How can hospitals address scarce resources during COVID-19?
School of Arts and Sciences political scientist and LDI Senior Fellow Julia Lynch has created guidelines for hospitals to allocate resources in times of medical scarcity.
After reading Julia Lynch’s latest draft paper, a typical layperson would likely be surprised to realize that despite decades of national concern about terrorists, biological warfare attacks, and dirty bombs, hospitals don’t have an actual how-to guide for deciding how to allocate scarce resources during such catastrophic incidents.
Lynch, an associate professor of political science at the School of Arts and Sciences and an LDI Senior Fellow, realized this a few weeks ago. A colleague from a Michigan health system called her trying to find—or have her create—step-by-step instructions for how to make ongoing scarce resource allocation decisions in hospitals during emergencies like the current coronavirus pandemic.
“The call came in because political scientists like myself set up decision-making rules, and these decision rules were what was absent from existing guidance,” says Lynch. “Most hospitals have contingency plans designed to guide decision-making about scarce resource allocation during crises like a pandemic. But most of these plans start from abstract bioethical principles and then jump to detailed plans for triaging particular forms of treatment.”
“What’s missing,” she continues, “is the in-between step that says when hospital staff are confronted with a shortage that wasn’t foreseen in the triage guidelines, or that provokes a conflict between bioethical principles that we haven’t accounted for, or that prompts a conflict between different stakeholders in the hospital setting, what do we actually do in that case? How do we come to a decision about how to deal with that scarcity? And that is the hole that our guidance was designed to fill.”
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