BALTIMOREIn the event of a flu pandemic, who should have priority access to life-saving ventilators, and who should make that determination? Few disaster preparedness plans have taken community values regarding allocation into account, but a new study is aiming to change that through public engagement with Maryland residents.
"In the event of a healthcare crisis, understanding the community perspective and having citizen buy-in will be critical to avoid compounding the initial disaster with further social upheaval," says principal investigator Elizabeth L. Daugherty Biddison, MD, MPH, Vice Chair for Clinical Operations in the Department of Medicine, Johns Hopkins School of Medicine.
"When life-saving medical resources become scarce, there are no ideal options, even among ethically-permissible ones. Understanding community perspectives and values will help policy-makers craft guidelines for those difficult choices," Biddison says.
To gain this perspective, Biddison and colleagues from the Johns Hopkins Berman Institute of Bioethics, Carnegie Mellon University and University of Pittsburgh Medical Center are exploring the use of "deliberative democratic methods" typically employed to understand how the public views potential policy changes. A pilot study consisted of two community meetings; one in affluent Howard County, which ranks top among the state's county health rankings, and the other in a neighborhood near Johns Hopkins Hospital in inner Baltimore City, which ranks last. The results were published online ahead of print in April in the Annals of the American Thoracic Society.
"We found that participants' ethical perspectives were framed in large part by their place-based life experiences," says Ruth R. Faden, PhD, MPH, director of the Johns Hopkins Berman Institute of Bioethics, a member of the study team. "Our results thus far underscore the importance of broad and diverse community input, to capture more full
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Johns Hopkins Medicine