Natural calamities are unpredictable phenomenas where the damage may be countless and immeasurable examples of natural calamities are earthquakes, floods and famine. In situations like this relief operations are challenging even though many organizations and nations extend their resources to overcome the disaster. We often face issues and concerns in a massive disaster which may lead to ethical-dilemma and criticism. When we analyze disaster situation ethical concerns arises. Here I would like to present the ethical dilemma involved in the rescue operations in Haiti disaster and analysis of the issues.
Event and ethical implications
One of the biggest and most recent disaster world encountered is the Haiti disaster in January, 12, 2010. It was a massive earthquake with 7.0 magnitudes, wiped out thousands of lives and affected millions of people (Haiti earthquake, 2010). The earthquake ploughed the main city Port-au-prince just into rubbles. Many people were trapped in the collapsed buildings. Many important buildings were damaged including parliament, schools, hospitals and main jail (Haiti earthquake, 2010). It resulted in lack of food, water, shelter and medical services.
Many wounded were waiting for immediate medical help and many died without prompt treatment. In natural disasters people from all over the world offer humanitarian aid in the form of donations, medical care team services, food and other necessary supplies. The U.S Government and many other nations extended their hands for rescue operations. The Israel Government sent a military task force consisting of 230 people within 48 hours (NEJM, 2010). Their ultimate goal was to provide lifesaving treatments to the injured to the level it was possible. Other troops and volunteer workers on the scene also tried their best to deliver the best possible care to the causalities.
Ethical concerns and ethical dilemma
The troops mission was to provide help to as many people as possible. But the limited resources fell far short than the demands. This put the medical team in various ethical issues. Haiti is one of the poorest countries of the world with minimal facilities. The disaster left millions of people homeless and in urgent medical needs. The Israeli Field Hospital extended their hospital capacity to 72 from 60 and added one more operating room to accommodate increased causalities (NEJM, 2010). In a normal triage system we are setting priorities among patients depending on their clinical conditions and assuming that we will be able to provide care to all. In Haiti disaster it was impossible for them to provide care to all who needed. Here the health care workers as well as the victims faced ethical dilemma.
The medical team was forced to recognize the fact that the clients who need most urgent care may consume the majority of their resources. So they had to set up priorities according to the resources available, the severity of the problem and can they be saved. Another ethical dilemma the medical team had to encounter was those come with severe injuries needed prolong rehabilitation and that may run out all of their supplies. So they planned to accommodate patients who can be stabilized in 24 hours. The practical implication of this prioritization resulted in people those who have small chance to survive were not likely to be treated in the ICU (NEJM, 2010).
In addition to that discharging the patients were also challenging since no homes left and children without parents, there was no place for them to go. Personal ethical values and position using ethical principles In a massive disaster plan in an ethical aspect I believe the theory of Act- utilitarianism works best to that situation. Act-utilitarianism states, the actions people choose will produce over all good in any given circumstances. This theory also allows different actions in certain circumstances. Their decision on triaging the patients based on the resources and the possible outcome of the intervention in a humanitarian aspect.
The ethical principles of beneficence and justice applied in this scenario. According to the principle of beneficence the health care workers were trying their best to provide care to as many as people possible. The ethical principle of distributive justice emphasis on fair and equitable distribution of goods and services (Burkhardt & Nathaniel, 2008), but in certain situations it is impossible for all people to have everything that they might need. In such cases they can formulate and enforce policies for fair and equitable distribution of the available resources.
Possible alternatives for resolving the problem
I.Ask for more medical supplies from organizations like, World Health Organization, Red Cross et. II.Make arrangements to send patients who need more complex care to the nearest available medical centers or hospitals. III.Call for more volunteers to help there by reducing the cost and request for funds from charitable organizations. IV.Since geographically U. S. is the closest country, request for airlifting the patient to the nearby states hospitals for advanced care. V.Even though insurance can be a hindrance to accept the patients, U. S. Government can offer tax exemptions and grants for the accepting hospitals. VI.Airlift the patients to the accepting countries for advanced care.
Examine and categorize the alternatives
When we categorize the alternatives from 1-6, the first five options are possible alternatives. The 6th option can be possible, but it will be more expensive, time consuming and unsafe for unstable patients. Since many organizations started their rescue operations, if the military task force can receive more supplies, they will be able to continue with their life saving measures.
Possible consequences for the acceptable alternatives
When other hospitals can accommodate more patients, it may reduce the burden on a single group. Since they already have disaster plan set up, more supplies from other organizations will help them to continue their task without time delay. With tax exemption and grants, more hospitals may take initiative to involve in the health care delivery and if the patient can be airlifted on time many lives can be saved.
Prioritize acceptable alternatives
I.Provision of more supplies to the functioning units.
II.Make arrangements to transfer patients with complex issues to the nearest hospitals.
III.Call for more volunteers for additional help
IV.Airlift patients to the nearby countries at the earliest possible
V.Request for more funds, grants, donations from the federal governments and common wealth countries.
Plan of actions
The plan of care is to provide care to as many people as possible with added resources. Transferring of patients to the nearest available hospital for complex care and management. Through financial aid rebuild the health care infrastructure to provide continued care to the Haiti people.
Natural disasters are unpredictable and every effort needs to be taken to overcome such situation through voluntary support. In this situation the ethics committee from a group of physician had to prioritize the cases according to the availability of resources and the chances of survival. In a humanitarian aspect it is necessary to provide fair and equitable distribution of health care as much as possible for a healthy recovery. We often see the best of humanity in moments of extreme calamity. In every disaster situations people who directly involved often faces some sort of ethical issues and dilemma. The best possible way to overcome such situations through mutual effort, ethical decision making and appropriate action plans. Fair and equitable distribution of health care is the best approach to every mankind.