This article reports on revised state crisis standards of care (CSC) guidance from the Massachusetts Department of Public Health that addresses allocations of scarce critical care resources.

As discussed in an earlier post, some lawmakers and advocates raised objections to earlier guidelines from the state on the basis that patients would be less likely to receive scarce resources due to underlying health conditions. This would potentially result in a disproportionate burden of rationing falling on patients with disabilities and patients of color, who are more likely to have such co-morbidities due to systemic inequities.

The updated guidance removes references to co-morbidities and emphasizes a patient’s near-term prognosis and likelihood of short-term survival. The guidance also notes that appropriate modifications should be applied for persons with disabilities in determining Sequential Organ Failure Assessment (SOFA) score, the core basis for establishing near-term prognosis. The guidelines are voluntary and encourage hospitals to include diversity officers on review and oversight committees when possible.

The revised guidance is available here.