Untrained Hospitals Cautious Providing Ebola Treatment

Barbara Smith, a registered nurse with Mount Sinai Medical Health Systems, St. Luke's and Roosevelt Hospitals in New York, demonstrates putting on personal protective equipment (PPE) during an Ebola educational session for healthcare workers at the Jacob Javits Convention center in New York, October 21, 2014.
REUTERS/Mike Segar
Credit: REUTERS/Mike Segar

[From article]
The Ebola crisis is forcing the American healthcare system to consider the previously unthinkable: withholding some medical interventions because they are too dangerous to doctors and nurses and unlikely to help a patient.
U.S. hospitals have over the years come under criticism for undertaking measures that prolong dying rather than improve patients' quality of life.
But the care of the first Ebola patient diagnosed in the United States, who received dialysis and intubation and infected two nurses caring for him, is spurring hospitals and medical associations to develop the first guidelines for what can reasonably be done and what should be withheld.
[. . .]
Their concern is that poorly trained or poorly equipped hospitals that perform invasive procedures will expose staff to bodily fluids of a patient when they are most infectious. The U.S. Centers for Disease Control and Prevention is working with kidney specialists on clinical guidelines for delivering dialysis to Ebola patients. The recommendations could come as early as this week.
[. . .]
Throughout the history of medicine some doctors have declined to treat infectious patients or fled epidemics, said Michigan's Markel. Greek physician and philosopher Galen fled Rome during the bubonic plague 1,800 years ago, doctors deserted European cities stricken by the Black Death of the Middle Ages, and some health workers refused to treat HIV/AIDS patients in the 1980s.
"The idea that a doctor would stick to his post to the last during an epidemic, that's not part of the Hippocratic Oath," Markel said. "If you feel your life is at risk you don't have to stay and provide care."
[. . .]
If a patient goes into cardiac or respiratory arrest, a team would have to don protective gear. Rushing could leave them without proper protection, but a delay could make the procedure ineffective.

http://www.reuters.com/article/2014/10/22/us-health-ebola-usa-interventions-idUSKCN0IB2OM20141022

Some U.S. hospitals weigh withholding care to Ebola patients
BY JULIE STEENHUYSEN AND SHARON BEGLEY
CHICAGO/NEW YORK
Wed Oct 22, 2014 7:16pm EDT