If Idaho runs out of crucial supplies — like ventilators or intensive care units — to treat patients with coronavirus, hospitals and providers will need to make difficult decisions about how to prioritize care for certain people.
Many states have “crisis standards of care” documents to help guide ethical decision-making for how to triage medical care when it has to be rationed. Idaho doesn’t have a crisis standards of care plan, but a group is currently working on developing one.
These plans are created with the hope that they’ll never need to be implemented, but having a plan in place ahead of time helps medical providers, said Susie Pouliot, the CEO of the Idaho Medical Association, which advocates for physicians.
“You don’t want the individual clinician — the doctor, the nurse — at the bedside trying to make decisions within their own patients about who gets this and who gets that,” added Dr. Matt Wynia who directs the Center for Bioethics and Humanities at the University of Colorado.
Many states include clauses in the crisis plans that protect providers from lawsuits, Pouliot said, though she hasn’t seen Idaho’s upcoming version.
Some states wrote their plans after Hurricane Katrina or during the 2009 H1N1 pandemic.
“This really prompted a lot of people to start looking at how do people make these heart-wrenching decisions in tragic circumstances where they are forced into deciding who are we going to take care of and who are we not going to,” Wynia said.
By now, around 36 states have crisis standards of care documents. The protocols vary state to state, but many prioritize care based on a patient's likelihood of surviving.
Idaho’s plan should be ready for Gov. Brad Little’s coronavirus working group to review by mid to late April, according to the Idaho Department of Health and Welfare.
Though the projections continue to change, the University of Washington’s COVID-19 model shows April 14 as the peak day for resource demand in Idaho. It also indicates the state will not see a shortage of hospital beds or ICU beds.
The group drafting Idaho’s standards includes Idaho Department of Health and Welfare, the Idaho Hospital Association, the Idaho Office of Emergency Management and local physicians, emergency personnel and palliative care specialists.
While local hospital systems might have already thought these scenarios through, Wynia said it’s important for these conversations to happen at a higher level during a crisis because organizations might be used to competing with one another for resources.
“By sitting down together and trying to come up with a plan like this, you really force health care systems to figure out how they’re going to work together,” he said.
Find reporter Rachel Cohen on Twitter @racheld_cohen
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