‘Terribly Traumatic.’ Patients, Doctors Confront Medical Rationing in the Coronavirus Era

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A lack of resources is making medical staff deal with difficult choices in treating their patients, and decision-making guidelines are inconsistent from state to state

By Christopher Weaver, Melanie Evans and Tom McGinty Updated March 27, 2020 3:30 pm ET As Jerry Ed Roth prepared for heart surgery this month, doctors told the former theater director that the procedure might buy him a couple extra years for his life.

Now, states and hospitals are dusting off pandemic guidelines about who gets treated—basically, who lives and who dies. But what is critical is having a plan, “so there is some fairness or transparency,” Dr. Khouli said. He noted that some states haven’t done so and face the prospect of justifying their decisions in the midst of a crisis.

Ethical guidelines for rationing ventilators, devised by New York State and adopted or referenced by other states including Indiana, Connecticut, Mississippi, Kansas, Minnesota, Louisiana and Arizona.Balance saving the most lives against caring for each patient.Plans must be public, and evaluate feedback from the public.That would leave more than 15,000 “blues,” “reds” and “yellows” without needed care at the peak of the crisis.

Joneigh Khaldun, the top state doctor guiding Michigan’s pandemic response, said she couldn’t give an exact number of ventilators available at hospitals in her state. “I know it is not enough,” she said. “The letter is part of a ‘worst case scenario’ planning document, and we are not in a worst case scenario,” said Henry Ford spokeswoman Brenda Craig. The system hadn’t run out of ventilators nor intentionally shared the document with any patients, she said.

The New York task force, for instance, rejected the idea of giving health-care workers top priority for ventilators in their 2015 plan, arguing they likely wouldn’t be able to return to work soon enough to help fight the pandemic. On the other hand, some states like Oklahoma and Utah offer little more than checklists and flow charts that rate patients’ odds of survival, leaving the decision-making mostly to individual doctors.

Such decision-making has taken a toll on doctors in Italy, where a coronavirus epidemic has overwhelmed hospitals in some areas. In Bergamo, one of the hardest-hit areas, intensive care units have been taking almost no patients older than 70, doctors have said. “We have approved the technology that allows one ventilator to serve two patients—what they call splitting,” said New York’s Gov. Cuomo during a Thursday news conference, referring to a MacGyver-style approach that involves retrofitting tubing to connect multiple patients to the same ventilator. “It’s not ideal, but we believe it’s workable.”

Source: Healthcare Press (healthcarepress.net)

 

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A LACK OF RESOURCES ? I WONDER WHY ?

pdacosta So, if there is an issue with inconsistency among the states, might federal leadership be...lacking? Could it be that the Trump administration isn’t doing enough? You’re close...so close to falling into some true statements. You can do it!

shannonrwatts This is Trump’s solution to Medicare and Social Security budgets. Decrease the surplus population.

pdacosta Why not write about when hospital and medical treatment became privatized thus creating an impossible situation for all governmental agencies to respond to this emergency or any others in the future.

kolachkes Excellent !! Everything is going as planned by trump, XI, and Putin.

B-b-but Dr. Birx said it ain't so!

Stop worrying about all this little stuff. There is important news: Trump succeeds! $500,000,000,000. Stolen! With a signing statement! Happiness throughout the land Donald says so.

In a week the system will start to broke down.

Don't panic President Twitter really runs the country

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