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Examining Standards of Care in Disasters

Following the terrorist attacks of September 11, 2001 in the United States, experts began to re-examine current approaches to providing care during disasters. A definitive standard of care for disaster victims has yet to emerge. One popular approach that has been proposed is to create “crisis” or “altered” care standards. These are meant to reduce the legal standard or duties of care for medical responders. In the  Annals of Emergency Medicine, George J. Annas, JD, MPH, and I published an article that attempted to explain why altering the standard of care for disaster situations is both unnecessary and dangerous. Reason & Prudence During Disaster Considering that resources are limited during disasters, patients must be managed as a population rather than as individuals to maximize outcomes for that particular group of people. To determine the best approach, it’s critical that specific metrics or standards of care are used to assess the actions of physicians. Efforts must be made to ensure that these standards of care remain the same in disasters as they would for normal situations. While the circumstances may change based on the event, the metric or standard should remain the same: to perform the same actions that reasonable and prudent physicians would do in similar situations. During disasters, physicians could and should ration care and allocate resources to patients who stand to benefit most. The ultimate goal is to maximize survival. By using the reasonable and prudent metric, disaster victims will receive the same standard of care as any other person. Squelching Fears of Liability The fear of liability is a real concern in establishing a standard of...
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