# 436
In an article in tomorrow's Sunday Times, Sarah-Kate Templeton, their Health Correspondent takes on the subject of the dangers doctors will face during a pandemic, stemming from patient's relatives, not from the virus.
February 11, 2007
Bird flu doctors could be given military guards
Sarah-Kate Templeton, Health Correspondent
DOCTORS treating victims of avian flu may need security guards and even military protection to shield them from violent relatives should they be forced to choose which dying patients to treat and which to turn away during a pandemic, a government committee has warned.
The elderly, patients who have long-term health problems and those who are least likely to survive will be at the end of the queue and might be denied life-saving treatment.
The draft report by the critical care contingency planning group, a joint committee between the Department of Health and the Intensive Care Society, warns that relatives could resort to violence when they are told their loved one is not considered a high enough priority to receive care.
This is a subject I touched on briefly last November here, and have mentioned several other times in the past. Given the stresses inherent in a pandemic situation, one that could drag on for months, the potential for violence will be enhanced.
How will parents accept the news that their are no beds, or ventilators, or perhaps even any antivirals available for their sick children? To be told that they must carry their deathly ill child back home, and do the best they can, and pray for a miracle?
This news article glosses over the worst-case scenario, and makes it sound like the choice will be between saving children and the elderly. But in a severe pandemic, the choice could well become, which child do we save? Some will likely go without treatment.
The report says: “Additional security measures (possibly including military protection) may be necessary because of the risks of violence directed at staff making triage decisions.”
In a western country, where the assumption is that proper medical care will be there when you need it, the concept of triage can be hard to grasp. It's done, of course. At accident scenes where there are multiple injuries and in emergency waiting rooms, but nothing on this scale.
The closest thing people can equate it to today would be waiting for a donor organ. Each year, thousands of people on the list die before an organ becomes available. In a pandemic, people would be waiting for a ventilator, or a hospital bed, in much the same way.
Here in the US, there are between 105,000 and 120,000 ventilators available. Most are already in use. The government estimates during a pandemic, up to 750,000 could need a ventilator. Obviously, a great many will go without.
There will be heartbreaking decisions to be made regarding who gets a ventilator, and when you decide to remove someone from that life support to make room for a more viable patient. Medical ethicists are working on guidelines as to how best to handle this, but there are no clear answers.
Regardless of what they decide, relatives and loved ones will be unlikely to understand, and are apt to direct their anger towards the most visible target: the doctor who must make that call.
While they are at it, authorities need to be thinking about protection for ambulance crews, too. They will be placed in much the same position; called out to the scene, and forced to refuse to transport to already overfilled hospitals.
Just another ugly ramification of a pandemic, should one come. But one we need to address now, before it happens.
