Overview Planning, preparedness, and response to an influenza pandemic involve balancing potentially conflicting individual and community interests. In crisis situations, the enjoyment of individual human rights and civil liberties may have to be limited in the public interest. However, efforts to protect individual rights should be part of every policy. Measures that limit individual rights and civil liberties must be necessary, reasonable, proportional, equitable, non-discriminatory, and in full compliance with national and international laws. Pandemic planning should include details that address expectations concerning staffing. If a plan is written that expects healthcare workers to “volunteer” during a pandemic event this should be expressly documented in the plan and discussed beforehand. Instructions Discuss the feasibility of mandating healthcare workers to report for duty and treat potentially infected patients during a pandemic. Do governments and employers have a right to mandate this? To what extent can healthcare providers be expected to tolerate a risk of infection that might possibly be fatal to themselves or their families? Answer the following questions in your initial post: 1. Describe and experience you have had regarding ethical decisions made by staff which conflict with agency prerogatives. How might agencies and staff resolve these dilemmas? 2. Review the following case study: Then comment as to whether you support Hospital A or B’s decision. How did you arrive at your decision? How does this potential issue impact the role of an emergency manager? The context is as follows. An influenza pandemic has been underway for 6 weeks, and the health care system has been burdened beyond capacity, with every hospital bed full, every ventilator in use and all health care providers working extended shifts. To increase the number of beds to accommodate the surge of influenza patients, all scheduled operations have been postponed for the past 2 weeks. The postponed procedures include diagnostic and palliative operations for patients with pancreatic cancer, ovarian cancer, and malignant brain tumors. The expected survival of many of these patients is less than 6 months, but, without an immediate operation, they will probably die within 2 weeks. As a result of the pandemic, medical resources are scarce, and the usual critical care that would follow such operations could not be provided to all those who need it. Hospitals throughout the country are independently making decisions to modify the standards of critical care in order to provide limited interventions and processes for many additional patients. Hospital A decides to provide critical care according to the usual standards on a first-come, first-served basis. Hospital B decides to provide important critical care interventions only to those patients who are expected to survive for more than 6 months. A surgeon, Dr. Smith, deeply opposes hospital B’s decision. This new rule requires that Dr. Smith cancel bowel obstruction surgery was scheduled for later in the week. Without surgery, his patient, a 36-year-old mother of three with ovarian cancer will die within 2 weeks. Dr. Smith is considering whether to perform the operation in violation of hospital rules, potentially risking his career. In light of this disagreement with recent hospital policies, Dr. Smith is torn between his professional mission to use his skills and expertise to help the patients who need him and his obligation to observe the rules of his institution ( Levine et al. 2009). Reference: Levin D, Cadigan RO, Biddinger PD, Condon S, Koh HK, on behalf of the Joint Massachusetts Department of Public Health – Harvard Altered Standards of Care Working Group (2009) Altered standards of care during an influenza pandemic: identifying ethical, legal, and practical principles to guide decision making. Disaster Med Public Health Preparedness 3(Suppl 2):S132 – 40. First, you will share your initial discussion post based on the assignment guidelines. • Submit an analysis • Use course content and external sources to support your thoughts. o Cite using APA style • Write a 500 – 750 word-initial discussion post • Please be sure to provide references to the peer-reviewed literature. For graduate-level scholarship this is a requirement. I am looking for you to go beyond the assigned readings and use the literature to support your conclusions and analysis. At the graduate level, we are not able to simply assert our opinions but it must be linked to the theories and supported by scholarly work. For this class, in particular, I would like you to support your analysis with the most current literature possible. Use of external non-peer reviewed sources can also be utilized in conjunction with your peer-reviewed sources such as government websites and think tanks. • A minimum of 2-3 references from academic peer-reviewed journals is required
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