Decision-making in the time of a pandemic

We as radiation oncologists stay in the realm of unknowns. We deal with uncertainties and since ages have been trying to reduce them with more quantifiable measures. Viral pandemics are almost “similar”; start off somewhere and end up infecting nations.

The current crisis is a case in point. How the pandemic is going to unfold is unknown and unknowable. The full set of possible outcomes is too complex to enumerate, and it is foolish to think there are precise, objective probabilities for each of those outcomes.

However, survival values do have quantifiable outcomes- a patient is either alive or not. However, the range of complex probabilities make it extremely difficult (and morally repugnant decisions) to continue with “targeted therapies” in the vain hope of keeping someone alive (with the promise of a “disease-free-survival”). In this scenario, I have always pushed out for palliative care.

As western economies will be forced to accept these decisions (to triage patients with the best possible outcomes), I would be prepared for a lot of heart wringing narratives.

via Decision-making in the time of a pandemic | Financial Times