institute of Medicine and published by National Academies Press. This book was released on 2013-10-27 with total page 217 pages. Available in PDF, EPUB and Kindle. Book excerpt: Disasters and public health emergencies can stress health care systems to the breaking point and disrupt delivery of vital medical services. During such crises, hospitals and long-term care facilities may be without power; trained staff, ambulances, medical supplies and beds could be in short supply; and alternate care facilities may need to be used. Planning for these situations is necessary to provide the best possible health care during a crisis and, if needed, equitably allocate scarce resources. Crisis Standards of Care: A Toolkit for Indicators and Triggers examines indicators and triggers that guide the implementation of crisis standards of care and provides a discussion toolkit to help stakeholders establish indicators and triggers for their own communities. Together, indicators and triggers help guide operational decision making about providing care during public health and medical emergencies and disasters. Indicators and triggers represent the information and actions taken at specific thresholds that guide incident recognition, response, and recovery. This report discusses indicators and triggers for both a slow onset scenario, such as pandemic influenza, and a no-notice scenario, such as an earthquake. Crisis Standards of Care features discussion toolkits customized to help various stakeholders develop indicators and triggers for their own organizations, agencies, and jurisdictions. The toolkit contains scenarios, key questions, and examples of indicators, triggers, and tactics to help promote discussion. In addition to common elements designed to facilitate integrated planning, the toolkit contains chapters specifically customized for emergency management, public health, emergency medical services, hospital and acute care, and out-of-hospital care.
Download or read book Allocation of Scarce Resources During Mass Casualty Events written by U. S. Department of Health and Human Services and published by Createspace Independent Pub. This book was released on 2013-03-19 with total page 306 pages. Available in PDF, EPUB and Kindle. Book excerpt: Most experts define a mass casualty event (MCE) as a natural (e.g., earthquake, pandemic) or manmade (e.g., detonation of a nuclear device, conventional explosive, bioterror attack) incident that suddenly or progressively generates large numbers of injured and/or ill people who require medical and/or mental health care. The magnitude of demand for medical care resources has the potential to vastly outstrip the ability of a health care facility or a local, regional, or national public health and health care delivery system to deliver medical care services consistent with generally established standards of care. The scope and complexity of an MCE can severely challenge even the most highly experienced and well-equipped health care providers and systems. By definition, an MCE generates a level of demand for health care resources that outstrips available supply. Under those circumstances, local and regional health care providers are unable to meet victims' needs at the level normally expected of a modern health care delivery system. Because such situations are difficult to predict and can occur with little or no warning, health care systems and providers must be prepared to swiftly implement contingency plans to reduce less-urgent demand for health care services; optimize the use of existing resources; and secure additional resources, if possible, from backup sources. If these measures are insufficient to meet demand, providers may be forced to shift from the traditional treatment approach, which strives to deliver optimum care to every patient, to one that seeks to do the most good for the most people with the available resources. This latter concept has come to be known as “crisis standards of care.” The Institute of Medicine (IOM) Committee on Guidance for Establishing Standards of Care for Use in Disaster Situations published a landmark Letter Report recommending that health care providers, organizations, government officials, and the public approach the challenge in a thoughtful and proactive way, anchored in four values: fairness; equitable processes; community and provider engagement, education, and communication; and the rule of law. The IOM Letter Report also recommended that State plans incorporate, among other things, evidence-based clinical processes and operations. To help Federal, State, and local policymakers, providers, and interested members of the public address the issue with the best available evidence, we were asked to build on the work of the IOM and previous reviews by conducting a thorough review of the evidence regarding allocation of scarce medical resources during MCEs. This report addresses the following Key Questions: Key Question 1. What current or proposed strategies are available to policymakers to optimize the allocation and management of scarce resources during MCEs? What outcomes are associated with these strategies? What factors act as facilitators or barriers to their implementation or effectiveness? Key Question 2. What current or proposed strategies are available to providers to optimize the allocation of scarce resources during MCEs? What outcomes are associated with these strategies? What factors are identified as facilitators or barriers to their implementation or effectiveness? Key Question 3. What are the public's key perceptions and concerns regarding the development and implementation of strategies to allocate and manage scarce resources during actual and potential MCEs? Key Question 4. What current or proposed methods are available to engage providers in discussions regarding the development and implementation of strategies to allocate and manage scarce resources, both in planning for and during an MCE? What outcomes are associated with these strategies? What factors are identified as facilitators or barriers to engaging providers in these discussions?
Download or read book Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations written by Institute of Medicine and published by National Academies Press. This book was released on 2009-10-23 with total page 160 pages. Available in PDF, EPUB and Kindle. Book excerpt: The influenza pandemic caused by the 2009 H1N1 virus underscores the immediate and critical need to prepare for a public health emergency in which thousands, tens of thousands, or even hundreds of thousands of people suddenly seek and require medical care in communities across the United States. Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations draws from a broad spectrum of expertise-including state and local public health, emergency medicine and response, primary care, nursing, palliative care, ethics, the law, behavioral health, and risk communication-to offer guidance toward establishing standards of care that should apply to disaster situations, both naturally occurring and man-made, under conditions in which resources are scarce. This book explores two case studies that illustrate the application of the guidance and principles laid out in the report. One scenario focuses on a gradual-onset pandemic flu. The other scenario focuses on an earthquake and the particular issues that would arise during a no-notice event. Outlining current concepts and offering guidance, this book will prove an asset to state and local public health officials, health care facilities, and professionals in the development of systematic and comprehensive policies and protocols for standards of care in disasters when resources are scarce. In addition, the extensive operations section of the book provides guidance to clinicians, health care institutions, and state and local public health officials for how crisis standards of care should be implemented in a disaster situation.
Download or read book Crisis Standards of Care written by Institute of Medicine and published by National Academies Press. This book was released on 2012-08-26 with total page 519 pages. Available in PDF, EPUB and Kindle. Book excerpt: Catastrophic disasters occurring in 2011 in the United States and worldwide-from the tornado in Joplin, Missouri, to the earthquake and tsunami in Japan, to the earthquake in New Zealand-have demonstrated that even prepared communities can be overwhelmed. In 2009, at the height of the influenza A (H1N1) pandemic, the Assistant Secretary for Preparedness and Response at the Department of Health and Human Services, along with the Department of Veterans Affairs and the National Highway Traffic Safety Administration, asked the Institute of Medicine (IOM) to convene a committee of experts to develop national guidance for use by state and local public health officials and health-sector agencies and institutions in establishing and implementing standards of care that should apply in disaster situations-both naturally occurring and man-made-under conditions of scarce resources. Building on the work of phase one (which is described in IOM's 2009 letter report, Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations), the committee developed detailed templates enumerating the functions and tasks of the key stakeholder groups involved in crisis standards of care (CSC) planning, implementation, and public engagement-state and local governments, emergency medical services (EMS), hospitals and acute care facilities, and out-of-hospital and alternate care systems. Crisis Standards of Care provides a framework for a systems approach to the development and implementation of CSC plans, and addresses the legal issues and the ethical, palliative care, and mental health issues that agencies and organizations at each level of a disaster response should address. Please note: this report is not intended to be a detailed guide to emergency preparedness or disaster response. What is described in this report is an extrapolation of existing incident management practices and principles. Crisis Standards of Care is a seven-volume set: Volume 1 provides an overview; Volume 2 pertains to state and local governments; Volume 3 pertains to emergency medical services; Volume 4 pertains to hospitals and acute care facilities; Volume 5 pertains to out-of-hospital care and alternate care systems; Volume 6 contains a public engagement toolkit; and Volume 7 contains appendixes with additional resources.
Download or read book Crisis Standards of Care written by and published by . This book was released on 2014 with total page 7 pages. Available in PDF, EPUB and Kindle. Book excerpt: At the April 2014 Preparedness Summit in Atlanta, Georgia, the Institute of Medicine's Forum on Medical and Public Health Preparedness for Catastrophic Events hosted a session to further the work on Crisis Standards of Care (CSC) and the fair and ethical allocation of scarce resources during a medical or public health emergency. The purpose of this learning session was to share lessons and examples from communities who have been working on developing their plans and to provide a venue allowing participants to discuss challenges they experienced or are anticipating as they begin this type of planning in their own communities. After hearing lessons from various perspectives including state health, local health, health care coalitions, and emergency medical services (EMS), participants had discussions on specific challenges and opportunities for advancement within different disciplines. The discussions highlighted the critical role key stakeholders and facilitators play in developing CSC frameworks within each discipline, and how integrating medical surge plans into the emergency management system could improve disaster preparedness.
Download or read book Secondary Analysis of Electronic Health Records written by MIT Critical Data and published by Springer. This book was released on 2016-09-09 with total page 435 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book trains the next generation of scientists representing different disciplines to leverage the data generated during routine patient care. It formulates a more complete lexicon of evidence-based recommendations and support shared, ethical decision making by doctors with their patients. Diagnostic and therapeutic technologies continue to evolve rapidly, and both individual practitioners and clinical teams face increasingly complex ethical decisions. Unfortunately, the current state of medical knowledge does not provide the guidance to make the majority of clinical decisions on the basis of evidence. The present research infrastructure is inefficient and frequently produces unreliable results that cannot be replicated. Even randomized controlled trials (RCTs), the traditional gold standards of the research reliability hierarchy, are not without limitations. They can be costly, labor intensive, and slow, and can return results that are seldom generalizable to every patient population. Furthermore, many pertinent but unresolved clinical and medical systems issues do not seem to have attracted the interest of the research enterprise, which has come to focus instead on cellular and molecular investigations and single-agent (e.g., a drug or device) effects. For clinicians, the end result is a bit of a “data desert” when it comes to making decisions. The new research infrastructure proposed in this book will help the medical profession to make ethically sound and well informed decisions for their patients.
Download or read book The Virtues in Medical Practice written by Edmund D. Pellegrino and published by Oxford University Press. This book was released on 1993-11-11 with total page 222 pages. Available in PDF, EPUB and Kindle. Book excerpt: In recent years, virtue theories have enjoyed a renaissance of interest among general and medical ethicists. This book offers a virtue-based ethic for medicine, the health professions, and health care. Beginning with a historical account of the concept of virtue, the authors construct a theory of the place of the virtues in medical practice. Their theory is grounded in the nature and ends of medicine as a special kind of human activity. The concepts of virtue, the virtues, and the virtuous physician are examined along with the place of the virtues of trust, compassion, prudence, justice, courage, temperance, and effacement of self-interest in medicine. The authors discuss the relationship between and among principles, rules, virtues, and the philosophy of medicine. They also address the difference virtue-based ethics makes in confronting such practical problems as care of the poor, research with human subjects, and the conduct of the healing relationship. This book with the author's previous volumes, A Philosophical Basis of Medical Practice and For the Patient's Good, are part of their continuing project of developing a coherent moral philosophy of medicine.
Download or read book Surgical Ethics written by Laurence B. McCullough and published by Oxford University Press, USA. This book was released on 1998 with total page 417 pages. Available in PDF, EPUB and Kindle. Book excerpt: This is the first textbook of surgical ethics. It is a practical, clinically comprehenive, well-organized guide to ethical issues in surgical practice, research, and education written by leading figures in surgery and bioethics. The authors cover the surgeon-patient relationship, the full range of surgical patients, surgical education and research, and surgery and managed care. Their chapters are not abstract discussions of ethical principles; rather, they connect directly with the everyday concerns of practicing surgeons.
Download or read book Healthy Resilient and Sustainable Communities After Disasters written by Institute of Medicine and published by National Academies Press. This book was released on 2015-09-10 with total page 535 pages. Available in PDF, EPUB and Kindle. Book excerpt: In the devastation that follows a major disaster, there is a need for multiple sectors to unite and devote new resources to support the rebuilding of infrastructure, the provision of health and social services, the restoration of care delivery systems, and other critical recovery needs. In some cases, billions of dollars from public, private and charitable sources are invested to help communities recover. National rhetoric often characterizes these efforts as a "return to normal." But for many American communities, pre-disaster conditions are far from optimal. Large segments of the U.S. population suffer from preventable health problems, experience inequitable access to services, and rely on overburdened health systems. A return to pre-event conditions in such cases may be short-sighted given the high costs - both economic and social - of poor health. Instead, it is important to understand that the disaster recovery process offers a series of unique and valuable opportunities to improve on the status quo. Capitalizing on these opportunities can advance the long-term health, resilience, and sustainability of communities - thereby better preparing them for future challenges. Healthy, Resilient, and Sustainable Communities After Disasters identifies and recommends recovery practices and novel programs most likely to impact overall community public health and contribute to resiliency for future incidents. This book makes the case that disaster recovery should be guided by a healthy community vision, where health considerations are integrated into all aspects of recovery planning before and after a disaster, and funding streams are leveraged in a coordinated manner and applied to health improvement priorities in order to meet human recovery needs and create healthy built and natural environments. The conceptual framework presented in Healthy, Resilient, and Sustainable Communities After Disasters lays the groundwork to achieve this goal and provides operational guidance for multiple sectors involved in community planning and disaster recovery. Healthy, Resilient, and Sustainable Communities After Disasters calls for actions at multiple levels to facilitate recovery strategies that optimize community health. With a shared healthy community vision, strategic planning that prioritizes health, and coordinated implementation, disaster recovery can result in a communities that are healthier, more livable places for current and future generations to grow and thrive - communities that are better prepared for future adversities.
Download or read book Crisis Standards of Care written by Institute of Medicine and published by National Academies Press. This book was released on 2010-01-22 with total page 175 pages. Available in PDF, EPUB and Kindle. Book excerpt: During a wide-reaching catastrophic public health emergency or disaster, existing surge capacity plans may not be sufficient to enable health care providers to continue to adhere to normal treatment procedures and follow usual standards of care. This is a particular concern for emergencies that may severely strain resources across a large geographic area, such as a pandemic influenza or the detonation of a nuclear device. Under these circumstances, it may be impossible to provide care according to the standards of care used in non-disaster situations, and, under the most extreme circumstances, it may not even be possible to provide basic life sustaining interventions to all patients who need them. Although recent efforts to address these concerns have accomplished a tremendous amount in just a few years, a great deal remains to be done in even the most advanced plan. This workshop summary highlights the extensive work that is already occurring across the nation. Specifically, the book draws attention to existing federal, state, and local policies and protocols for crisis standards of care; discusses current barriers to increased provider and community engagement; relays examples of existing interstate collaborations; and presents workshop participants' ideas, comments, concerns, and potential solutions to some of the most difficult challenges.
Download or read book Crisis Leadership written by Ian Mitroff and published by Jossey-Bass. This book was released on 2004 with total page 148 pages. Available in PDF, EPUB and Kindle. Book excerpt: The text presents a systematic, behavioral model that underlies crisis management, showing which personality functions are required for managing and preparing for major crises. The book discusses the extreme importance of Emotional IQ in handling, responding, and preparing for any crisis. Crisis Leadership presents the findings from new national surveys and new concrete, easy-to-understand models for implementing programs of proactive leadership. The combination of models-including a comprehensive look at what happens before, during, and after a crisis-creates a truly integrated and systematic approach.
Download or read book Mass Medical Care with Scarce Resources written by Marc J. Roberts and published by Agency for Healthcare Research & Quality. This book was released on 2007 with total page 184 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations written by Committee on Guidance for Establishing Standards of Care for Use in Disaster Situations and published by . This book was released on 2009-09-23 with total page 160 pages. Available in PDF, EPUB and Kindle. Book excerpt: The influenza pandemic caused by the 2009 H1N1 virus underscores the immediate and critical need to prepare for a public health emergency in which thousands, tens of thousands, or even hundreds of thousands of people suddenly seek and require medical care in communities across the United States. "Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations" draws from a broad spectrum of expertise--including state and local public health, emergency medicine and response, primary care, nursing, palliative care, ethics, the law, behavioral health, and risk communication--to offer guidance toward establishing standards of care that should apply to disaster situations, both naturally occurring and man-made, under conditions in which resources are scarce. This book explores two case studies that illustrate the application of the guidance and principles laid out in the report. One scenario focuses on a gradual-onset pandemic flu. The other scenario focuses on an earthquake and the particular issues that would arise during a no-notice event. Outlining current concepts and offering guidance, this book will prove an asset to state and local public health officials, health care facilities, and professionals in the development of systematic and comprehensive policies and protocols for standards of care in disasters when resources are scarce. In addition, the extensive operations section of the book provides guidance to clinicians, health care institutions, and state and local public health officials for how crisis standards of care should be implemented in a disaster situation.
