How can hospitals deal with scarce resources during COVID-19?


After reading Julia Lynch’s latest draft paper, a typical layman would probably be surprised to realize that despite decades of national concern over terrorists, biological warfare attacks, and dirty bombs, hospitals have failed a practical guide to deciding how to allocate limited resources in such catastrophic incidents.

Lynch, an associate professor of political science at the School of Arts and Sciences and a senior researcher at IDL, realized it a few weeks ago. A colleague from a Michigan healthcare system called her to try to find – or have her create – step-by-step instructions on how to make decisions about allocating scarce resources in hospitals during emergencies. like the current coronavirus pandemic.

“The call came because political scientists like me put in place decision-making rules, and those decision-making rules were what was missing from existing guidance,” says Lynch. “Most hospitals have contingency plans designed to guide decision making about allocating scarce resources during crises like a pandemic. But most of these plans start with abstract bioethical principles and then move on to detailed plans to sort out particular forms of treatment. “

“What is missing,” she continues, “is the middle step that says when hospital staff are faced with a shortage that was not foreseen in the triage guidelines, or that causes a conflict between bioethical principles that we did not take into account. , or which causes a conflict between the different actors of the hospital environment, what do we do concretely in this case? How to make a decision on how to deal with this shortage? And that’s the hole our tips were designed to fill.

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