Title : "Doctors have reckoned with the need to allocate resources in the face of overwhelming demand long before coronavirus."
link : "Doctors have reckoned with the need to allocate resources in the face of overwhelming demand long before coronavirus."
"Doctors have reckoned with the need to allocate resources in the face of overwhelming demand long before coronavirus."
"[Lydia Dugdale, professor of medicine and director of the center for clinical medical ethics at Columbia University] points out that the New York department of health’s ventilator allocation guidelines, published in November 2015 to address the issue amid a flu epidemic, states that first-come first-serve, lottery, physician clinical judgment, and prioritizing certain patients such as health care workers were explored but found to be either too subjective or failed to save the most lives. Age was rejected as a criterion as it discriminates against the elderly, and there are plenty of cases in which an older person has better odds of survival than someone younger. So the decision was to 'utilize clinical factors only to evaluate a patient’s likelihood of survival and to determine the patient’s access to ventilator therapy.' In tie-breaking circumstances, though, they did approve treating children 17 and younger over an adult where both have an equal odds of surviving.... 'I would say that leaving some to die without treatment is NOT ethical, but it may be necessary as there are no good options,' David Chan, philosophy professor at the University of Alabama at Birmingham, writes. 'Saying that it is ethical ignores the tragic element, and it is better that physicians feel bad about making the best of a bad situation rather than being convinced that they have done the right thing.'"From "Ethicists agree on who gets treated first when hospitals are overwhelmed by coronavirus" by Olivia Goldhill (Quartz).
Do you think it's right to take age into account only to benefit the super-young — those under 18? Would you choose between a 20 year old and a 70 year old solely on the basis of who is more likely to survive? I suspect the age factor is bundled into the assessment of who's more likely to survive, which would simply hide the disapproved-of discrimination against the elderly. By contrast:
Italy has prioritized treatment for those with “the best chance of success” but adds as a second criterion those “who have more potential years of life.”Another thing I wonder about is the issue of surviving without the ventilator. What if, for example, X has an 80% chance of surviving without a ventilator and a 90% chance of surviving with it and Y has a 10% chance of surviving without a ventilator and a 60% chance of surviving with it? Does X, the more vigorous person, get the task of struggling to survive without the ventilator? And do you take into account how long a person will need the ventilator? Maybe you could save 2 of my Xs in the time it would take Y to get well or perish.
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