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CME / ABIM MOC

When Resources Are Limited During a Public Health Catastrophe: Nondiscrimination and Ethical Allocation Guidance

  • Authors: Jeffrey T. Berger, MD; Lois Snyder Sulmasy, JD; Matthew W. DeCamp, MD, PhD
  • CME / ABIM MOC Released: 2/23/2023
  • Valid for credit through: 2/23/2024, 11:59 PM EST
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  • Credits Available

    Physicians - maximum of 0.50 AMA PRA Category 1 Credit(s)™

    ABIM Diplomates - maximum of 0.50 ABIM MOC points

    You Are Eligible For

    • Letter of Completion
    • ABIM MOC points

Target Audience and Goal Statement

This activity is intended for infectious disease physicians, internists, intensivists, public health officials, pulmonologists, and other clinicians who treat and manage patients in a pandemic setting or public health emergency.

The goal of this activity is for learners to be better able to describe ethical considerations regarding guidelines for allocation of healthcare resources during a pandemic or other public health catastrophe, based on an American College of Physicians ethics case study and commentary.

Upon completion of this activity, participants will:

  • Assess the ethical considerations regarding guidelines for fairness and nondiscrimination and necessary conditions for ethical triage affecting allocation of healthcare resources during a pandemic or other public health catastrophe, based on an American College of Physicians ethics case history and commentary
  • Evaluate the ethical considerations regarding guidelines for institutional support and physicians’ duty to care directing allocation of healthcare resources during a pandemic or other public health catastrophe, based on an American College of Physicians ethics case history and commentary
  • Determine the ethical considerations regarding guidelines for medicine’s additional responsibilities to society directing allocation of healthcare resources during and after a pandemic, based on an American College of Physicians ethics case history and commentary


Disclosures

Medscape, LLC requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated. Others involved in the planning of this activity have no relevant financial relationships.


Authors, Case History and Commentary

  • Jeffrey T. Berger, MD

    Professor of Medicine
    NYU Long Island School of Medicine
    Chief
    Division of Palliative Medicine and Bioethics
    NYU Langone Hospital-Long Island
    Mineola, New York

    Disclosures

    Jeffrey T. Berger, MD, has no relevant financial relationships.

  • Lois Snyder Sulmasy, JD

    Director
    Center for Ethics and Professionalism
    American College of Physicians
    Philadelphia, Pennsylvania

    Disclosures

    Lois Snyder Sulmasy, JD, has no relevant financial relationships.

  • Matthew W. DeCamp, MD, PhD

    University of Colorado Anschutz Medical Campus
    Associate Professor
    Department of Medicine
    Aurora, Colorado

    Disclosures

    Matthew W. DeCamp, MD, PhD, has no relevant financial relationships.

CME Author

  • Laurie Barclay, MD

    Freelance writer and reviewer
    Medscape, LLC

    Disclosures

    Laurie Barclay, MD, has no relevant financial relationships.

Editor

  • Lois Snyder Sulmasy, JD

    Director 
    Center for Ethics and Professionalism 
    American College of Physicians 
    Philadelphia, Pennsylvania

    Disclosures

    Lois Snyder Sulmasy, JD, has no relevant financial relationships.

Compliance Reviewer

  • Leigh Schmidt, MSN, RN, CNE, CHCP

    Associate Director, Accreditation and Compliance, Medscape, LLC

    Disclosures

    Leigh Schmidt, MSN, RN, CNE, CHCP, has no relevant financial relationships.

Peer Reviewer

This activity has been peer reviewed and the reviewer has no relevant financial relationships.


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Interprofessional Continuing Education

In support of improving patient care, Medscape, LLC is jointly accredited with commendation by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

    For Physicians

  • Ethics case studies are developed by the American College of Physicians Ethics, Professionalism and Human Rights Committee and the ACP Center for Ethics and Professionalism.

    Medscape, LLC designates this enduring material for a maximum of 0.50 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 0.50 MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

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CME / ABIM MOC

When Resources Are Limited During a Public Health Catastrophe: Nondiscrimination and Ethical Allocation Guidance

Authors: Jeffrey T. Berger, MD; Lois Snyder Sulmasy, JD; Matthew W. DeCamp, MD, PhDFaculty and Disclosures

CME / ABIM MOC Released: 2/23/2023

Valid for credit through: 2/23/2024, 11:59 PM EST

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Note: The information on the coronavirus outbreak is continually evolving. The content within this activity serves as a historical reference to the information that was available at the time of this publication. We continue to add to the collection of activities on this subject as new information becomes available. It is the policy of Medscape Education to avoid the mention of brand names or specific manufacturers in accredited educational activities. However, manufacturer names related to the approved COVID-19 vaccines are provided in this activity in an effort to promote clarity. The use of manufacturer names should not be viewed as an endorsement by Medscape of any specific product or manufacturer.

CASE HISTORY

A pandemic respiratory virus has gripped the United States, including the area served by Community Healthcare Trust Incorporated (Community), a large, integrated health system that includes several area hospitals, multiple specialty and subspecialty groups, and primary care clinics. The best models and estimates regarding the pandemic are dire. Although uncertain, they suggest that infections will peak in 18 days and that, if so, patient need for critical resources, such as ventilators, could exceed the current total capacity. As a result, Community has to plan for the worst while hoping to increase capacity and that state and local public health measures and “shelter in place” orders can stem the tide of infections.

Community has decided to create a team to develop institutional policy on how to allocate scarce resources in the event the pandemic is as bad as models predict. Dr Giles, an internal medicine physician and ethicist for Community, has been asked to join this team and lead the drafting of the policy.

Dr Giles just got off the telephone with Dr Stead, a critical care colleague and friend in a smaller community in another state. Dr Stead was distressed, relaying that staffing is strapped, as a number of employees are home ill, on quarantine, caring for ill relatives, or engaged in childcare because of school closures intended to prevent spread of disease. Almost every intensive care unit bed is occupied by a patient receiving mechanical ventilation, and new patients are arriving regularly at the emergency department (ED) in respiratory distress. Dr Stead noted that among the patients currently in his intensive care unit whose condition is most dire is the grandmother of the hospital’s director of social work. A half dozen of her friends and family members were in the lobby wanting to go to her bedside; meanwhile, he just evaluated an elderly leader in his church and a 24-year-old patient with asthma and severe viral pneumonia for possible admission from the ED. The elderly man’s brother (a health professional) keeps mentioning the Emergency Medical Treatment & Labor Act (EMTALA).

Dr Giles can only imagine what his hospital soon may be facing. What ethical considerations and principles should guide Dr Giles in drafting the policy?

Table of Contents

  1. CASE HISTORY
  2. COMMENTARY
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