Ethics in disaster, mass casualty care, and critical care
- PMID: 38646029
- PMCID: PMC11029244
- DOI: 10.1136/tsaco-2024-001389
Ethics in disaster, mass casualty care, and critical care
Abstract
The primary ethical principle guiding general medical practice is autonomy. However, in mass casualty (MASCAL) or disaster scenarios, the principles of beneficence and justice become of foremost concern. Despite multiple reviews, publications, and training courses available to prepare for a MASCAL incident, a minority of physicians and healthcare providers are abreast of these. In this review, we describe several MASCAL scenarios and their associated ethical, moral, and medicolegal quandaries in attempts to curb potential future misadventures.
Keywords: Ethics, Medical; Mass Casualty Incidents; Patient Comfort; intensive care units.
© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Conflict of interest statement
Competing interests: None declared.
Figures



Similar articles
-
[ATLS® and TDSC®: how it fits together : A treatment concept for mass casualty and terrorist-related mass casualty situations, life-threatening and special scenarios].Unfallchirurg. 2020 Jun;123(6):453-463. doi: 10.1007/s00113-019-00735-z. Unfallchirurg. 2020. PMID: 31690983 German.
-
Making difficult ethical decisions in patient care during natural disasters and other mass casualty events.Otolaryngol Head Neck Surg. 2008 Aug;139(2):181-6. doi: 10.1016/j.otohns.2008.04.027. Otolaryngol Head Neck Surg. 2008. PMID: 18656712 Free PMC article. Review.
-
Expression of ethical principles in Australia's disaster plans.Emerg Med Australas. 2022 Dec;34(6):989-994. doi: 10.1111/1742-6723.14035. Epub 2022 Jun 24. Emerg Med Australas. 2022. PMID: 35748344
-
The impact of mass casualty incidents on intensive care units.Aust Crit Care. 2020 Sep;33(5):469-474. doi: 10.1016/j.aucc.2019.12.004. Epub 2020 Jan 22. Aust Crit Care. 2020. PMID: 31980255 Review.
-
Prehospital Interventions During Mass-Casualty Events in Afghanistan: A Case Analysis.Prehosp Disaster Med. 2017 Aug;32(4):465-468. doi: 10.1017/S1049023X17006422. Epub 2017 May 3. Prehosp Disaster Med. 2017. PMID: 28464968
References
-
- Agency for Healthcare Research and Quality . Altered standards of care in mass casualty events. Rockville, MD: US Department of Health and Human Services; 2005.
-
- Institute of Medicine (US) . Forum on medical and public health preparedness for catastrophic events. Crisis standards of care: summary of a workshop series. Washington (DC) National Academies Press (US); 2010. - PubMed
-
- Department of Health, Education, and Welfare; National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research . The Belmont report. ethical principles and guidelines for the protection of human subjects of research. J Am Coll Dent 2014;81:4–13. - PubMed