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Date: Sept. 24, 2009
Contacts: Christine Stencel, Senior Media Relations Officer
Rebecca Alvania, Media Relations Officer
Luwam Yeibio, Media Relations Assistant
Office of News and Public Information
202-334-2138; e-mail <email@example.com>
FOR IMMEDIATE RELEASE
IOM Provides Guidance on Standards of Health Care for Disaster Situations
"Health care workers pride themselves on giving optimal treatment to all their patients, and are obliged by law and professional ethics to use a high standard of care," said committee chair Lawrence O. Gostin, associate dean and the Linda and Timothy O'Neill Professor of Global Health Law,
According to the committee that wrote the report, crisis standards of care, which involve substantial changes to health care operations and the level of care it is possible to deliver, are put into place out of necessity in response to a disaster situation. Under such circumstances, failing to adopt crisis standards of care -- which include guidance on conserving, substituting, adapting, and doing without resources -- is likely to result in greater death, injury, or illness. Crisis standards-of-care policies and protocols ensure the best health care possible, given the resources at hand.
Some state and local health agencies have made considerable strides in developing crisis standards-of-care policies and protocols, but many have only just begun to address this need. Following the national guidelines recommended by the committee would help ensure states develop protocols within an ethical framework so they are consistent, and would allow coordination and fair allocation of resources during a disaster. Consistency in developing and implementing crisis standards of care is needed between all levels of government and especially between neighboring jurisdictions.
The ethical precepts of medicine still apply during a disaster. Health care professionals must provide the best care they reasonably can to each patient. In conditions of overwhelming resource scarcity, however, clinicians are ethically justified to perform some actions that would not be acceptable under normal circumstances, such as allotting resources to provide treatments preferentially to those patients most likely to benefit. The standards governing health care during a disaster must be seen as fair by both patients and providers, the report says, and health care decisions and implementation must be equitable and transparent. Stakeholders in the community and in the health care professions should be engaged in developing and evaluating local crisis standards of care.
Stronger legal protections are needed for health care providers forced to make difficult decisions during disasters. State health agencies should be legally empowered to institute crisis standards of care in affected areas, and incentives should be in place to support health care providers responding to an emergency, such as legal protections for practitioners and institutions.
Copies of Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations are available from the National Academies Press; tel. 202-334-3313 or 1-800-624-6242 or on the Internet at http://www.nap.edu. Reporters may obtain a copy from the Office of News and Public Information (contacts listed above).
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[ This news release and report are available at http://national-academies.org ]
Board on Health Sciences Policy
Committee on Standards of Care for Use in Disaster Situations
Linda D. and Timothy J. O’Neill Professor of Global Health Law, and
O'Neill Institute for National and Global Health Law
Dan Hanfling, M.D. (vice chair)
Emergency Preparedness and Disaster Response
Inova Health System
Damon T. Arnold, M.D., M.P.H.
Illinois Department of Public Health
Stephen V. Cantrill, M.D.
Emergency Physician, and
Associate Director (retired)
Department of Emergency Medicine
Brooke Courtney, J.D., M.P.H.
Center for Biosecurity of the University of
Asha Devereaux, M.D., M.P.H.
Pulmonary/Critical Care Physician, and
Edward J. Gabriel, M.P.A., AEMT-P
Director, Global Crisis Management
Walt Disney Co.
John L. Hick, M.D.
Associate Medical Director for
Medical Director for Emergency Preparedness
James G. Hodge, J.D., LL.M.
Sandra Day O'Conner
Donna E. Levin, J.D.
Massachusetts Department of Public Health
Marianne L. Matzo, Ph.D.
Frances E. and A. Earl Ziegler Chair in Palliative Care Nursing
Cheryl A. Peterson, M.S.N., R.N.
Director of Nursing Practice and Policy
American Nurses Association
Tia Powell, M.D.
Merritt D. Schreiber, Ph.D.
Senior Manager for Psychological Programs, and
Associate Research Psychologist
Umair A. Shah, M.D., M.P.H.
Bruce M. Altevogt, Ph.D.