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new pandemic guidelines

Discussion in 'Psychiatry' started by BabyPsychDoc, May 6, 2008.

  1. BabyPsychDoc

    BabyPsychDoc 2+ Year Member

    Now, THIS is concerning. On the rational level, I have to agree with rationing resources and time, but on the other... Are those with severe mental illness less entitled to life than the rest of us? And how will the severity of the mental illness be defined in that case? Do our parents have less of a right to survival? If the disaster strikes, it will be a time for difficult choices - and some of the choices now have the official endorsement from the government.
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  3. Faebinder

    Faebinder Slow Wave Smurf 10+ Year Member

    May 24, 2006
    I agree with the guideline. It's up to us in that situation to decide who can live and die... some compromise has to be made. It's not unreasonable to pick for example to give the only vent that is left to a someone with a controlled mental illness over a severely mentally ill person with resistance to meds.

    I wouldn't assume that this decision will be made fully by a critical care physician... they will ask a psychiatrist's opinion.
  4. Anasazi23

    Anasazi23 Your Digital Ruler Moderator Emeritus 10+ Year Member

    First off, I must point out the wonderful Freudian Slip:
    Now that that's out of the way......

    I've been an alternate-reality, cold-war nuclear era disaster buff since I was a kid. I have a big collection of civil defense booklets and guides outlining how stuff like this should go down, and I've often thought about how this scenario would bear out.

    It's not a scene anyone wants to even think about, but it's necessary and important. Everyone was outraged when after Katrina forced us to think about doctors making these decisions. But again, it's part of our world.

    One could go extreme and think about the worst case scenario, affectionately termed (WCS0 in the old pamphlets where even re-population is a consideration. In a more common scenario, the old "women and children first" cliche comes from somewhere, and in essence, it's correct.

    Attempting to save the severely demented or badly burned is considered a waste and lessens the chances of survival of those with more meaningful life ahead of them by brain draining and using valuable resources. This of course makes sense. Complexities arise, however, when a survival group knows that a particular type of patient is typecast into a death sentence should they contract a particular disease or affliction. i.e. morale and such.

    In terms of "our patients," I think it's good to fight for our so-called population of patients. However, psychiatry is by no means unique in this regard. Those with COPD who are unable to walk, travel or would otherwise hold up the group may not be a priority to save, nor would someone who's likely to die from infection without heroic measures.

    How will severity of mental illness be defined? Again, there's no easy answer. There is likely to be a non-published checklist of basic human funcitons that are expected of a member of a survival group. If you don't make that cutoff, then you'll not be maintained.
  5. Chrismander

    Chrismander Junior Member 7+ Year Member

    Apr 30, 2006
    Dude, you must be sooo pumped about Fallout 3 then. How did Fallout 1 & 2 live up to your vision of the post-apocalypse? ;)
  6. BabyPsychDoc

    BabyPsychDoc 2+ Year Member

    Sure, they will... Good luck making the appropriate assessment (when you physically and mentally exhausted yourself) in a seriously medically ill person with the time constraints and likely with no access the each patient's personal health records - ie, in the major disaster scenario when the guidelines like this one is most likely to be evoked. And if the person in question is over a certain age, good luck discriminating between delirium, pseudodepression and Alzheimers.

    Having not to treat patients with COPD, severe burns etc I can accept as the clear cut necessity of medical triage. The diagnoses are pretty obvious. "Severe mental illness" is something entirely different, muddying the waters for me. Same goes for age. Some 85 year olds I know are more fit than some 25 year old waste of DNA. In the heat of the moment, though, no-one will have time, desire or resources to make individualised decisions - hence, of course, the need for guidelines.

    Sorry, I am rambling - had a loooong night oncall.... BTW, Sazi, I am not sure I understand your reference to the "wonderful Freudian slip". What do you mean?
  7. Anasazi23

    Anasazi23 Your Digital Ruler Moderator Emeritus 10+ Year Member

    I was one of the first to order the collector's edition on and have No Mutants Allowed on the top of my RSS reader!

    Fallout 1 & 2 are God.

    I also have an unused nuclear shelter water ration barrel/toilet in my living room for decoration.
  8. Anasazi23

    Anasazi23 Your Digital Ruler Moderator Emeritus 10+ Year Member

    Perhaps I'm the one with the slip. By "our parents," I assumed you meant "our patients."

  9. Hurricane

    Hurricane Senior Member 5+ Year Member

    Aug 14, 2005
    The Metroplex
    I like that you pointed out that it's unused. :laugh:

    So you must be missing Jericho more than me. That was a good TV show.

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