Publications by authors named "Chin-Lin Ching"

Article Synopsis
  • The study examines different Crisis Standards of Care (CSC) protocols for rationing ventilators during the COVID-19 pandemic, focusing on the balance between saving lives, life-years, and reducing racial disparities.
  • Using a Monte Carlo simulation based on patient data from a New York hospital, the research compares the effectiveness of various age-sensitive and non-age-sensitive protocols in saving lives and life-years.
  • Results indicate that age-sensitive protocols perform best in saving lives and life-years, whereas certain New York and Maryland protocols saved the least lives but did not significantly impact racial disparities.
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Introduction: Arguments over the appropriate Crisis Standards of Care (CSC) for public health emergencies often assume that there is a tradeoff between saving the most lives, saving the most life-years, and preventing racial disparities. However, these assumptions have rarely been explored empirically. To quantitatively characterize possible ethical tradeoffs, we aimed to simulate the implementation of five proposed CSC protocols for rationing ventilators in the context of the COVID-19 pandemic.

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AbstractWe explore the various ethical challenges that arise during the practical implementation of an emergency resource allocation protocol. We argue that to implement an allocation plan in a crisis, a hospital system must complete five tasks: (1) formulate a set of general principles for allocation, (2) apply those principles to the disease at hand to create a concrete protocol, (3) collect the data required to apply the protocol, (4) construct a system to implement triage decisions with those data, and (5) create a system for managing the consequences of implementing the protocol, including the effects on those who must carry out the plan, the medical staff, and the general public. Here we illustrate the complexities of each task and provide tentative solutions, by describing the experiences of the Coronavirus Ethics Response Group, an interdisciplinary team formed to address the ethical issues in pandemic resource planning at the University of Rochester Medical Center.

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