Ethical Considerations During Disasters
A collection of articles looking at ethics and legal issues in disasters.
Files are .pdf unless otherwise noted.

AAP Guidelines on Forgoing Life Sustaining Medical Treatment
Overview of concerns surrounding pediatric resuscitation and prolonged care

AAP Initiation or Withdrawal of Treatment for High-Risk Newborns
Discussion of decision making for intensive therapies for neonates

ABA Checklist for Government Attorneys to Prepare for Disasters
A draft of guidelines for state and local government attorneys

Adapting Standards of Care Under Extreme Conditions: Guidance for Professionals During Disasters
The American Nursing Association's guide for Altered Standards of Care in disasters

AHRQ Altered Standards of Care in Mass Casualty Events
An Agency of Healthcare Research and Quality White Paper

CHEST Journal Supplement: Emergency Mass Critical Care (EMCC) FAQ
CHEST Journal supplement on respiratory emergency preparedness general questions

CHEST Journal Supplement: EMCC Message Points
Overview of recommendations for EMCC 

CHEST Definitive Care for the Critically Ill During a Disaster: Current Capability and Limitations
Introductory document to CHEST Journal Emergency Mass Critical Care (EMCC) supplement

CHEST Definitive Care for the Critically Ill During a Disaster: A Framework for Optimizing Critical Care Surge Capacity
Pre-event guidance for critical care surge preparedness

CHEST Definitive Care for the Critically Ill During a Disaster: Medical Resources for Surge Capacity
Recommendations for specific quantities and types of critical care equipment/supplies, staffing, and treatment space for EMCC

CHEST Definitive Care for the Critically Ill During a Disaster: A Framework for Allocation of Scarce Resources in Mass Critical Care
Guidance for standardized and fair means to distribute scarce critical care resources

Clinical review: Allocating ventilators during large-scale disasters
Minnesotan investigation into ventilator triage

Development of a triage protocol for critical care during an influenza pandemic
An Ontario group proposes SOFA as a method for ventilator triage

Ethical Choices in a Medical Emergency - A Pediatrics Perspective
Bauer, Dooley and Wallington - June 25, 2008

Hospital and Health Systems article on Altered Standards of Care
A discussion of the "graceful degradation" of care necessary in a disaster

Making the Tough Calls: Ethics and Disasters .ppt
A Power Point of Providence Ethicist Dr. Jan Heller's overview of disaster ethics

Technical Recommendations for Pediatric Medical Triage and Resource Allocation in a Disaster - December, 2008
Technical Recommendations for pediatric scarce resource allocation during disasters with appendicies detailing ethical reasoning and frequently asked questions.

NEJM - Dr. Pou and the Hurricane: Implications for Patient Care During Disasters
A story of the fallout from difficult decisions made during hospital evacuations after Katrina.

NYS Workgroup on Ventilator Allocation in an Influenza Pandemic: Planning Document DRAFT
Preliminary plan from the New York Dept. of Health on ventilator triage

NYS Frequently Asked Questions on Ventilator Allocation
A document for the public discussing the NY plan for ventilator allocation.

Physician Obligation in Disaster Preparedness and Response
Exploring professional duties in disaster situations   

Practice Makes Perfect - Even in Ethics
This Power Point presentation from the Catholic Health Association examines many angles on ethics during a pandemic

Public Health Preparedness Laws in Alaska: An Overview .ppt
A clear overview presentation of relevant laws from the State Assistant Attorney General
 
Stand on Guard for Thee: Ethical considerations in preparedness planning for pandemic influenza
A landmark discussion from the University of Toronto

Utah Pandemic Influenza Triage Guidelines DRAFT
Technical recommendations for medical facilities based on SOFA scoring. Basis for MEP-P Technical Recommendations.

Virginia Model for Process to Address Ethical Issues and Altered Standards of Care in a Pandemic
Addresses healthcare delivery, legal and critical infrastructure considerations

WHO's Ethics of Public Health Measures in Response to Pandemic Influenza DRAFT
A comprehensive World Health Organization workgroup discussion

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