A Chilling Scenario
Governor Arnold Schwarzenegger and the state legislature commissioned a report on how to deal with a massive emergency caused by a natural disaster (in California, that usually means either an earthquake or a huge wild fire), bioterrorism, or a raging pandemic. That report is now out, and the proposals and conclusions are chilling, according to this article in the Sacramento Bee.
Older, sicker patients could be allowed to die in order to save the lives of patients more likely to survive a massive disaster, bioterror attack or influenza pandemic in California.
It's not how nurses and doctors are accustomed to doing things, nor how Californians expect to be treated. But it is part of a sweeping statewide plan being praised for its breadth, even as it rankles providers who will have to carry it out. ...
The 1,900-page document lays the practical – and ethical – groundwork for local and county health departments, hospitals, emergency responders and any able-bodied health care worker likely to be called upon in a catastrophe.
Striking in its specificity and its frank focus on the need to suspend or flex established laws and to ration health care, the plan is being hailed as a model for the rest of the nation. ...
The $5 million plan was developed as a result of Gov. Arnold Schwarzenegger's 2006 health care surge initiative. That $172 million effort included the stockpiling of millions of doses of antiviral medications, thousands of ventilators, mobile field hospitals and extra hospital beds.
But health care officials acknowledge that when and if a global pandemic or major disaster strikes, no amount of extra drugs or supplies will be sufficient to manage the impact on an already strained health care system.
That's why the state assembled public health professionals, hospitals, ethicists, nurses and others to hash out guidelines for procedures they hope will minimize red tape and maximize survival rates.
The procedures envisioned in this doomsday scenario include using veterinarians to set human bones, allowing those with military medic experience to sew up wounds, and waiving specialized training requirements for the use of sophisticated medical machinery such as ventilators. But the report goes beyond that into the realm of decision making which up until now had been unthinkable.
Perhaps the most jarring aspect of the guidelines, though, is the seemingly hard-hearted treatment of some kinds of needy patients.
The plan will allow hospitals to empty beds for higher priority patients, sending ill patients into hallways, make-shift hospitals in tents, nursing homes or even back home.
"Everybody will have to think differently," Dauner said. "Radio, TV and police will direct patients where to go. People will be herded like cats."
Scarce life-saving resources will be rationed under a radically different system of care that puts the good of the larger population over that of the individual patient.
That means that instead of starting with the sickest or most critically injured, treatment will go first to those more likely to survive with immediate intervention. A patient's kidney disease or congestive heart failure could diminish their chances of getting life-saving treatment in such an emergency.
Such decision making goes against every bit of instinct and training of care givers, and nurses especially are aghast at the implications of such a plan. I can certainly understand the anxiety. I am, after all, 61 with a heart problem. Still, I also have to admit that such pragmatic decisions under crisis situations might have to be made, and I understand why the guidelines need to be formulated now, before any such situation arises.
Complicating matters even further is that state governments can't rely on the federal government (FEMA, DHS) for any assistance, as Katrina showed us, and don't have the state national guards to rely on for emergency help. Much of California's National Guard is either in Iraq, or patrolling the border, or so equipment depleted that it could not provide even any short-term assistance.
Mr. Bush's legacy is becoming clearer with each passing day.
Older, sicker patients could be allowed to die in order to save the lives of patients more likely to survive a massive disaster, bioterror attack or influenza pandemic in California.
It's not how nurses and doctors are accustomed to doing things, nor how Californians expect to be treated. But it is part of a sweeping statewide plan being praised for its breadth, even as it rankles providers who will have to carry it out. ...
The 1,900-page document lays the practical – and ethical – groundwork for local and county health departments, hospitals, emergency responders and any able-bodied health care worker likely to be called upon in a catastrophe.
Striking in its specificity and its frank focus on the need to suspend or flex established laws and to ration health care, the plan is being hailed as a model for the rest of the nation. ...
The $5 million plan was developed as a result of Gov. Arnold Schwarzenegger's 2006 health care surge initiative. That $172 million effort included the stockpiling of millions of doses of antiviral medications, thousands of ventilators, mobile field hospitals and extra hospital beds.
But health care officials acknowledge that when and if a global pandemic or major disaster strikes, no amount of extra drugs or supplies will be sufficient to manage the impact on an already strained health care system.
That's why the state assembled public health professionals, hospitals, ethicists, nurses and others to hash out guidelines for procedures they hope will minimize red tape and maximize survival rates.
The procedures envisioned in this doomsday scenario include using veterinarians to set human bones, allowing those with military medic experience to sew up wounds, and waiving specialized training requirements for the use of sophisticated medical machinery such as ventilators. But the report goes beyond that into the realm of decision making which up until now had been unthinkable.
Perhaps the most jarring aspect of the guidelines, though, is the seemingly hard-hearted treatment of some kinds of needy patients.
The plan will allow hospitals to empty beds for higher priority patients, sending ill patients into hallways, make-shift hospitals in tents, nursing homes or even back home.
"Everybody will have to think differently," Dauner said. "Radio, TV and police will direct patients where to go. People will be herded like cats."
Scarce life-saving resources will be rationed under a radically different system of care that puts the good of the larger population over that of the individual patient.
That means that instead of starting with the sickest or most critically injured, treatment will go first to those more likely to survive with immediate intervention. A patient's kidney disease or congestive heart failure could diminish their chances of getting life-saving treatment in such an emergency.
Such decision making goes against every bit of instinct and training of care givers, and nurses especially are aghast at the implications of such a plan. I can certainly understand the anxiety. I am, after all, 61 with a heart problem. Still, I also have to admit that such pragmatic decisions under crisis situations might have to be made, and I understand why the guidelines need to be formulated now, before any such situation arises.
Complicating matters even further is that state governments can't rely on the federal government (FEMA, DHS) for any assistance, as Katrina showed us, and don't have the state national guards to rely on for emergency help. Much of California's National Guard is either in Iraq, or patrolling the border, or so equipment depleted that it could not provide even any short-term assistance.
Mr. Bush's legacy is becoming clearer with each passing day.
Labels: Bush Legacy, California, Health Care
posted by Diane at 9:12 AM
3 Comments:
Sounds like Californians better stary dying their gray hair, as a matter of survival!
Want to look as young as possible.
I guess looking rich might not be a bad idea as well.
Shudder.
jawbone
Civil society in complete breakdown? The streets in total chaos? Anarchy? Rioting? Mass panic? Epidemic? Armed posses? And then how to respond with a health care system that is nowhere nearly ready to address such a gargantuan task?
Well Schucks...
Methinks they've cribbed the entire Gaza health care plan...
"The Gaza healthcare plan." I am so using that. Thanks!
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