Saturday, February 17, 2018

Triaged Medicine, The Veterinary Professions Answer to Who Gets What In Times Of Scarcity.

One of the hot topics on the human side of healthcare is how to manage limited resources in the face of an overwhelming need and critical shortages?

The scenarios range from anything like a massive flu pandemic where things like life saving medications or ventilators are in shorter supply than the demand requires.

Another would be oxygen in areas where natural disaster has hit. Think about a hurricane hitting an island and the power is lost. People need supplemental oxygen for surgery, respiratory disease, infection, burns, etc. What happens when the ability to provide supplemental oxygen is at a place of rationing?

What about food? Shelter? Medications? Or any kind of medical, health or supply that the masses need in a catastrophe? What about epinephrine pens that are now 800 times more expensive than it was a few years ago and needed in seconds to save lives? What about generic drugs that are no longer profitable (enough) to manufacturer but would be basic and life saving on a scale that hundreds of thousands of people might need immediately? Who would be given them if there wasn't enough for everyone?

Would you give it to the children first? The patient with the greatest chance of survival? The patient who provides the greatest contribution to society? Like the doctors? Nurses? Emergency response personnel? Yourself? Your family?

It is a tough thing to answer. It is also a real-life scenario in much of the world.

Does it happen in vet med? Of course. Every single day. Resources are limited. Access is limited. And not everyone gets the best of veterinary care even if it is available and accessible simply because they need it.

It is a common practice to utilize the skills, practice and lessons of another profession when trying to decide the best course of action in a current dilemma. So, why wouldn't human medicine follow our guidelines and protocols for the same set of scenario's?

The same scenarios apply in both human and veterinary medicine, BUT, the compassion is lacking on one side of the care giving side. Veterinarians provide care to those that pay for it. If it was free and available on the same scale to everyone who needed it we would face the same ethical decisions to deciding who gets what when they need it. But alas we don't. It is far simpler to ration based on economics. Cut and dry.

Should it be this way? I am not sure? I think that the reason we on the veterinary side don't provide everything we can to everyone who needs it being simply based on a case of economics limits our ability to understand more complex scenarios. It skews our reasoning skills, our preparation, our sacrifice for a common good. It reduces humanity to individually centered scenarios and decision making trees. It promulgates and promotes self preservation on an individual level. It is impossible to make life saving decisions in mass casualty scenarios when the individual is the source of the lack of compassion on a larger scale.

So the next time you need help ask not what you have access to, ask what you are willing to sacrifice to provide it. Maybe the abandonment of self is the salvation of all?

Resources and Inspiration;

NY Times article, Aug 21, 2016. Whose Lives Should Be Saved? Researchers Ask The Public.

More information on me, this blog, and who we are at Jarrettsville Vet can be found here: is about saving lives, and providing options with data. Let the data set the standard of care and integrity via transparency be the guide.

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