National Academy of Medicine

The National Academy of Medicine, referred to in the book as the Institute of Medicine (IOM), enters the account through its published work rather than through direct participation in the events at Memorial. The cited reports address crisis standards of care: how medical systems might organize treatment when a disaster strains available resources and ordinary standards become difficult to maintain.

Reports on Crisis Standards

A 2009 publication cited in the book is Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations: A Letter Report, edited by Bruce M. Altevogt, Clare Stroud, Sarah L. Hanson, Dan Hanfling, and Lawrence O. Gostin, and published by the National Academies Press. Its title places the work within the effort to formulate guidance for care during disasters, rather than treating emergency practice as a collection of isolated bedside decisions.

The book also cites the IOM’s seven-volume Crisis Standards of Care: A Systems Framework for Catastrophic Disaster Response, published in 2012. The reference identifies volume 6, pages 347–463, as an extensive treatment. Together, the two citations trace a movement from a 2009 letter report to a large, multivolume framework for catastrophic response; the book does not, however, attribute specific recommendations from those volumes to the institution beyond what the cited references establish.

Place in the Book’s Argument

These works appear in the book’s discussion of how crisis-care protocols are devised and what they can—and cannot—settle. The surrounding analysis questions whether protocols for withdrawing life-sustaining care can be justified when patients have not consented, and whether a protocol that is unlikely to save more lives can be defended. The IOM reports provide documentary context for that wider debate about standards under extreme scarcity; their presence does not make them a direct account of Memorial’s decisions.

The citations also situate the discussion within a broader systems-level inquiry. Rather than treating disaster medicine solely as the choices of individual clinicians, the book places crisis standards alongside reports concerned with catastrophic disaster response. The institution’s significance here is therefore evidentiary and intellectual: its publications mark an attempt to frame emergency care as a matter of organized policy, while the book tests the moral limits and practical consequences of such frameworks.