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Title:

The Community Speaks: Understanding Ethical Values in Allocation of Scarce Lifesaving Resources During Disasters

Authors:
Elizabeth L Daugherty Biddison, Howard Gwon, Monica Schoch-Spana, Robert Cavalier, Douglas B White, Timothy Dawson, Peter B Terry, Alex John London, Alan Regenberg, Ruth Faden, Eric S Toner
Date posted:
May 01, 2014
Publication type:
Article
Publication:

Ann Am Thorac Soc 2014;11(5):777-783

Publisher:
American Thoracic Society
DOI:
10.1513/AnnalsATS.201310-379OC
Availability:
Full article on publisher's site
See also:

Press release from Johns Hopkins: http://www.bioethicsinstitute.org/media/who-should-be-saved"

Full article on publisher's site: HTML • PDF

Introduction:

Pandemic influenza or other crises causing mass respiratory failure could easily overwhelm current North American critical care capacity. This threat has generated large-scale federal, state, and local efforts to prepare for a public health disaster. Few, however, have systematically engaged the public regarding what values are most important in guiding decisions about how to allocate scarce healthcare resources during such crises.

The aims of this pilot study were to (1) test whether deliberative democratic methods could be used to promote engaged discussion about complex, ethically challenging healthcare related policy issues, and (2) develop specific deliberative democratic procedures that could ultimately be used in a state-wide process to inform a Maryland framework for allocating scarce healthcare resources during disasters. Using collaboratively developed focus group materials and multiple metrics for assessing outcomes, we held 5-hour pilot community meetings in two locations in Maryland with a total of 68 community members. Most participants were thoughtful, reflective, and invested in this pilot policy-informing process. 

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