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Thoughts

Ethical dilemmas under disaster conditions

02-July-2015
02-July-2015 15:07
in General
by Dr. Megan Joffe

Five days at Memorial: Life and Death in a Storm Ravaged Hospital by Sheri Fink is the non-fictional account of what happened at this large privately owned hospital in New Orleans during Hurricane Katrina. It vividly describes the chaos, fear, heat and desperation of the staff and patients marooned in a hospital when the lower floors are flooded and the only way out is by boat or by air. The hospital had planned for disasters based on a terrorist event but oddly not for one caused by such serious flooding even though there is ample evidence that New Orleans is at greater risk of flooding than many cities.  The electricity fails, and the usual mechanics of high quality care become difficult to deliver when the backup equipment starts to fail. The conditions are almost dystopian both inside and outside the hospital. There seems to be no one in control, confusion about who will/should provide help – the company which owns the hospital, the town services, the state or the US government.

 

The dilemma for the staff is how to triage the patients for evacuation. The story focuses on the decisions of one doctor and two nurses who take action to support the weakest and terminally ill patients on a private ward in the hospital sub-let to a care home. The issue of euthanasia becomes the central topic of the story and highlights the moral and ethical challenges faced by frontline staff who are also in fear for their own lives. It is a horrifying but true story that reads like an investigatory novel. It shows the strains in relationships between managers and clinicians; it questions corporate ownership of healthcare; it challenges notions of justice.  It exposes our deepest fears; illustrates the depth of humanity shown by those in whom we put our trust; questions our prejudices and asks us to think about what we would do in a similar situation. It’s a good and thoughtful read!

 

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