Pandemic panic conflict

November 01, 2009

Hospital administrators and public health officials are sleeping somewhat better knowing that they have flu pandemic plans in place. While there may or may not be a deadly H1N1 pandemic, with climate changes will come other diseases that will each bring its own scares. It’s good to have a plan in place against pathogens.– The plans developed for the last flu scare dealt lightly with 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?– It is foreseeable that not all people will do as they are told, especially when they are frightened and ill. 

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 just silent on how decision makers plan to keep the peace by keeping patients in their place?

Conflict creates hard choices, even when decisions, policies and plans are ethically and scientifically based. If the– planners– believe that– science and medicine will deal with the conflicts their plans create, they are mistaken. 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.

Filed Under: Cassandra files, Conflict Competence      

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