Wednesday, September 23, 2009

Welcome To Triage

"Flu Nightmare: In Severe Pandemic, Officials Ponder Disconnecting Ventilators From Some Patients." No, that's not a Facebook entry from Sarah "death panels" Palin. Instead, that's the headline put up by the blue-chip investigative outfit, Pro Publica:

With scant public input, state and federal officials are pushing ahead with plans that -- during a severe flu outbreak -- would deny use of scarce ventilators by some patients to assure they would be available for patients judged to benefit the most from them.

The plans have been drawn up to give doctors specific guidelines for extreme circumstances, and they include procedures under which patients who weren’t improving would be removed from life support with or without permission of their families.

Pro Publica, helmed by Paul Steiger, the former managing editor of The Wall Street Journal, is funded by private donors, so it is not in the business of sensational headlines to sell papers. So when one of Steiger's team members, Sheri Fink, writes, people should take heed:

Many of the draft guidelines, including those drawn up by the Veterans Health Administration, are based in part on a draft plan New York officials posted on a state web site two years ago and subsequently published in an academic journal. The New York protocol, which is still being finalized, also calls for hospitals to withhold ventilators from patients with serious chronic conditions such as kidney failure, cancers that have spread and have a poor prognosis, or "severe, irreversible neurological" conditions that are likely to be deadly.

There's no way to know if any of this will happen, but the Pro Publica report is a window into the triaged future we seem to be heading towards.

For those who say, "It can't happen here," well, maybe it will.

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