Hospital leadership should consider which of the following ethical dilemmas prior to experienc-ing an actual disaster (select all that apply)?
a. Which clinical leader will make the deci-sion about distribution of scarce resources
b. Criteria to determine which patients re-ceive aggressive treatment and which will receive palliative care
c. Which nursing staff will be the first to re-port to the hospital in the event of a disas-ter
d. How prophylactic pharmaceuticals will be distributed to protect staff and their fami-lies
e. Who will be primarily responsible for ex-ternal communication
A, B, D
An emerging issue that challenges care during a disaster is allocation of scarce resources when the system is overwhelmed. Implementing periodic tabletop discussions regarding how to allocate resources in a time of scarcity will prove to be a powerful tool in setting the stage for what to do if such an event occurs. Collaborative professional staff and hospital leadership discussions about scarce resource allocation will present ethical dilemmas that need to be thoughtfully considered in a planning time that is devoid of emotion. Questions to be discussed at the tabletop include which hospital and/or clinical leader will make the final decision about ventilator allocation and other scarce resource distribution; the criteria used to determine which patients receive aggressive treatment and which will receive palliative care, both imminently and long term, as other life-threatening complications ensue; and how prophylactic pharmaceutical dissemination plans are going to be activated to protect staff and their families.
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