AMA meeting: CEJA to study how ethics may shift during disasters

Delegates also commented on treating STD patients' sex partners without an exam.

By Kevin B. O'Reilly, AMNews staff. July 16, 2007.

Chicago -- After disasters such as Hurricane Katrina and the tsunami following the Indian Ocean earthquake, physicians say they need ethical guidance on triage and other matters in catastrophic situations.

More than 20 delegates expressed their concerns to the Council on Ethical and Judicial Affairs at the AMA Annual Meeting last month.

Daniel P. Edney, MD, a Vicksburg, Miss., internist, said he had volunteered to serve in four world-class disasters but that Hurricane Katrina differed in that physicians also were victims of the catastrophe who had to choose between fleeing with their families and remaining behind.

"We have the dilemma of deciding, 'Do I stay irrespective of what help I can provide?' " Dr. Edney said. "Especially when we reach the point where staying is futile in terms of benefiting patients, yet when I leave I'm abandoning the patient."

Other delegates said public authorities, not necessarily physicians, manage disaster response operations and that any ethical guidance should take that into account.

CEJA member Dudley M. Stewart Jr., MD, said the council "would like to develop guidelines consistent with the basic principles of medical ethics but take into consideration some of the exigencies of emergency situations." A central conflict, he said, is between the doctor's traditional responsibility to individual patients versus the population-based medicine that takes priority during disasters.