Drug Shortages Forcing Hard Decisions at Hospitals

Drug shortages are forcing hard decisions at medical centers across the country. In recent years, shortages of anesthetics, painkillers, antibiotics, and cancer treatments have become the new normal in American medicine.

The American Society of Health-System Pharmacists currently lists inadequate supplies of more than 150 drugs and therapeutics, as a result of manufacturing problems, federal safety crackdowns, and drugmakers abandoning low-profit products, The New York Times reports.

In some cases, the shortages have led to rationing the medications.

At medical institutions across the country, choices about who gets drugs have often been made in ad hoc ways that have resulted in contradictory conclusions, murky ethical reasoning, and medically questionable practices, The Times reports.

Some hospitals have formal committees that include ethicists and patient representatives; in other places, individual physicians, pharmacists and even drug company executives decide which patients receive a needed drug — and which do not.

A group of pediatric cancer specialists was so troubled about the approach to distributing scarce medicine that it released rationing guidelines Friday in The Journal of the National Cancer Institute.

“It was painful,” said Dr. Yoram Unguru, an oncologist at the Children’s Hospital at Sinai in Baltimore and a faculty member at the Berman Institute of Bioethics at Johns Hopkins University. “We kept coming back to wow, we’ve got that tragic choice: two kids in front of you, you only have enough for one. How do you choose?”