Welcome to CDC Stacks | Ethical considerations for decision making regarding allocation of mechanical ventilators during a severe influenza pandemic or other public health emergency - 5961 | Stephen B. Thacker CDC Library collection
Stacks Logo
Advanced Search
Select up to three search categories and corresponding keywords using the fields to the right. Refer to the Help section for more detailed instructions.
 
 
Help
Clear All Simple Search
Advanced Search
Ethical considerations for decision making regarding allocation of mechanical ventilators during a severe influenza pandemic or other public health emergency
  • Published Date:
    July 1, 2011
Filetype[PDF - 397.89 KB]


Details:
  • Corporate Authors:
    Centers for Disease Control and Prevention (U.S.), Ethics Subcommittee of the Advisory Committee to the Director., Ventilator Document Workgroup.
  • Description:
    Preamble -- Introduction -- Key assumptions -- Routine versus emergency practice -- Priorities for ventilator allocation -- What prinicples should guide ventilator allocation? (Basic Biomedical Ethical Principles: Respect for Persons and their Autonomy, Beneficence, Justice; Specific Ethical Considerations: Maximizing Net Benefits, Social Worth, The Life Cycle Principle, Fair Chances versus Maximization of Best Outcomes; Incorporating Multiple Principles -- Who should make ventilator allocation decisions? -- Other considerations (Uniform Decision Criteria versus Local Flexibility; Community Engagement; Obligations to Healthcare Professionals; Provision of Palliative Care; Withdrawal of Patients from Ventilators; Special Considerations Relating to Children -- Conclusions -- References -- Ventilator document workgroup members

    "This document provides ethical considerations that the Ethics Subcommittee of the Advisory Committee to the Director, Centers for Disease Control and Prevention (CDC) proposes to aid in the decision making specific to allocation of mechanical ventilators during a severe influenza pandemic. This document supplements a previous document written by the Ethics Subcommittee, Ethical Guidelines in Pandemic Influenza, and released by CDC in 2007 (1). The 2007 document was developed in response to a request from HHS/CDC that the Ethics Subcommittee address ethical considerations in vaccine and antiviral drug distribution prioritization and in the development of interventions that create social distancing (in discourse on pandemic influenza, often referred to as non-pharmaceutical or community mitigation interventions). After release of the initial ethics document, numerous public health stakeholders requested that HHS/CDC specifically address ethical issues for allocation of mechanical ventilators. This current document is not intended to comprehensively revisit all of the topics and issues promulgated in the 2007 document; instead, it is intended to supplement the initial document. Circumstances and major issues specific to allocation of mechanical ventilators as well as issues which require alternative ethical considerations from that proposed in the original document form the basis for this supplemental document. The intent of this document is to provide decision makers at all levels--federal, tribal, territorial, state, and local--with an overview of the complex ethical landscape associated with decision making about allocation of scarce life-sustaining healthcare resources. This document is not meant to serve as detailed guidance about allocation decisions. Rather it is intended to serve as a conceptual framework to assist the planning process. Planning will need to occur at the state, local, and institutional level to develop specific operational details and implementation steps. Thus, this document will not address how to approach specific allocation decisions, but will instead highlight ethical standards and principles relevant to allocation of ventilators during a severe pandemic or other public health emergency and discusses some of the advantages and disadvantages inherent in different approaches to allocation. Some of the approaches are sufficiently and obviously problematic that we suggest that they not be used to guide decisions. Other approaches have positive and negative aspects that must be considered. In the interest of encouraging broader public deliberation about ethically contested matters, we refrain from making specific recommendations and instead highlight these issues and controversies." - p. 3

  • Supporting Files:
    No Additional Files