Who should MDs let die in a pandemic? Report offers answers
May 5th, 2008 By LINDSEY TANNER, AP Medical Writer(AP) -- Doctors know some patients needing lifesaving care won't get it in a flu pandemic or other disaster. The gut-wrenching dilemma will be deciding who to let die.
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Another question, if these humans are to be left without treatment, are they to be given pain-killers?
Or if not, are they to be permitted to die quickly, in *relative* freedom from suffering?
( that might require providing them with suicide pills, though they would obviously have to take the pills themselves, to make certain that the professionals weren't "killing" anyone )
Or are they simply to be stacked somewhere until they expire?
That /would/ cost the least, wouldn't it?
( no this isn't facetious: consider what has happened in the past, throughout this world's wars, particularly in ethnic-wars, and these sorts of questions must be asked, or they get answered in the maximal-suffering way, by default )
You've got to be kidding. This is where those without health insurance and insufficient health insurance are now.
#2:CPR certification (or re-certification) is not a survey course in triage nor could one consider themselves well versed in the shortcomings of a single-payer system after attending a 4 hour Red Cross class. Sorry.
#3:I can assure you that should such a disaster occur, those who need to will be VERY capable of determining who qualifies to receive care, and who should be de-prioritized for care allotment. While it is hard to imagine for most people in the U.S., this is something that occurs every day on a much smaller scale in the form of allocating OR time, ER beds, ventilators, etc. In other words, Physicians are 'practicing' for just such an event every day.
#4: This 'rationing' planning is needed due in large part to a paring down of vital resources and equipment by PRIVATE COMPANIES in order to streamline healthcare delivery. One cannot argue that we have a greater 'surge capacity' as a result of managed care. Trust me, whether our healthcare system is private or government run, in a pandemic, there will NEVER be enough 'stuff' for everyone, but given our current system, we are all gravely underequiped.
Triaging patients has been a key strategy in allocating limited resources since WWI. There's nothing at all shocking here.
At our major public research hospital/medical center (the largest in our region) for the hundred thousand people in the immediate area and the millions within an hour long drive from here, do you know how many beds we have? Well under a thousand. Do you know how many are ALREADY in use at any given time? 85% or more.
Each of those beds costs $1M to $2M to construct. Running a well equipped facility at 50% occupancy isn't an option for _any_ hospital, public or private, in any country, regardless of whether it's a single payer system or not.
This rationing would (will) be needed in any country, in any hospital. Yes, we've got surge capacity in an emergency, but it's simply impossible to equip yourself to treat everyone in a pandemic where >10% of the population needs to be in a million dollar hospital room.
Calling this a failure of the single-payer system is beyond ridiculous.
It won't matter what your ailment, you won't be treated past a certain stage of critical care demand (easily surpassed in a bad seasonal 'flu year).
Don't sweat the concept of treating incarcerated patients; you get a virus with the case fatality rate like SARS or H5N1, in crowded quarters with various viral diseases and a decided lack of vitamin D - trust me, it won't be an issue.