Editorial Staff

New Study Calls for Re-thinking Massachusetts’ COVID-19 Care Standards

/in , , , , , , , , /by Editorial Staff
Share on Facebook
Share on Twitter
Share on
LinkedIn
+

BOSTON – The Massachusetts Department of Public Health’s (DPH’s) Crises Standards of Care (CSC) issued earlier this month bear the earmarks of a state bureaucratic effort. The guidelines need to be rethought under a process that includes a thorough vetting by Massachusetts citizens, according to a new study published by Pioneer Institute.

“The guidelines have not been vetted by the vulnerable populations most likely to be affected by them,” said Barbara Anthony, author of “Massachusetts Crisis Standards of Care Guidelines Need Re-thinking.” “Nor do they include a sufficient role for either the medical teams that care for patients or the patients’ families.”

The insidious nature of COVID-19 means those who need ventilation to breathe but have no access to the necessary equipment will likely die.

The DPH guidelines appear to take direction from a 2011 report prepared by the Centers for Disease Control and Prevention’s Ventilator Working Group. But that report repeatedly highlights the need for transparency and community input in the development of such guidelines.

Instead, the DPH guidelines focus on strict mathematical formulas, first to determine the likelihood that a patient will survive, then to calculate the number of years the patient is likely to live post-recovery. This second calculation is based on variables such as age, comorbidities and pre-existing conditions – even if the conditions are under control thanks to medication.

While it’s unclear who would perform the initial assessments on which calculations are based, responsibility for implementing the guidelines falls to a “Triage Team” that is unlikely to have ever seen the patient. Clinical staff have no involvement in decisions about the initiation, continuation or withdrawal of treatment.

Initial decisions can first be appealed to a “Triage Team,” but the scope of review is limited to mathematical errors in calculating the scores on which decisions are based. One further appeal can be made to a Triage Appeals Board and its decision is final. It does not appear that the patient’s family or a personal advocate for the patient would have any involvement in any appeal.

While there appears to be little or no role for the patient’s family or clinical team, the guidelines require legal counsel to be present when the Triage Appeals Board makes decisions.

“These guidelines put the state in a godlike position,” said Pioneer Executive Director Jim Stergios. “There are too many variables involved to accurately forecast a person’s lifespan—or the value of that life.”

Earlier this month, The Boston Globe reported that 18 organizations had already written Governor Baker asking him to reconsider the guidelines.

In Italy, which has been devastated by COVID-19, similar guidelines came from a medical society on the front lines of battling the pandemic, not central or regional governments.

About the Author

Barbara Anthony, lawyer, economist, and public policy expert, is a Senior Fellow in Healthcare Policy at Pioneer Institute. She was also a former Senior Fellow and Associate at the Harvard Kennedy School’s Center for Business and Government where she researched and wrote about Massachusetts market reform and healthcare cost containment efforts. She served as Massachusetts Undersecretary of the Office of Consumer Affairs and Business Regulation from 2009 to 2015 and has worked at the intersection of federal and state commercial regulation and the business community for many years. Among other positions, Anthony served as the Director of the Northeast Regional Office of the Federal Trade Commission in Manhattan, and was a top deputy to the Massachusetts Attorney General. She began her career as an Antitrust Trial Attorney at the U.S. Justice Department in Washington, D.C. Anthony is a well-known consumer advocate and regularly appears as a media commentator on consumer protection and business regulation issues.

About Pioneer

Pioneer Institute is an independent, non-partisan, privately funded research organization that seeks to improve the quality of life in Massachusetts through civic discourse and intellectually rigorous, data-driven public policy solutions based on free market principles, individual liberty and responsibility, and the ideal of effective, limited and accountable government.

Get Our COVID-19 News, Tips & Resources!

  • This field is for validation purposes and should be left unchanged.

Recent Content

MA Commissioner Jeff Riley on Remote Learning, Voc-Techs, & Reforming Boston’s Schools

0 Comments
/
This week on “The Learning Curve,” Cara and Gerard open with commentary on the George Floyd tragedy and K-12 education’s role in addressing racial injustice. Then, they are joined by Jeffrey Riley, the Massachusetts Commissioner of Elementary and Secondary Education, to talk about the unprecedented challenges of COVID-19.

Easthampton High Scores A National Educational Victory During The COVID-19 Pandemic

0 Comments
/
This spring, Massachusetts’ Easthampton High School was crowned national champion in the “We the People: The Citizen and the Constitution” contest. The competition brings together about 1,200 students from across the country to answer civics questions based on America’s Founding Documents including the U.S. Constitution; The Federalist Papers; and U.S. Supreme Court decisions.

Experts Find K-12 Online Education Can Be Appropriate for Most Special Needs Students

School closures due to COVID-19 have separated more than seven million K-12 special needs students from support they receive in the classroom, but online learning can be appropriate for most of those students if teachers and parents work as a team to provide each one with what he or she needs, according to a new report published by Pioneer Institute and ASU Prep Digital.

Pioneer Institute Looks Ahead to the Protection of Civil Liberties

Challenges to Americans’ civil liberties have increased in recent years.  History teaches us that during national emergencies governments are even more likely to overstep and violate constitutionally guaranteed freedoms. To address this concern, Pioneer Institute has created “Respect My Rights,” a web-based hotline to which citizens can submit complaints and descriptions of violations they have experienced.

COVID-19 Roundup from Pioneer: Antibodies & immunity; Talking about WHO; Telecommuting Survey Results; Mapping COVID – Update; & more!

0 Comments
/
Pioneer staff share their top picks for COVID-19 stories highlighting useful resources, best practices, and questions we should be asking our public and private sector leaders.

Even for the most remote part of Massachusetts (Franklin County), it’s far from business as usual

0 Comments
/
The Connecticut River valley is home to some of the most productive…

Hubwonk Ep. 8: Who is WHO? COVID-19, Massachusetts, and the unhealthy World Health Organization

0 Comments
/
Hubwonk host Joe Selvaggi and Pioneer Healthcare Senior Fellow Josh Archambault are joined by Hoover Institution’s Dr. Lanhee Chen to discuss the role that the World Health Organization (WHO) plays, what dysfunction may have contributed to the scale of the COVID-19 pandemic, and what steps can be taken to bring back transparency and trust.

Study: Safely Reopening Office Buildings Will Require Planning, Innovation

0 Comments
/
Safely bringing employees back into workplaces presents a significant challenge for employers located in office buildings, particularly when it comes to elevator operations and building entry and exit.  To address the challenge, managers must develop plans to control the flow of workers, according to a new study published by Pioneer Institute.

Acclaimed Poet & Former NEA Chairman Dana Gioia on Poetry & Arts Education

0 Comments
/
This week on “The Learning Curve,” Cara and Gerard are joined by Dana Gioia, a poet, writer, and the former Chairman of the National Endowment for the Arts, to talk about why the arts are so pivotal to the intellectual and civic development of America’s K-12 schoolchildren.

38.8 percent of the Massachusetts workforce and 28.3 percent of the U.S. workforce have filed unemployment claims over the past ten weeks.

0 Comments
/
Data released today by the U.S. Department of Labor shows that 38.8 percent of the Massachusetts workforce and 28.3 percent of the U.S. workforce have filed unemployment claims since the COVID-19 unemployment surge began ten weeks ago.

Once anchored by higher education, Hampshire County, MA finds itself out of work after a cancelled semester

0 Comments
/
The 38,000 college and university students at the Five College…

In Hampden County, COVID-19 exacerbates a stark employment divide between urban and rural areas

0 Comments
/
Hampden County, Massachusetts, home of Western New England’s…

Study: Officials Must Address Basic Questions to Improve Public School Computer Science Education

Even as the COVID-19 pandemic has further transitioned education towards electronic devices, computer science education in K-12 public schools around the country faces a number of daunting challenges, according to a new study published by Pioneer Institute.

Hubwonk Ep. 7: Covid Testing: What went wrong, where we are & when we’ll get closer to normalcy

0 Comments
/
https://www.podtrac.com/pts/redirect.mp3/chtbl.com/track/G45992/feeds.soundcloud.com/stream/828394294-pioneerinstitute-hubwonk-ep-7-covid-testing-what-went-wrong-where-we-are-when-well-get-closer-to-normalcy.mp3 Join…

As stay-at-home orders remain in place at the start of summer tourist season, COVID-19 takes a bite out of resort towns’ economies

0 Comments
/
Last month, Pioneer Institute showed that the hospitality and…

Survey Suggests Demand for Telecommuting After COVID-19 Crisis

Citing an avoidance of the commute and more flexible scheduling, nearly 63 percent of respondents to Pioneer Institute’s survey, “Will You Commute To Work When The COVID-19 Crisis Is Over?” expressed a preference to work from home one day a week, and a plurality preferred two to three days a week, even after a COVID-19 vaccine is available. Respondents cite social isolation as the biggest drawback of remote work. The survey was conducted from April 22nd to May 15th, and received responses from over 700 individuals.

It’s Time for the MBTA to Actively Engage Riders to Understand Their Commuting Plans

0 Comments
/
The MBTA should conduct a survey of mTicket app users regarding their future plans. Some may never work in offices again. Some will certainly do some workdays in the office and some at home. Others will be in offices and back to business as usual at some point. Using their responses, the T can calculate ridership and determine projected revenue.

Today’s Bureau of Labor Statistics estimate of a 15.1 percent unemployment rate in April only reflects half of Massachusetts’ COVID-19 unemployment surge

0 Comments
/
Today's release by the Bureau of Labor Statistics of a 15.1%…