Priority setting of ICU resources in an influenza pandemic: a qualitative study of the Canadian public's perspectives

<p>Abstract</p> <p>Background</p> <p>Pandemic influenza may exacerbate existing scarcity of life-saving medical resources. As a result, decision-makers may be faced with making tough choices about who will receive care and who will have to wait or go without. Although previous studies have explored ethical issues in priority setting from the perspective of clinicians and policymakers, there has been little investigation into how the public views priority setting during a pandemic influenza, in particular related to intensive care resources.</p> <p>Methods</p> <p>To bridge this gap, we conducted three public town hall meetings across Canada to explore Canadian's perspectives on this ethical challenge. Town hall discussions group discussions were digitally recorded, transcribed, and analyzed using thematic analysis.</p> <p>Results</p> <p>Six interrelated themes emerged from the town hall discussions related to: ethical and empirical starting points for deliberation; criteria for setting priorities; pre-crisis planning; in-crisis decision-making; the need for public deliberation and input; and participants' deliberative struggle with the ethical issues.</p> <p>Conclusions</p> <p>Our findings underscore the importance of public consultation in pandemic planning for sustaining public trust in a public health emergency. Participants appreciated the empirical and ethical uncertainty of decision-making in an influenza pandemic and demonstrated nuanced ethical reasoning about priority setting of intensive care resources in an influenza pandemic. Policymakers may benefit from a better understanding the public's empirical and ethical 'starting points' in developing effective pandemic plans.</p

The Rise and Demise of the Soviet-Made Housing Shortage in the Baltic Countries

This chapter reviews the factors underlying the rapid emergence and subsequent narrowing of the Soviet-made housing shortage (i.e. the rise and slow demise of underurbanisation) in the Baltics, corroborating the analysis with findings from archival research on housing construction and allocation in the Latgalian city of Daugavpils between 1945 and 1991. It is suggested that the dynamics of the housing shortage, and the way the Soviet authorities attempted to tackle it, acted as a powerful alternative source of housing and socio-spatial differentiation, and that tracing the priorities assigned by economic planners to the different actors involved in housing construction facilitates the decoding of the Baltic residential landscapes. The chapter starts by portraying the roots of housing shortage, including the radical suppression of market forces and the housing nationalisation shock of the post-WWII years. It then discusses housing construction, housing tenure forms and housing allocation, and describes the specific experience of Daugavpils within these areas in order to shed light on the overall context of residential differentiation in the Baltics