In case of an epidemic or some other kind of disaster, a group of doctors know that some patients needing lifesaving care won’t get it, says the AP. The dilemma will be deciding who to let die. No problem, says one group of doctors. They’ve come out with a list. (I hope you’re not on it)

An influential group of physicians has drafted a grimly specific list of recommendations for which patients shouldn’t be treated. The list appeared Monday in the May edition of Chest, the medical journal of the American College of Chest Physicians.

The list of those to “let die” include “the very elderly, seriously hurt trauma victims, severely burned patients and those with severe dementia.”

To prepare, hospitals should designate a team with the Godlike task of deciding who will and who won’t get lifesaving care, the task force wrote. Those out of luck are:

-People older than 85.

-Those with severe trauma, which could include critical injuries from car crashes and shootings.

-Severely burned patients older than 60.

-Those with mental impairment, which could include Alzheimer’s disease.

-Those with a severe chronic disease, such as advanced heart failure, lung disease or poorly controlled diabetes.

The list was compiled by a task force whose members come from prestigious universities, medical groups, the military and government agencies -which is to say the last people you’d want making a list like this.

The proposed guidelines are designed to be a blueprint for hospitals “so that everybody will be thinking in the same way” when pandemic flu or another widespread health care disaster hits, said Dr. Asha Devereaux, a critical care specialist in San Diego and lead writer of the task force report.

Show of hands -anytime a group that’s in charge say they want everyone “thinking in the same way” do you get a little nervous?

The idea, they say, is to try to make sure that scarce resources — including ventilators, medicine and doctors and nurses — are used in a uniform, objective way, task force members said.

Dr. Kevin Yeskey, director of the preparedness and emergency operations office at the Department of Health and Human Services, was on the task force. He downplayed the report saying it would be among many the agency reviews as part of preparedness efforts.

I would just like to know which hospitals sign on to the list, OK?

The proposals, said one public policy expert, resemble a battlefield approach in which limited health care resources are reserved for those most likely to survive.

Look, nobody suspect more than me that we are way overdue for an Old Testament sized butt whoopin’. And everyone knows if things really hit the fan and there are scarce resources that care must be given to those with a greater chance of survival. But to come out with a list such as this seems like the first step of something, doesn’t it? It codifies something that maybe would be better left unsaid for a while.

One of the scariest things about this is the question of who defines how scarce resources have to get before the list is utilized. Does a recession count? Resources are always finite so when do we start “letting” people die? Doesn’t it make you feel a little uneasy?