Week 6: 2011-04-14
Today I’m asking our professionals to weigh in on the question: Should medication be rationed at TEOTAWKI? How and why?
You, too, are welcome to post your responses and questions below.
Check back soon and see what our panel of over 100 professionals has to say.
– Doc Cindy
About Cynthia J. Koelker, MD
CYNTHIA J KOELKER , MD is a board-certified family physician with over twenty years of clinical experience. A member of American Mensa, Dr. Koelker holds degrees in biology, humanities, medicine, and music from M.I.T., Case Western Reserve University School of Medicine, and the University of Akron. She served in the National Health Service Corps to finance her medical education.
A few more questions to ponder . . .
1. Do those who have bothered to prepare have the right to keep their stockpiled medicines to themselves?
2. What factors would you take into account when determining how to ration?
In order:
1) Yes, absolutely. Just as with stocked food and supplies, property rights will need to be defended. On a side note, this is a place where staying small and keeping a low profile is probably the best way to do so.
2) 2 factors, cost-benefit ratio (in regards to “the group” however it is defined) and likelihood of recovery. This would be a horrible horrible decision to have to make, but it must be done in a true (Armageddon) situation.
Perhaps this article will offer some insight into rationing a life or death treatment regime.
Here is a snippet from the article, titled, When the drug you need to cure a cancer is nowhere to be found
http://www.washingtonpost.com/national/health/when-the-drug-you-need-to-cure-a-cancer-is-nowhere-to-be-found/2011/04/11/AFH802zD_story.html
…..a large California provider that cares for several million members. “As of this morning, the entire inventory of cytarabine in our system was 30 grams,” he wrote. “We are prioritizing the little remaining drug to go first to pediatric patients requiring cytarabine. . . . Patients will inevitably die as a result of this tragedy.”
A colleague from Wisconsin wrote, “We have been forced to form a panel of physicians, pharmacists, and nurse practitioners to make difficult decisions regarding . . . this drug (i.e. who can receive it and who can’t).”
Based on Katrina, the military will be slow to arrive and act. Personal med supplies will remain personal and perhaps shared by those who believe they have a moral responsibility to do that.
Pharmacies will be raided almost immediately and the strongest and most violent will control those drugs. Drugs already under government and/or military control (warehoused) may be rationed.
It will be incredibly difficult for any public entity to obtain and maintain a supply of some meds to ration. Analgesics will be at a premium. Some drugs may end up being used in place of currency.
I agree with Chris MD. Just as in WWI and WWII, those commodities that will need to be military “fielded” will get rationed.
It is best for us to accept the fact now, that military TRIAGE will occur and rationing of medications, supplies, and any other logistics will be conserved for use to do the most good, for the youngest and the healthiest.
Suppose I could refer to previous threads, but at the risk of repeating, if a real TEOTWAWKI event occurs, and we lose our industrial base, the modern meds that you have are all that you will have. Rationing will be absolutely necessary to stretch whatever supply there is as far as possible. Triage will have to be done, which is something we medical professionals who have thought about it seriously dread. Some folks will die. Even some who could be saved, but would use up supplies that could save many others, will have to be triaged to “comfort only.” Horrible? Yes, absolutely. Necessary? Even more so. I think the only answer to “how” is to have an experienced, objective professional make the call.