Who Would You Save? New Study Takes a Look at Healthcare Disaster Planning

According to a Johns Hopkins press release, a new study is focusing on community values and opinions when it comes to allocating resources in healthcare disaster planning, namely life-saving ventilators in the event of a flu pandemic.

“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,” said Elizabeth L. Daugherty Biddison, MD, MPH, vice chair for clinical operations in the Department of Medicine, Johns Hopkins School of Medicine.

Biddison is the principal investigator on the study, which used public engagement with Maryland residents to gain community perspective.

“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,” said Biddison.

Biddison is collaborating with colleagues from the Johns Hopkins Berman Institute of Bioethics, Carnegie Mellon University and the University of Pittsburgh Medical Center to explore the “deliberative democratic methods” typically used to understand how the public views potential policy changes. They ran a pilot study which consisted of two community meetings: one in Howard County which is top among the state’s county health rankings, and one in a neighborhood near Johns Hopkins Hospital in inner Baltimore City, which ranks last in the state.

“We found that participants’ ethical perspectives were framed in large part by their place-based life experiences,” said Ruth R. Faden, PhD, MPH, a member of the research team.

“Our results thus far underscore the importance of broad and diverse community input, to capture more fully the issues that matter to people of various backgrounds.”

The study used the community meetings to gather information on people’s views in regard to policy issues like marriage equality, regional tax sharing and economic development.

According to the study results, the Baltimore City group had significant discussions about whether certain people should be disqualified from access to ventilators, such as convicted felons and undocumented immigrants. The Howard County group were concerned about the potential for bias in decision-making when it comes to choosing who gets to use the ventilators. They were also concerned with the amount of time that might be spent making those decisions, and if someone might die while waiting for an answer.

The study states, “The differences reflected distinct ways of thinking about the issues. This finding underscores the importance of achieving a diverse, regionally varied sample of Marylanders.”

The project is set to expand across the state to gain more of this diverse feedback from citizens, so “health authorities and elected officials will be better prepared both to shape and to communicate the content of Maryland’s future framework in meaningful ways,” said the study.

Biddison said the statewide version of the study will have at least 10 forums, five for community members and five for healthcare professionals. The results will be given to Maryland health officials to be applied to the state’s policy on healthcare resource allocation in disasters.


For the original Johns Hopkins press release, click here: http://www.bioethicsinstitute.org/media/who-should-be-saved