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Fri Apr 3, 2020, 06:59 PM

In Crowded Hospitals, Who Will Get Life-Saving Equipment?

STEPHEN WALL, AN emergency room doctor in Manhattan, could see the surge on the horizon. In calmer times, he might need one ventilator per shift—for a patient suffering from a trauma, usually, like a fall. But as the Covid-19 patients arrived last week, the intubations were happening every two hours, he says, “like clockwork.” He had watched the situation unfold elsewhere in New York, like at Elmhurst Hospital, in Queens, where patients reportedly died waiting for staff and beds. At the current rate, Wall knows his own ER is headed in the direction of a similar shortage. “We’re going to have to ration,” he says. “We’re just a few weeks behind.”

But what would rationing a ventilator actually mean? To Wall, who also researches clinical bioethics at New York University, the answer was opaque. Would he be asked to prioritize by age, turning away the elderly, as some hospitals in Italy did? What if the choice was between an old person and a younger one who was far less healthy and more likely to die, even with a ventilator’s aid? What if that patient was a health care worker who might, in the weeks ahead, get better and save more people? The guidance was unclear.

“This is being discussed all over America right now,” says Nancy Berlinger, a researcher at the Hastings Center, a nonprofit bioethics think tank. The situation is for now most pressing in New York, with its dramatic surge in cases. But for medical ethicists elsewhere, the scenes there are a warning to prepare.

“[Deborah] Birx said it’s not time to be talking about rationing, that people shouldn’t worry there is no bed for them. I completely disagree with that,” says Arthur Caplan, head of the medical ethics division at New York University Medical School, referring to the response coordinator for the White House Coronavirus Task Force. “It’s time to get ready for surges. Some little guys like Elmhurst Hospital are already overwhelmed.” Caplan is leading efforts at NYU to develop a rationing plan that will help guide doctors like Wall. He expects to release it within days.


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Reply In Crowded Hospitals, Who Will Get Life-Saving Equipment? (Original post)
icymist Apr 3 OP
delisen Apr 3 #1
keithbvadu2 Apr 3 #2
elocs Apr 3 #3

Response to icymist (Original post)

Fri Apr 3, 2020, 07:30 PM

1. Ethics is also speaking truth to power. Caplan need to address the big picture

or he is not being ethical in his desire to create rationing rules.

He needs to ask his school and NYU itself to speak out against the Trump administration's failures and demand that the administration act immediately and completely to provide what is needed.

Any so called medical ethicist who wants to focus on drawing up rationing ruled for citizens without demanding addressing the ethics of withholding supplies and materials on the national level is no ethicist.

What we are seeing here is the hollowness of our so-called elite educational institutions.

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Response to icymist (Original post)

Fri Apr 3, 2020, 07:38 PM

2. Who Will Get Life-Saving Equipment?

Who Will Get Life-Saving Equipment?

Will there be a loyalty test to Trump involved?

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