Is this what we have come to? Doctors being forced to decide who lives and who dies because there are not enough basic medical supplies, including life-saving ventilators, for desperately sick patients?
The medical industry publication MedPage Today asked physicians what they would do if forced to choose between keeping an elderly #coronavirus patient with a heart condition on a ventilator or giving it to a younger patient with a better chance of survival.
Ultimately, because of ventilator shortages, physicians may have to decide “who lives and who dies,” said Dr. Ezekiel Emanuel, an oncologist and chairman of the University of Pennsylvania’s department of medical ethics and health policy, reported USA Today.
“It’s horrible,” Emanuel said. “It’s the worst thing you can have to do.”
Because the worst cases of #COVID-19 rob the patient of the ability to breathe, they can die without the oxygen provided by the machines. But there are less than 100,000 ventilators in the U.S., a number that could be far less than the number of patients who may need them.
The reality of this is such that MedPage Today published a survey, called Ethics Consult: COVID-19, to take the pulse of providers.
Here's the setup:
"A 71-year-old patient with an underlying heart condition arrives at the hospital with symptoms of COVID-19. He is placed in isolation in the emergency department. Test results confirm the patient has COVID-19. His condition deteriorates and he is placed on a ventilator.
"During his stay in the hospital, the infection rate spikes in the city. Severely sick patients overrun the hospital capacity quickly and there aren't enough resources. Many of the patients are young, between 20-50, and otherwise healthy but still require ventilators.
"Doctors, nurses, and the rest of the healthcare team are forced to decide which patients they should focus their attention and care on."
Reader Responses
Answer 1 -- "You would use all information in such a situation to make the decision (triage) If the old patient was seriously demented and had no conscious life would be an important factor. Any younger patient whose condition was dire with minimal chance of recovery should not replace a previously healthy old person."
Answer 2 -- "Would it make a difference if you knew the oldster is involved with helping the less fortunate, is an employer of 1500 people? Just because one is young doesn't mean they are a better contributor to the community."
Answer 3 -- "If one follows basic religious/ethical doctrine (Christian-Judaic), one human life is not more important than another. In the real world however, with limited resources, ultimately prioritization becomes necessary. Triage during war and or major disasters teach us that we must try to salvage those most likely to survive. The problem with the questions posed by this post is that the college student, from a medical perspective, is more likely to survive using other technology than a ventilator, e.g. IPPB etc. than the older patient who likely would not survive without the machine."
Answer 4 -- "Many 70 years old are not “old” at all and are full of life, happiness, joy, love and in pretty good health. Making a decision to remove an older person off a respirator to give it to a younger patient is different with every individual situation and person."
Answer 5 -- "In the USA the older population is unwanted, it knows a lot and has credit multiply by years to be alive here. So what is the point? This is the policy of the leading crowd and politicians. Democracy is only for believers and freedom just for sale."
Why are our doctors and nurses being put in such a position? Why weren't we better prepared? There was plenty of notice, if Trump and his people had paid attention to the warnings and taken action.
Ventilators by Ford?
Why must President Trump now ask automobile companies to start making ventilators instead of cars?
Really, they can convert their automobile assembly lines into ventilator assembly lines? And just like that?
“You’re not going to take a car-assembly line and start making ventilators on it,” said Carla Bailo, chief executive officer of the Center for Automotive Research in Ann Arbor, Michigan, according to Bloomberg.com. “It won’t make sense.”
However, said Bloomberg, automakers are working to see if they can orchestrate provisional manufacturing of ventilators in as soon as two weeks.
“It’s more or less getting an army together to get all the different parts and then you can set-up a makeshift assembly line,” Bailo said.
Meanwhile, doctors and nurses may soon be faced with the kind of decision nobody ever should have to make. Who should live, and who should die?
My question is this: Who should be held accountable for this mess?