Document Detail


Critical appraisal of: triaging pediatric critical care resources during a pandemic: ethical and medical considerations.
MedLine Citation:
PMID:  20453611     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To identify the ethical norms that should govern the allocation of pediatric critical care resources during a pandemic. DESIGN: Narrative review. METHODS: Review the literature on triage and pandemics. FINDINGS: When care that is functionally equivalent to usual patient care practices can no longer be maintained, resources should be allocated primarily on the basis of medical need and/or benefit. Unequal treatment may be justified to increase the supply of available resources and thereby save more lives. When ethically relevant distinctions can no longer be made between patients, resources should be distributed by chance. Allocation on the basis of quality of life, general contributions to society, or age are potentially problematic. Existing triage protocols inconsistently articulate the relationship between these ethical norms and their specific recommendations. In addition, they have limited applicability in pediatrics principally because of the lack of a simple validated global scoring system, which predicts mortality and/or resource utilization. CONCLUSIONS: Although research to develop such scoring systems is ongoing, clinicians will need to rely more heavily on individual diagnoses of acute illnesses with high mortality rates and underlying conditions with short life expectancies and on random allocation methods.
Authors:
Armand H Matheny Antommaria; Jill Sweney; W Bradley Poss
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies     Volume:  11     ISSN:  1529-7535     ISO Abbreviation:  Pediatr Crit Care Med     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-10     Completed Date:  2010-09-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100954653     Medline TA:  Pediatr Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  396-400     Citation Subset:  IM    
Affiliation:
Division of Medical Ethics and Humanities, University of Utah School of Medicine, Salt Lake City, UT, USA. armand.antommaria@hsc.utah.edu
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Child, Preschool
Critical Care*
Disease Outbreaks
Health Care Rationing / ethics*
Health Services Needs and Demand
Humans
Infant
Influenza A Virus, H1N1 Subtype*
Influenza, Human / epidemiology*
Triage / ethics*
United States / epidemiology
Comments/Corrections
Comment In:
Pediatr Crit Care Med. 2010 May;11(3):436-8   [PMID:  20453622 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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