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Shortages of drugs, surpluses of ethical challenges: An allocation framework for childhood cancer


Leikin Lecture - Shortages of Drugs, Surpluses of Ethical Challenges: An Allocation Framework for Childhood Cancer

Presented by
Yoram Unguru, MD, MS, MA
Attending Physician, Division of Pediatric Hematology/Oncology,
The Herman & Walter Samuleson Children’s Hospital at Sinai
Core Faculty, Johns Hopkins Berman Institute of Bioethics
Assistant Professor, John Hopkins School of Medicine

Drug shortages in general, and chemotherapy shortages specifically, have become commonplace in the US. Children are particularly prone to drug shortages, including shortages of life-saving chemotherapy and supportive care agents, which provide a unique lens from which to examine this problem. Clinicians lack formal guidance when confronted with deciding how to allocate scare essential medications. A recently proposed ethical framework for allocating scarce life-saving chemotherapy will be reviewed. The framework provides explicit decision-making in the face of an actual drug shortage and is specifically designed to provide frontline clinicians assistance as they face medication rationing.

Learning Objectives
Attendees of this session will be able to:

  1. Recognize the ethical challenges clinicians & institutions face when rationing chemotherapeutics for children with cancer
  2. Propose an allocation schema for rationing life-saving chemotherapeutics
  3. Describe existing models used for allocating life-saving scarce resources, including their strengths and weaknesses
  4. Review the proposed prioritization framework to assist healthcare providers & administrators ethically ration life-saving drugs

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