Medicine of the Future in America

Care of the Critically ill and Injured During Pandemics and Disasters: Conclusion

Care of the Critically ill and Injured During Pandemics and Disasters: ConclusionPolitical careers have failed and governments have fallen when response to a disaster has been inadequate. If one resource is limited with adverse patient outcomes in one region while it is freely available in another region, patient care will be grossly inequitable. Despite excellent care delivery in these settings, population mistrust of health-care providers will occur and the high-quality response of front-line critical care providers will be greatly undermined. This mistrust will herald a larger collapse of the health system and eventually of the community. These principles are currently prevalent in West Africa, where the health-care community is seen as the source of the Ebola spread, and governments and health-care institutions are deemed inept, ineffectual, and a hindrance to good care. Thus, patients avoid the health-care system, further carrying and spreading disease. The effort of the Task Force to address inequity during disaster response, from resource allocation triage to care of special, vulnerable populations, is a massive step toward correcting these inequities at times of greatest stress on the health-care system.
While tackling the broad subject of mass critical care in a disaster, the Task Force perfectly balanced the individual with society, ultimately supporting the importance of justice. Any government official, politician, public health expert, or policy expert should incorporate these recommendations into disaster planning to ensure optimal patient outcomes in an equitable fashion. John Rawls, in A Theory of Justice, describes how individuals who make choices about society (eg, politicians) should consider resources concretely, because these resources, such as income, wealth, liberty, and opportunity, are ultimately the social basis for self-respect. Every person, regardless of circumstances, should have an equal right to the most extensive system of liberties. From an extreme paucity of evidence-based medicine, the Task Force has ultimately created a foundation of disaster response for the critically ill that provides justice to the most adversely affected patients. In the current literature, there is no guideline, recommendation, study, or consensus statement that can claim such a feat, and thus, the work of the Task Force is unparalleled.

This entry was posted in Care and tagged critical care, critically ill patients, health care.
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