TY  - JOUR
PY  - 2014//
TI  - The community speaks: understanding ethical values in allocation of scarce lifesaving resources during disasters
JO  - Annals of the American Thoracic Society
A1  - Daugherty Biddison, Elizabeth Lee
A1  - Gwon, Howard
A1  - Schoch-Spana, Monica
A1  - Cavalier, Robert
A1  - White, Douglas B.
A1  - Dawson, Timothy
A1  - Terry, Peter B.
A1  - London, Alex John
A1  - Regenberg, Alan
A1  - Faden, Ruth R.
A1  - Toner, Eric S.
SP  - 777
EP  - 783
VL  - 11
IS  - 5
N2  - INTRODUCTION: Pandemic influenza or other crises causing mass respiratory failure could easily overwhelm current North American critical care capacity. This threat has generated large-scale federal, state, and local efforts to prepare for a public health disaster. Few, however, have systematically engaged the public regarding what values are most important in guiding decisions about how to allocate scarce healthcare resources during such crises. <br><br>METHODS: The aims of this pilot study were to (1) test whether deliberative democratic methods could be used to promote engaged discussion about complex, ethically challenging healthcare related policy issues, and (2) develop specific deliberative democratic procedures that could ultimately be used in a state-wide process to inform a Maryland framework for allocating scarce healthcare resources during disasters. Using collaboratively developed focus group materials and multiple metrics for assessing outcomes, we held 5-hour pilot community meetings in two locations in Maryland with a total of 68 community members. The key outcomes used to assess the project were, (1) comprehensibility of the background materials and ethical principles, (2) salience of the ethical principles, (3) perceived usefulness of the discussions, (4) the degree to which participants' opinions evolved due the discussions, and (5) the quality of participant engagement. <br><br>RESULTS: Most participants were thoughtful, reflective, and invested in this pilot policy-informing process. Through the pilot process, changes were made to background materials, the verbal introduction, and pre- and post-surveys. Importantly, by holding pilot meetings in 2 distinct communities - an affluent suburb and inner city neighborhood - investigators discerned that participant's ethical reflections were framed in large part by their place-based life experiences. <br><br>CONCLUSION: This finding, coupled with extensive feedback from participants, yielded a refined methodology suitable for wider-scale use and underscored the need for involvement of diverse communities in a state-wide engagement process on this critical policy issue.<p />  <p>Language: en</p>
LA  - en
SN  - 2329-6933
UR  - http://dx.doi.org/10.1513/AnnalsATS.201310-379OC
ID  - ref1
ER  -