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The recent massive preparations for a potential bioterrorist smallpox attack may radically change the way the nations health system is expected to respond to public health threats, at the same time ushering in a new wave of dilemmas for hospital ethics committees and administrators, say some policy experts.
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For management of a single presumptive smallpox patient, assume the following.
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Some people are at greater risk for serious side effects from the smallpox vaccine. Individuals who have any of the following conditions, or live with someone who does, should NOT get the smallpox vaccine unless they have been exposed to the smallpox virus.
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At the University of Connecticut Health Center in Farmington, infectious diseases physician John D. Shanley, MD, faced a difficult decision last month. Would he be one of his hospitals smallpox response team volunteers and receive the vaccine?
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Updated EMTALA rule eases hospitals risk; Johns Hopkins program loses its accreditation; AMA to provide ethics alerts to MDs
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The privacy regulations enacted as part of the federal Health Insurance Portability and Accountability Act (HIPAA) have caused some unforeseen complications for hospitals trying to ensure patient safety and improve communication between providers and patients, say health care professionals and legal experts.
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Would your ethics committee approve a request to perform nontherapeutic surgery that would permanently alter the body of a healthy patient without his or her consent? What if the patient was very young and the parents wanted the surgery for religious or cultural reasons?
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For cancer patients who have exhausted all available treatment options, Phase I research trials of new oncology drugs may be their only hope. But does that hope come at too high a price?
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Ask many physicians about informed consent and often youll find they consider it a concept clear in ethics texts, but murky in practice.