Utah traige guidelines for bioterror attack questioned

Recent triage guidelines in Utah, which could deny treatment to patients during times of severe disaster ranging from large-scale bioterrorist attacks to earthquakes, have become a hot subject of debate.

The guidelines, developed by the Utah Hospitals and Health Systems Association for the Utah Department of Health, were largely finalized in January. They were required as part of the Governor's Task Force for Pandemic Influenza Preparedness created by former Governor Jon Huntsman, Jr., in 2006, homelandsecuritynewswire.com reports.

Under the guidelines, which aren’t mandatory but are left to the discretion of individual doctors, patients with severe burns, the flu, incurable cancer, fatal genetic diseases and severe dementia could be turned away by hospitals during worst-case scenario medical emergencies when understaffed hospitals could become inundated with thousands of patients.

The guidelines list 11 ways an adult can be excluded from care, including stroke victims with low chances of recovery. According to the homelandsecuritynewswire.com report, the guidelines do not address treatment for pregnant women. The guidelines also list six reasons that children 13 and younger would be turned away, including spinal muscular atrophy. Under the guidelines, premature babies with an 80 percent or greater chance of dying would not be resuscitated.

Although some states have begun to implement similar measures, the subject is still controversial.

Medical ethicist Jay Jacobson told homelandsecuritynewswire.com that he had difficulty with the guidelines.

“It was difficult grappling with the idea we would say no for any reason,” Jacobson told homelandsecuritynewswire.com.

Dr. Norman Foster, director for the Center for Alzheimer’s Care, Imaging and Research at the University of Utah, said he agrees that it is reasonable to allocate scarce care based on a patient’s conditions. He told homelandsecuritynewswire.com, however, that he is concerned about some of the vague language in the guidelines.

He pointed to the fact that in Utah, many dementia patients are not properly evaluated, which means medical staff in a triage situation may not know how severe a patient's condition is.

“Dementia care is not a priority in our health system or among health professionals,” Foster told homelandsecuritynewswire.com. “There is a significantly greater risk of abuse of these patients in a triage system of any kind.”