Objective 2: New Guidelines for Disaster Medicine are Needed

Most existing AMA and other guidelines are not designed to address catastrophic events. Under ordinary procedures, extensive counseling with the patient, coordination and dialogue with family members and documentation of the process is required. During catastrophic events such as those witnessed during Hurricane Katrina, these normal procedures are often not possible and physicians and nurses are left with their "good faith medical judgment" under the existing extenuating circumstances. Military or government directives, loss of communication with outside resources, loss of routine medical equipment to sustain life, absence of complete medical records, and lack of routine consultation with treating physicians on safety concerns are all factors to be considered and guidelines should incorporate such factors.

Objective 3: A New Standard of Care: "Good Faith Medical Judgment During Disaster Response"

The normal "standard of care" by which doctor conduct is reviewed is difficult to gauge when conditions are not normal. The standard of care review should be "good faith medical judgment in the context of the disastrous circumstances under which doctors judgment is rendered." This would require bad faith/or malice to be an element of the proof of doctor misconduct, similar to the requirement to make government conduct actionable.

Objective 4: Panel Review or "A Jury of Your Peers"

Most states require some type of medical review panel before civil litigants can be proceed to court. This panel concept should be used for state and federal declared disasters and be presided over by special review panels consisting in part of medical personnel who are familiar with the medical issues involved and who are knowledgeable as to disaster medicine. In effect, the panel review process should be a condition precedent for further action by state prosecutors and/or civil litigants in connection with disaster related actions.

Again, the concepts suggested above will only be applicable in disaster situations, which can be ascertained by the timing of declaration of such disaster by the President and/or the Governor. Numerous federal laws and regulations are contingent upon a "Presidential Declaration of a disaster area." When these events occur, the "rules" change and if medical personnel are to respond to these situations, additional protections should be afforded when these disasters occur.

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