Medical ethics experts identify, address key issues in H1N...(latives: 57% agreed that caring for a fa...),Health

A related paper dedicated to their legal obligations says health care providers (HCPs) who breach the "duty to care," causing a patient to suffer an injury or loss, may be guilty of negligence and forced to pay damages.

"There has been limited case law, literature, and legislation on what a HCP's legal duty to care is during a pandemic," the authors say. "HCPs can gain insight into their obligations by informing themselves about the general legal doctrines developed in non-pandemic cases and legislation."

Priority setting

The JCB papers say a major pandemic will demand difficult ethical choices related to ventilators, vaccines, antivirals and other resources. Who should get the last bed and ventilator in an intensive care unit, for example: an accident victim suffering a severe but potentially reversible brain injury or a nurse who contracted the flu while caring for patients in the hospital?

Should resources be allocated to save the most lives or to give everyone a fair chance at survival? Should special consideration be given to vulnerable populations in determining access to resources? Who should make these allocation decisions?

The authors say some of the ethical goals of priority-setting involve legitimacy, fairness and equity. Public participants in JCB research, meanwhile, identified three considerations in priority-setting decisions: need, survivability, and social value.

Need was described as giving resources to those most sick or those directly responsible for the care of others (such as elderly parents). Participants also suggested that scarce resources be given to individuals most likely to benefit and survive, and that consideration be given to the social value of health care workers, police officers or others integral to a functioning society in a pandemic crisis.

Those surveyed seem
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