Certain emergencies (e.g., pandemics) as well as financial and human resource constraints,
make the consideration of how to manage conflicting duties all that more critical for
each healthcare professional. Under the extreme pressure that such an event can have
on the healthcare system, surge response strategies often need to be put into place to
ensure that the greatest number of patients/clients benefit from the available resources.
In these situations, the basic principles for ethical treatment of patients/clients must
remain. However, there sometime needs to be a shift in the focus from what is best for
each individual to what will benefit those most in need. Even less urgent situations may
necessitate making the best use of limited resources.
A patient/client who has suffered a head injury is being transported from a community hospital to a tertiary care centre. There are two RTs on nights at the community hospital and one is being asked to accompany the non-intubated individual on transport. This would leave the other RT to care for the entire hospital alone. What would be the best course of action?
The ethical principles involved are to do good and do no harm, balanced with the need to act fairly.
There are a great many variables when determining whether the RT should go out on the transport or remain in hospital. Many facilities have criteria set out in policy in order to assist the RT in establishing priorities in situations such as this. There is no one correct answer and it depends on factors such as the likelihood the patient/client going on transport will not be able to protect their airway, the level of current acuity at the hospital, etc. It is expected that the RT make a decision, with the greater good in mind.