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The ethical justification for the Affordable Care Act (ACA) is distributive justice, with the goal of making health insurance available to more Americans, notes Dennis M. Sullivan, MD, director of the Center for Bioethics at Cedarville (OH) University
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At the University of Missouri School of Medicine in Columbia, MO, about 80% of ethics consults are called for patients who are either dying or near death in the critical care setting, estimates David A. Fleming, MD, MA, FACP, professor of medicine, chairman of the Department of Medicine and director of the Center for Health Ethics.
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Should cardiopulmonary resuscitation (CPR) be given to end-stage Ebola patients, despite the risk to health care providers? What training is necessary at this point to ensure staff and patients are protected?
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Blogs, message boards, and patient communities are being used not only by patients, but also by research participants. In some cases, this reveals whether or not a participant is taking actual medication or placebos, compromising the studys validity.
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In one sense, undocumented patients are like any other patients some have health insurance, but many will not. Whats particularly challenging is that undocumented patients who are uninsured will usually not qualify for the safety net programs that provide assistance for similar patients with citizenship, says Mark Kuczewski, PhD, chair of the Department of Medical Education and director of the Neiswanger Institute for Bioethics at Loyola University in Maywood, IL.
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Relying on the authority of the Centers for Disease Control and Prevention (CDC) for infection control procedures should be safe, even if the CDC later proves to be wrong, suggests Jane J. McCaffrey, MHSA, CIC, DASHRM, a risk management consultant in Easley, SC, and a past president of American Society for Healthcare Risk Management. However, that statement does not diminish the hospitals obligation to properly train staff on protocols and provide the necessary equipment, she says.
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Insurers are quick to see the needs and the danger in a problem such as Ebola care, and some already are responding with coverage options for potential losses. Some also are looking for ways to avoid paying for those losses.
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One hospitals experience with another deadly infectious disease revealed lessons for how hospitals can respond to Ebola, say two healthcare attorneys who helped that facility through the incident. The key is preparation.
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This summary of Texas Health Presbyterian Hospital Dallas experience with the first Ebola patient in the United States is compiled from statements and data provided by the hospital and the Centers for Disease Control and Prevention (CDC):
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The patient, an adult woman, was admitted to a hospital in early September 2002, approximately two months before her due date. She was diagnosed with preeclampsia by an obstetrician, and the obstetrician decided to induce labor rather than perform a caesarean section.
