RSS Feeds
Ethical Issues and the Allocation of Scarce Resources During a Public Health Emergency
- Tia Powell, MD;
- Guthrie Birkhead, MD, MPH; and
- Kelly Christ, MHS
- From Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10467; New York State Department of Health and School of Public Health, University at Albany, Albany, NY 12237; and New York City Department of Health and Mental Hygiene, New York, NY 10038.
TO THE EDITOR:
White and colleagues (1) offer an interesting and useful critique of existing proposals for allocating critical care resources in public health disasters. We comment as drafters of the New York proposal cited by these authors, a group that included numerous ethicists, clinicians, and public health experts and developed an ethical framework to guide allocation principles. The differences in the specific recommendations about allocation are testimony to the difficulty of translating ethical principles into concrete actions in the clinical realm. For instance, we use exclusion criteria before applying a Sequential Organ Failure Assessment (SOFA) score, thus barring patients with severe comorbid conditions from receiving ventilators in …
