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Who should doctors save? Inside the debate about how to ration #coronavirus treatment: https://bit.ly/2XcFzW1
"The reality is, we already have a very unfair allocation of health care resources," says @BobTruog, a critical-care pediatrician and bioethicist at @harvardmed. "If you're poor and uninsured, you already don't get the kind of health care you need."
State guidelines for "crisis standards of care," which are meant to help when ERs are inundated and resources are short, vary widely from one state to another.
"Many states have policies that exclude whole groups of patients," Dr. Douglas White, director of the Program on Ethics and Decision Making in Critical Illness at @UPMC.
These Pittsburgh protocols, as they're called, embody an idea that most bioethicists agree on: that bedside doctors should not make the life-or-death decisions about who gets a scarce ventilator and who does not.
"The people making the triage decisions should not even have access to that information," says @MatthewWynia, director of @COBioethics at the University of Colorado.
"How will we handle it, if and when it comes? It's a good question," says @Dr_BrendanCarr, Chair of emergency medicine at @MountSinaiNYC.
"If and when we get down to a very low number of ventilators for our health system, would it make sense to just have a protocol in place that makes us the decision-maker?" says @Dr_BrendanCarr.
A wild card is how a litigious society will respond when patients are denied care. In the absence of clear protocols, doctors and hospitals run the risk of legal challenges.
"We think the risk to physicians is low, but not zero, and not trivial," says @CohenProf, law professor and bioethics expert at @Harvard_Law. "Case law says that shortening a life even by a few hours could lead to charges of manslaughter or murder."
