Hospital administrators and public health officials are sleeping somewhat better knowing that they have flu pandemic plans in place. The plans develop policies for such items as who gets what in which order of priority.
Pandemic planning seems to depend on the expectations that patients, families and loved ones will accept decisions about priority for treatment. If so, is this a reasonable expectation?
Do pandemic plans take into account the conflict that comes with fear of scarce resources and the frantic desire to get a share? Is there an appeal mechanism, place for advocacy to have someone bumped up the priority scale, or process for the patient who argues with the ranking given? Where is the plan for dealing with people who refuse the ranking that might mean death for a child, spouse, parent, or friend? What are the provisions for when the three-person team making the ranking decisions cannot agree? Is there a void in the plan, or is the plan mum on how it will keep the peace by keeping patients in their place?
Conflict creates hard choices, even when ethically and scientifically based. In each pandemic plan should be conflict management strategies and training for the daily dramas that come with staff shortages, contagion fears, dread of disease, burn-out of those who are filling in, stress related illness, and too little of everything. At the very least, those making the treatment ranking decisions must have strategies and training for resolving the conflicts that will almost certainly arise during their decision-making.