(精选)Allocation of Medical Resources in the Lifeboat.pptVIP

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2018-03-21 发布于天津
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(精选)Allocation of Medical Resources in the Lifeboat.ppt

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演示文稿演讲PPT学习教学课件医学文件教学培训课件

Jon Stanger, MD, MDiv, MHS Ethics Chair Contra Costa Regional Medical Center;The Clinician’s “Hippocratic” Ethic; Unrestricted Advocacy Restricted Advocacy Justly Restricted (or Proportional) Advocacy;“Lifeboat” Ethics;;Social Justice in the Lifeboat;True emergency. Alternatives exhausted. Anticipate. Avoid. Plan. Priorities and criteria reflect values. Open public process determines rationing system. Identify constituency. Identify rationing criteria. Avoid “social worth” criteria – unless “instrumental”. Address social justice issues. Identify and involve vulnerable groups. Identify and address special needs. Triage by team without direct care. Clinician advocates for patient within constraints of plan. Retrospective review.;33 year-old housewife with 3 young children and low family income. 27 year-old single, businessman with no children; church leader and active volunteer in community; recently named “Citizen of the Year” in his town. 34 year-old single mother of 2; waitress on welfare. 43 year-old single woman; musician, composer, and conductor of the metropolitan symphony. 37 year-old husband and father of 4 young children; serving 10-year sentence for robbery.;SOFA Scoring to Predict Outcome