Don’t get infected if you want to live – U.S. hospitals weigh right to refuse Ebola cases

October 2014WASHINGTON The Ebola crisis is forcing the American healthcare system to consider the previously unthinkable: withholding some medical interventions because they are too dangerous to doctors and nurses and unlikely to help a patient. US hospitals have over the years come under criticism for undertaking measures that prolong dying rather than improve patients’ quality of life. But the care of the first Ebola patient diagnosed in the United States, who received dialysis and intubation and infected two nurses caring for him, is spurring hospitals and medical associations to develop the first guidelines for what can reasonably be done and what should be withheld. Officials from at least three hospital systems interviewed by Reuters said they were considering whether to withhold individual procedures or leave it up to individual doctors to determine whether an intervention would be performed. Ethics experts say they are also fielding more calls from doctors asking what their professional obligations are to patients if healthcare workers could be at risk. US health officials meanwhile are trying to establish a network of about 20 hospitals nationwide that would be fully equipped to handle all aspects of Ebola care. Their concern is that poorly trained or poorly equipped hospitals that perform invasive procedures will expose staff to bodily fluids of a patient when they are most infectious. The US Centers for Disease Control and Prevention is working with kidney specialists on clinical guidelines for delivering dialysis to Ebola patients. The recommendations could come as early as this week.
The possibility of withholding care represents a departure from the “do everything” philosophy in most American hospitals and a return to a view that held sway a century ago, when doctors were at greater risk of becoming infected by treating dying patients. “This is another example of how this 21st century viral threat has pulled us back into the 19th century,” said medical historian Dr. Howard Markel of the University of Michigan. Some ethicists and physicians take issue with the shift. Because the world has almost no experience treating Ebola patients in state-of-the-art facilities rather than the rudimentary ones in Africa, there are no reliable data on when someone truly is beyond help, whether dialysis can make the difference between life and death, or even whether cardiopulmonary resuscitation (CPR) can be done safely with proper protective equipment and protocols. Such procedures “may have diminishing effectiveness as the severity of the disease increases, but we simply have no data on that,” said Dr. G. Kevin Donovan, director of the bioethics center at Georgetown University. Donovan said he had received inquiries from fellow physicians about whether hospitals should draw up lists of procedures that would not be performed on an Ebola patient. “To have a blanket refusal to offer these procedures is not ethically acceptable,” he said he told the doctors. –Guardian
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7 Responses to Don’t get infected if you want to live – U.S. hospitals weigh right to refuse Ebola cases

  1. Janice says:

    Ok.  I promised not to respond/comment anymore. America is getting this Ebola thing under control.  No more hysteria or panic. Now its just anger…

    The NY doctor has tested positive for Ebola.  I pray he recovers quickly & that NO one else tests positive because of him.   How utterly reckless & arrogant of him.  As a medical professional working with Doctors Without Borders…he knew better.

    When will automatic/immediate quarantine kick in for ANYONE traveling from an Ebola Hot Zone?   You’d think that a health care worker w /direct Ebola contacts in Africa would not be permitted to wander the city…until symptomatic?!    Now they’re back to contact tracing. How far back…to Brussels?     Aw come on!

    This healthcare professional didn’t even self quarantine.  He’s out & about taking Uber cabs to
    a bowling alley and who knows where else.   On the other hand… a family of 6 returning Africans  were flagged at the airport and issued quarantine orders for 21 days in Connecticut, along w/3 others.   

    It should be mandatory that ANYONE returning from an affected area should be officially quarantined & monitored for 21 days.    How many other returning healthcare workers, NGO contract workers, businessmen/employees are currently wandering around our cities…with no orders to self isolate?  

    This doctor should have never been permitted to leave the airport except for supervised transport home w/self-quarantine orders pending monitoring & 21 days with no symptoms.    

    Those coming from Hot Zones for any reason…of any race… have potentially placed themselves & the public at risk.   Ebola knows no racial, ethnic or country of origin  boundaries.  All Hot Zone travelers should be suspect, quarantined & monitored.  No special treatment or exemptions.  Period.  

    This was not an abundance of caution. We’ve got a swiss-cheese, drive a Mack truck through it, arbitrary,  airport flagging process.  This is no way to contain Ebola.  We continue to be stupid.

    Like

    • niebo says:

      Hey, Janice, let’s start with the definition first:

      Above-and-beyond stupid; unsurpassably stupid; unbelievably stupid; insanely stupid; champion stupid; stupid “squared” (with the superscript 2 . . . which I cannot replicate here), aka “exponential stupid” and/or “geometric stupid”; uber stupid; stupid-perfect: STOOPID.

      My word, not in any dictionary, but please feel free to use at your discretion during moments of extreme frustration at wreckless stoopidity.

      Like

      • Janice says:

        All of your above definitions are spot on. But at least NJ & NY have Now moved to mandatory quarantine of some higher risk travelers. That a slow start.

        Like

  2. Judy Clarke says:

    To tell you the truth, Ebola patients should not be in public hospitals at all, there should be large quarantine stations erected for this, away from the mainstream public and fenced in.

    Like

  3. Elle says:

    Refusing to care for one person with the illness will be the same as throwing a match in a dry brittle forest, it will be a wild fire that they will never get control of. Mark my words, that one person will give the world something to write in the history books they’ll never forget. Love and compassion are keys, any situation with out them are useless.

    Like

    • Janice says:

      I’d go with love, compassion & self preservation. The ultimate in caring includes self.  If the compassionate failed to “care” for themselves…who will be left?  Maybe I misunderstood your post?

      Like

    • Yellow Bird says:

      i agree elle… should our time come to experience this horror personally, we are called by our Great Creator HIMself to do whatever each individually can to stand in the gap for one another.
      Nake Nula Waun.

      Like

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