Disaster planning and care rationing: Johns Hopkins team asks ‘Whose life would you save?’


A Johns Hopkins research team is building what could become a national model for health providers to use when a disaster occurs by asking the public which patients should take precedence in emergency situations.

A team led by Lee Daugherty Biddison, M.D., a critical care physician at the hospital, has met with people across Maryland to spark discussion on the subject, according to an article in The New York Times. The team will pitch its findings to state officials, according to the report, after sifting through the responses from hundreds of people to questions like “Should age be a factor when considering who to save?” or “Should one patient be bumped off of a potentially life-saving ventilator for another with a better chance of recovery?”

There is already a precedent for rationing in healthcare, as drug shortages cut available supply of medications. Physicians may be hesitant to order a test or prescribe a treatment that may have little effect due to cost concerns, too. But it's important that doctors hear the opinions of patients before developing plans like these, according to Daugherty Biddison. 

She told The Times that she was first inspired to explore the issue after traveling abroad for missionary work. Daugherty Biddison said she came to the realization that even a large system like Johns Hopkins would be faced with crucial, life-or-death decisions if a true pandemic or major natural disaster occurred.

One suggestion from patients is to create a fund in the image of the Susan G. Komen Foundation to pay for care in the event of a disaster. She has also heard arguments in favor of both saving the young and the old, and fiery debate over taking ventilators from some patients to treat others.

Once the protocols are decided, Maryland will join 18 other U.S. states that have such plans in place, according to The Times, and many individual hospitals and health systems. The team is targeting a mid-2017 pitch to state officials.

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