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Ethical considerations for decision making regarding allocation of mechanical ventilators during a severe influenza pandemic or other public health emergency

Filetype[PDF-397.89 KB]


  • English

  • Details:

    • Description:
      "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
    • Content Notes:
      prepared by the Ventilator Document Workgroup, Ethics Subcommittee of the Advisory Committee to the Director, Centers for Disease Control and Prevention

      "Disclaimer: This document represents the recommendations of the Advisory Committee to the Director, Centers for Disease Control and Prevention and does not necessarily represent Centers for Disease Control and Prevention views or policy. The document was approved by the Ethics Subcommittee on February 18, 20111 and by the Advisory Committee to the Director on April 28, 2011."

      Includes bibliographical references (p. 23-26).

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