Louisiana begins drawing up plans for bioattack treatments

Guidelines to specify which patients will receive access to lifesaving treatments in the event of a bioterrorist attack, severe pandemic or natural disaster that overwhelms the medical system are being developed by Louisiana health professionals.

Approximately 24 ethicists, health professional and hospital leaders in Baton Rouge have begun drawing up the guidelines, which are being created following a Department of Health and Hospitals draft.

“It’s an exceedingly ugly topic altogether,” Dr. Stephen Brierre, an intensive care unit physician with Louisiana State University Health Sciences Center who was chairman of the group developing the guidelines, told The New Orleans-Picayune.

Several categories of patients are identified in that initial draft, which was sent to representatives in Louisiana's nine public health regions for feedback.

Categories in that draft include those with less than six months of life expectancy as a result of incurable metastatic cancer and those with very low predicted survival from extensive burns. Both of those categories would be denied admission to hospitals without available beds and ventilators in the event of an attack. The guidelines call for those categories to be offered pain and discomfort care at home or in other facilities.

Patients with a higher risk of dying would be taken off of life support under the first draft. That would make room for those with a better prognosis if intensive care resources become over burdened.

The goal of the guidelines is to create a system wherein in resources that would become scarce can be directed to patients who doctors believe had a better chance of survival while struggling with how to predict survival.

Louisiana has also passed three laws to protect health workers from prosecution for acting "in accordance with disaster medicine protocol," after doctors struggled with prioritizing patients after Hurricane Katrina.