354 Schedule with Abstracts Vol. 39 No. 2 February 2010

Court to provide clear guidance, by the end ofthe session the learner should have a better un-derstanding of what the issues are and methodsof approaching cases that involve requests formedical treatments that are felt to be futile orunethical by the healthcare provider.Our hope is that the unique collaboration be-tween these two presenters, one a practicing pe-diatrician and palliative medicine specialist andone a registered nurse attorney who specializedin medical ethics, will stimulate a thoughtfuland educational discussion.

DomainEthical and Legal Aspects of Care

Pandemic Palliative Care: Time to Plan(315)Phillip Rodgers, MD, Ann Arbor, MI. C.Porter Storey, MD FACP FAAHPM, ColoradoPermanente Medical Group, Boulder, CO.(All speakers for this session have disclosed norelevant financial relationships, Rodgers will dis-cuss off-label use.)

Objectives1. Discuss the impact of a pandemic on commu-

nities, populations, and healthcare resources,as well as the nature and scale of an effectivesystemic response.

2. Identify key ethical considerations for pan-demic response, including scarce resourceallocation and duty to care.

3. Describe the role of palliative care and hos-pice resources in pandemic planning andresponse.

Over the past several years, consensus has grownthat an influenza pandemic is inevitable. Theemergence of the H5N1 strain (avian flu) andthe re-emergence of H1N1 (swine flu) strainhave raised concerns among governments,health officials, and the public at large that weare ill-equipped to manage another worldwideoutbreak, and have catalyzed broad action to en-hance preparedness. In the United States, theDepartment of Health and Human Services hasbeen joined by a growing number of state andprivate organizations to develop coordinatedpandemic response plans. Much of this efforthas focused on stockpiling and distribution strat-egies for vaccines, antiviral medications, me-chanical ventilators, and supplemental oxygen.Additional work has attempted to model thephysical plant and personnel needs for local

and regional pandemic responses, as well ethicalframeworks for duty to care and scarce resourceallocation.To date, however, there has been little writtenabout providing palliative and end-of-life careduring a significant pandemic. Based on thethree major 20th century influenza pandemics,3% to 5% mortality can be expected in mostcommunities. While mortality rates may beslightly lower today given more widespread avail-ability of advanced treatments, influenza-relateddeaths will be compressed in a very short periodof time (roughly 8 to12 weeks) and thus will re-quire a swift, structured response to adequatelymeet needs for supportive and palliative care.This session will outline the process used by theUniversity of Michigan Health System to createits pandemic response plan, including the roleof palliative care and hospice personnel and re-sources in responding to potentially massivenumbers of severely and terminally ill patientsand families. We will focus on practical, ethical,and systemic considerations in planning for pan-demic palliative care, and engage participantsactively to share and debrief their own experi-ences and perspectives.

DomainsStructure and Processes of Care; Ethical andLegal Aspects of Care

Update on National Palliative Care News:How the Big Picture Affects You (316)Diane Meier, MD, Mount Sinai School of Medi-cine, New York, NY.(Meier has disclosed no relevant financialrelationships.)

Objectives1. Identify national issues that affect their prac-

tice and the field of palliative care.2. Discuss national and state and regulatory

issues.3. Discuss how these national issues are affecting

their practice.

As the palliative care field grows, it is importantfor busy practitioners to keep current on the na-tional issues that affect you and your patients.This session will review the state of the fieldfrom the perspective of policy makers, payers,regulators, and quality organizations such asNQF, the Joint Commission, and CMS. Nationaland state legislative discussions in the pipelinefor policy decisions will also be presented. At