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Scarce Resource Allocation During Disasters: A Mixed-Method Community Engagement Study.

E Lee Daugherty Biddison1, Howard S Gwon2, Monica Schoch-Spana3

  • 1Johns Hopkins University School of Medicine, Baltimore, MD.

Chest
|August 14, 2017
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Summary
This summary is machine-generated.

Public values on allocating scarce mechanical ventilators during a pandemic prioritize survival but differ from expert guidance, especially regarding withholding versus withdrawing support. This highlights the need for inclusive policy-making.

Keywords:
allocationdisasterethicsventilator

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Area of Science:

  • Public Health Ethics
  • Disaster Preparedness
  • Resource Allocation

Background:

  • Healthcare providers face ethical dilemmas allocating scarce life-saving resources during catastrophes.
  • Expert panels have addressed ethical principles for resource allocation, but public and clinician input is limited.
  • Understanding public values is crucial for developing equitable crisis standards of care.

Purpose of the Study:

  • To characterize public values on allocating scarce mechanical ventilators during an influenza pandemic.
  • To inform the development of a statewide scarce resource allocation framework.
  • To identify discrepancies between public/clinician values and existing expert guidance.

Main Methods:

  • Utilized deliberative democracy through 15 community engagement forums across Maryland.
  • Involved general public and health/disaster response professionals in small group discussions.
  • Collected data via pre/post-deliberation surveys and facilitator notes.

Main Results:

  • 324 participants engaged in forums.
  • Participants favored prioritizing short-term and long-term survival but not exclusively.
  • Qualitative analysis revealed 10 themes, with significant divergence on withholding vs. withdrawing ventilator support.

Conclusions:

  • Public and clinician values on scarce resource allocation can differ from expert recommendations.
  • Awareness of these value differences is essential for effective policy development.
  • Incorporating public input can lead to more ethically sound crisis standards of care.