New York: Already, ambulance drivers are being told NOT to bring heart attack victims to hospitals if they cannot revive the patient at the scene; effectively denying life-saving surgery and treatment to those in need, who could otherwise be saved.
Now, a Harvard doctor is developing a “point system” to help decide which patients receive life-saving treatment.
Unfortunately, this is not a new concept. When faced with decisions regarding who gets treatment, doctors choose patients with the most promising possibility of positive outcomes.
Doctors have stated that more than 50% of people put on ventilators are dying anyway.
Guidelines that could determine which coronavirus patients get prioritized for lifesaving care vary by state, involving factors such as age, health problems, pregnancy and cognitive abilities.
A hospital in Washington State projects that it may not have enough ventilators in two weeks. New York State could be thousands of ventilators short of what it needs. In Michigan, a hospital system has prepared warnings for patients about what will happen if it gets more patients than it can handle.
The answers are stark: some patients would get full intensive care treatment, some would not. But which ones?
Across the country, hospitals and public health officials are working on plans for what happens if the number of coronavirus patients exceeds the available space in intensive care units.
Many states have developed triage plans for what happens in a natural disaster or a severe pandemic, if hospitals are overwhelmed. As the coronavirus pandemic expands, they have been re-examining those plans, hoping they will be useful if hospitals have more critically ill patients than ventilators.
The plans struggle to address a range of ethical issues, and also matters of social equality. People with underlying medical problems may get ranked lower, yet low-income people and people of color often have more health problems because they cannot afford top-notch care.
One common strategy, including for New York and Maryland, is to exclude patients who may have a cardiac arrest that is unresponsive to standard interventions such as defibrillation. Plans can also exclude those who may have had a major brain injury or severe burns where the likelihood of survival is low.
A triage plan on the Alabama health department’s website suggests that “persons with severe mental retardation” are among those who “may be poor candidates for ventilator support.” Washington State’s guidelines include the consideration of a “baseline functional status” for each patient, considering such factors as declines in energy level, physical ability and cognition.