Healthcare centers continue to perform a critical role in the provision of essential medical care to communities during disaster times. Depending on their nature and scope, disasters typically lead to the rapid increase of service demand, which in some cases overwhelms the functional capacities and safety of health care centers in question. Moreover, an exacerbation of disasters often leads to the crippling of entire healthcare systems. Although the World Health Organization and numerous health-based corporations provide checklists in case of hospital emergencies to assist administrators and emergency supervisors, their underlying efficiencies in the dynamic landscape of disaster management remains in question. In essence, hospital emergency responses need to offer a continuity of necessary services; and they need to coordinate an execution of hospital processes at all levels. Moreover, accurate and clear external and internal communication needs to be maintained; these among other fundamental procedures are decisive. However, the observance of such procedures in some healthcare facilities is a challenge. This paper looks at the legal and political ramifications of the decisions made and the response to the crisis at Memorial Hospital following Hurricane Katrina (Fink, 2014).
Legal and ethical concerns normally persist over issues to do with disaster planning and the crisis standards of care. As per the explanations of James Hodge, executive director at John Hopkins, laws pervade emergency responses at all governmental levels (Stroud, Bruce, Nadig & Hougan, 2010). This assertion makes laws a fundamental basis for the determination of public health emergency response. Moreover, they create a legal structure whereby individuals are able to respond to emergencies, prevent them or even detect them before they happen. In most states including the State of Alabama, where Memorial Hospital is situated, provisions within the law usually limit legal liability during times of emergencies. Although these laws limit medical malpractice, such stipulations define pertinent malpractices that pertain to health care especially during emergencies. During hurricane Katrina, the making of certain pertinent decisions vetoed the enactment of germane laws such as the Emergency Health Powers Act, which explicitly implies that health care providers are held liable to civil damages resulting from a demonstration of reckless disregard for the consequences of healthcare malpractice. The abandonment of patients by caregivers and doctors in Memorial Hospital indicated high medical malpractices that saw a revamp of the disaster response capacities within health centers in addition to the investigation of three LifeCare employees: Dr. Anna Pou, Cheri Laundry and Lori Bou (Fink, 2014).
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Hospitals endorsed by the Joint Commission on Accreditation of Healthcare Organizations in Alabama have a requirement to avail an emergency management plan (Ardent & Hess, 2006). The enactment of such management plans during disasters is of utmost importance for the survival and rescuing of patients. Common sense dictates that emergency management ensure economic and social cushioning. In the case whereby the Memorial Medical Center endured hurricane Katrina, appropriate emergency plans were required to address unfolding situations within the hospital. Typical emergency management plans require the identification of three classes of hospital staff members. The identification of these three classes was not done properly among the individuals present in the Memorial Medical Center Disaster. Moreover, the presence of non-essential staff members within the hospital premises deterred the efficiency of essential staff in dealing with the emergency. This nature was exemplified in cases whereby daughters refused to leave the bedside of their mothers and when others refused to abandon their loved ones (Berry, 2013). In the event of disasters, personal evacuation plans remain the most crucial directives for proper disaster management and response. In the case of Memorial, there was no strict compliance to personal evacuation procedures. This was seen when one employee resorted to carrying a suitcase while stipulations were there to deter this.
Healthcare protocols within places like New Orleans need intense critic for them to be altered and reflect compliance to disaster mitigation. The first protocol that most city planners and health care administrators saw especially after Hurricane Sandy was the need to be careful about the location of significant utilities such as hospitals (Ardent & Hess, 2006). The location of most New Orleans hospitals is below the sea level. As such, this makes disastrous events such as Hurricanes lethal to these premises as they are immediately covered by floods “in the bowl” that is New Orleans. The most affected hospitals located in this vicinity include the Lindy Boggs Medical Center, Medical Center of Louisiana, Memorial Medical Center, Tulane University Hospital, among others (Ardent & Hess, 2006). Moreover, stipulations need to be put in place to ensure that the placement of hospitals is along important levees that are able to drain excess water in the event of serious flooding.
Aside from these relevant requirements for disaster mitigation and control, the government in conjunction with non-profit organizations such as the World Health Organization should effect appropriate measures for the suppression of calamitous effects brought forth by the myriad of disasters experienced within certain regions of continental America. Pre-measures such as the augmentation of the command and control, the safety and security features, and the continuity of essential services lacked proper implementation by the government in their effort while responding to the Katrina disaster (World Health Organization, 2011). Along with command and control, communication is also pertinent in ensuring proper understanding of the situation and its efficient tacking. For the continuity of operations, the government disaster preparedness lacked the essential human resources required to ensure passable staff capacities. Having the needed resources would have helped the patients of Memorial Medical Center consequently deterring their result to euthanasia as a means to save the lives of patients.
References
Ardent, L., & Hess, D. (2006). Hospital Decision Making in the Wake of Katrina: The Case of New Orleans . New York, NY: MCEER.
Berry, J. (2013). ‘Five Days at Memorial,’ by Sheri Fink . Nytimes.com . Retrieved 9 November 2017, from http://www.nytimes.com/2013/09/04/books/five-days-at-memorial-by-sheri-fink.html
Fink, S. (2014). Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital . New York, NY: Broadway Books.
Stroud, C., Bruce, M., Nadig, A., & Hougan, M. (2010). Crisis Standards of Care: Summary of a Workshop Series (1st ed.). Washington, DC: The National Academies Press.
World Health Organization. (2011). Hospital emergency response checklist: An all-hazards tool for hospital administrators and emergency managers . Copenhagen, Denmark: WHO Regional Office for Europe.
