The “very elderly” likely won’t receive life-saving treatment in the event of a pandemic emergency, a new report states.

That is the reasoning behind new guidelines that would govern the allocation of scarce critical care resources in the event of a pandemic, such as a mass outbreak of deadly influenza. In an emergency, say report authors, resources should be dispersed among those who will benefit most from treatment, not those who already have a short life expectancy. Besides the elderly, those with severe dementia, seriously hurt trauma victims and severely burned patients could be denied treatment.

Withholding care from this group of victims in an emergency can be a harrowing decision for doctors and nurses, and the legal and ethical questions raised are enormous. The authors have recommended a liability shield to protect doctors who make these tough decisions in good faith. A consortium of caregivers formed the guidelines.

These guidelines were published as a supplement to the journal CHEST, the peer-reviewed journal of the American College of Chest Physicians (ACCP). For more information on the report and on its authors, please go to www.chestjournal.org.