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Review
. 2024 Apr 15;9(Suppl 2):e001389.
doi: 10.1136/tsaco-2024-001389. eCollection 2024.

Ethics in disaster, mass casualty care, and critical care

Tanya Egodage  1 , Jay Doucet  2 , Purvi Pravinchandra Patel  3   4 , Matthew J Martin  5   6
Affiliations
Review

Ethics in disaster, mass casualty care, and critical care

Tanya Egodage et al. Trauma Surg Acute Care Open. .

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.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
State laws regarding medical aid in dying (MAiD) in the USA. Illustration of the state-specific regulations with respect to MAiD. Legal to undergo MAiD in nine states and the DC. The Montana Supreme Court ruled in favor of MAiD despite no state law to that effect. It is illegal in the remaining states.
Figure 2
Figure 2
Mental health resources for disaster responders. Depiction of Substance Abuse and Mental Health Services Administration mental health resource guide for disaster responders. The QR code provides a link to the phone application which provides pre-deployment, in-the-field, post-deployment support. It can be downloaded prior to a disaster in the event of limited internet services.
Figure 3
Figure 3
Disaster and bioethics resources for US military medical professionals. This resource provides specific recommendations for military medical professionals to assist in balancing obligations as military officials with their obligations to patients.
See this image and copyright information in PMC

References

    1. Committee on Trauma, American College of Surgeons . Statement on disaster and mass casualty management. J Am Coll Surg 2003;197:855–6. 10.1016/S1072-7515(03)00808-1 - DOI - PubMed
    1. Agency for Healthcare Research and Quality . Altered standards of care in mass casualty events. Rockville, MD: US Department of Health and Human Services; 2005.
    1. 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
    1. 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
    1. Varkey B. Principles of clinical ethics and their application to practice. Med Princ Pract 2021;30:17–28. 10.1159/000509119 - DOI - PMC - PubMed