Ethical and Legal Challenges in Disaster Medicine: Are You Ready?

Authors: Anna M. Pou, MD


You are on call the weekend a category 5 hurricane made landfall and you, along with your colleagues, are trying to evacuate approximately 2000 people (approximately 200 patients) from the hospital which is now surrounded by 8 to 10 ft of floodwaters. Those trapped in the floodwaters are trying to break into the hospital. The National Guard and state police have gone to other parts of the city. Food and water are being rationed. The generators are not working. There is no running water and no electricity, and outside temperatures are more than 105°F. Communication with the outside world is sporadic. Patients are moaning and others are frightened. Chaos reigns. You and your colleagues have triaged the patients and are awaiting rescue. It is day 4 of lockdown and few patients and others have been evacuated, some to unknown “drop sites.” Children are crying as they are being evacuated without their mothers, who have stayed to care for patients. Hospital administrators were just told by state authorities that “hospitals are low priority” and if you wanted to be evacuated, you had to “save yourselves.”

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