Medical Ethics

Leigh Ann Loney

DB make-up.

“Women and Children First”, most would say as this is a nation that is not uncommon to us in the topic of triage. In society today, from an ethical standpoint I would oppose these practices as in mass casualties or emergent care of multiple patients needing medical treatment. The phrase of “women and children first might have been acceptable without negligence, but a standard of due care and rules specifying the principle of nonmaleficence. In urgency to wounds or illness of mass casualties in healthcare emergencies we use a system called triage to decide the order of care for each patient. The purpose is to prioritize incoming patients and indentify those patients who are the most critical and must be treated in a life threatened circumstances. Each healthcare provider performs a brief overview of the patient’s condition with a focused assessment. Then the patient gets assigned a triage acuity level to determine the order of care they will be treated in. This is a proxy measure of how long an individual patient care safely waits for medical care treatment. In 2008 there were 123.8 million visits to the United States emergency departments (Center for Disease Control and Prevention. 2008, tables 1, 4). With that said, only 18% of patients were seen within 15 minutes, leaving the majority of patients waiting on non-life threatening illnesses. (American College of Emergency Physicians 2010.)

With this system in place it allows a sense of organization and order to the Emergency room or in a disaster outside the hospital setting. This allows trained healthcare workers to identify the stability of the patient’s vital functions, the likelihood of an immediate life or organ threat, or high risk presentation.   Any patient of age, gender or race needing treatment being labeled at high risk to receive immediate care. Regardless, of race, age or gender in a fair manner to prevent legal action as it must be documented and follow the guidelines set forth by the healthcare organization. This allows patients to be seen in order of need compared to the other patients present that have been waiting for treatment of care. With waiting rooms getting flooded with non emergent patients a standardized triage acuity scale was adopted by the emergency nurses association and the American college of emergency physicians formed a joint level triage system that would backed up by the legal system and applied to all patients needing emergent care.