CARE FOR A DISASTER AND NORMAL ETHICAL STANDARDs

CARE FOR A DISASTER AND NORMAL ETHICAL STANDARDS

Introduction

Mass casualty disasters have driven health care and public health institutions to create and enhance emergency preparation standards for disaster response. Ethical guidelines and legal and medical standards are increasingly common components of disaster response plans. While public health preparation initiatives have increased their focus on  Critical standards of care ( CSCs )in recent years, CSC plans have been implemented seldom in the United States. However, some components are widespread (e.g., triage is used in US emergency departments regularly). On the other hand, nations outside the United States more frequently use CSCs in response to natural disasters or humanitarian crises, which may provide considerable insight into crisis response ethics for US-based practitioners.

Ethics in disaster medicine examines ethical challenges and issues during natural and artificial catastrophes. Disaster ethics is a vast discipline because it encompasses a variety of subjects ranging from individual to collective ethics; nonetheless, it is primarily concerned with macro-ethics rather than micro-ethics. Typically, disaster ethics is handled in three stages: Pre-disaster (pre-event) or preventative phase; disaster (event/crisis) and early reaction phase; and post-disaster (post-event) or rehabilitation phase.

Ethical Considerations and Issues and how they affect the practice of care

During Disaster Preparedness

Protection of safety, health, and well-being through harm reduction and benefit promotion. The result of During an emergency, planning actions should safeguard the health and reduce the extent of death, injury, disease, disability, and suffering.

Egalitarian liberty and human rights Preparedness activities should be planned so that they respect each person's equal liberty, autonomy, and dignity.

Accountability to the public. Preparedness initiatives should be founded on and involve participatory and transparent decision-making procedures that foster public confidence.

Disaster Mitigation

Justice: The most vulnerable individuals must be treated equitably. As stated in Wisconsin's 2009 State Expert Panel on Ethics of Health Care Disaster Preparedness statement, equitable resource allocation is guided by the notion of "community larger good." Not every need will be satisfied in the aftermath of a calamity. Regardless of the degree of care provided, all individuals should be treated with decency and respect.

Transparency: The strategy should be developed in collaboration with personnel, local and regional health care facilities, and community resources. Establish a method for stakeholders to provide feedback and opinions on the disaster plan. Inform it of any requirements that may or may not be satisfied. Individuals engaged must understand that strategies are evidence-based.

Accountability: We have a responsibility to respond as health care practitioners. As a facility, are staff expectations documented and communicated to employees? Are there repercussions for non-response?

Disaster Response

Triage - Triage assigns patients to treatment based on criteria, often based on their medical prognosis. It is the primary technique by which emergency departments in the United States and other countries regulate patient flow and plays a critical role in domestic catastrophe response.

In instances where triage necessitates classifying cases according to some criteria, repeat triage refers to the concept that health professionals (and patients) may be expected to review clinical and resource conditions during disasters continuously. This may have resulted (and has resulted) in a reallocation of treatment interventions.   The concept of "withdrawing" from intervention to transfer a resource to another is relatively unknown outside of disaster planning circles in the United States. Still, it is increasingly prevalent in international disaster relief. It is, nonetheless, crucial to a large number of academic and practitioner debates about CSCs, particularly in the ethical literature.

2. Resource Allocation — personnel at long-term care institutions must understand what resources are available in a crisis and who will receive them in the event of a shortage. Staff, concentrators, oxygen tanks; drugs, including antiviral and IV fluids; personal protection equipment, food and water, utilities, and transportation are just a few supplies that may be short in long-term care during a crisis.

The rationale for the transition from routine care to a triage environment

Respect for Autonomy: People rule themselves and make their own decisions. But there are two ways to look at autonomy. In paternalism, an authority prioritizes a dependent's best interests over their wants.

A libertarian perspective on autonomy is also possible. This viewpoint puts the patient's wishes before their own. Justice: Under the justice ethical concept, acts should be fair to all parties

Moral Theories People frequently choose an ethical philosophy based on their life experiences.

Deontology: According to deontological philosophy, humans should analyze ethical dilemmas based on their commitments and duties

Utilitarianism: To a utilitarian, the ethically correct decision is the one that benefits the most people. Act utilitarianism is doing what helps the most people, regardless of personal sentiments or society restraints like laws.

Rights are preserved and given priority in the rights ethical philosophy. Rights are regarded as ethically legitimate and valid because they are widely accepted.

An ethical issue is compared to previous ethical difficulties and their outcomes. This helps you assess the problem and propose the best solution based on others' experiences.

An activity that deviates from a person's norm is judged as a virtue. When assessing unethical conduct, it considers a person's values, reputation, and motive. The climax of all the rationales is beneficence.

Conclusion

The standard of care establishes the appropriateness of health care practitioners' conduct. It makes no recommendations about the steps that a practitioner should take. Defined, an individual's actions are appropriate if they are consistent with the actions taken by a reasonable and sensible physician in the same or similar circumstances. If the conditions alter, the steps will change as well. As a result, the existing standard is applicable in all cases. 

References

Leider, J. P., DeBruin, D., Reynolds, N., Koch, A., & Seaberg, J. (2017). Ethical Guidance for Disaster Response, Specifically Around Crisis Standards of Care: A Systematic Review. American journal of public health, 107(9), e1–e9. https://doi.org/10.2105/AJPH.2017.303882

Ozge Karadag, C., & Kerim Hakan, A. (2012). Ethical dilemmas in disaster medicine. Iranian Red Crescent medical journal, 14(10), 602–612.