Who Should Be Saved First? Experts Offer Ethical Guidance

from NYTs

How do doctors and hospitals decide who gets potentially lifesaving treatment and who doesn’t?

A lot of thought has been given to just such a predicament, well before critical shortages from the coronavirus pandemic.

“It would be irresponsible at this point not to get ready to make tragic decisions about who lives and who dies,” said Dr. Matthew Wynia, director of the Center for Bioethics and Humanities at the University of Colorado.

Facing this dilemma recently — who gets a ventilator or a hospital bed — Italian doctors sought ethical counsel and were told to consider an approach that draws on utilitarian principles.

In layman’s terms, a utilitarian approach would maximize overall health by directing care toward those most likely to benefit the most from it. If you had only one ventilator, it would go to someone more likely to survive instead of someone deemed unlikely to do so. It would not go to whichever patient was first admitted, and it would not be assigned via a lottery system. (If there are ties within classes of people, then a lottery — choosing at random — is what ethicists recommend.)

In a paper in The New England Journal of Medicine published Monday, Dr. Ezekiel Emanuel, vice provost for global initiatives and chairman of the Department of Medical Ethics and Health Policy at the University of Pennsylvania, and colleagues offer ways to apply ethical principles to rationing in the coronavirus pandemic. These too are utilitarian, favoring those with the best prospects for the longest remaining life.

In addition, they say prioritizing the health of front-line health care workers is necessary to maximize the number of lives saved. We may face a shortage of such workers, and some have already fallen ill.

More here.

Posted in Ethics, Healthcare and tagged , , , .

20 Comments

  1. This is a terrifying article. The fact that Italy and other countries must chooses who lives and dies solely due to the lack of supplies is horrific. If an elderly man is admitted to the hospital and needs a ventilator but a young mother is admitted at the same time, it is assumed that the young mother will receive the treatment. Is this ethical?

    The points brought up in this article are chilling but reality to not only Italy but countries across the world fighting Covid-19. The decisions are supposed to be based solely on who can be saved and “ensure that there are no considerations such as money, race, ethnicity or political pull…”
    Humans are inherently emotional, searching out a connection with human beings. So, the fact they must make this decision based on survival rate only is against biology. Doctors, though, have studies to look at facts only and base their treatment plans on these findings. But, if lack of supplies is the sole reason for choosing one life over another, someone must be held accountable.

    Doctors and nurses take a vow to do no harm. But countries lacking in supplies and quick action have caused these vows to be in jeopardy. Is choosing to save one life over another “doing no harm?” A common hypothetical question presented to students pops into my mind. The runaway train theory asks is it better to stay on the path killing five people on board of the train or change the way the train is going to kill one innocent bystander?

    As stated in the article, “there’s no perfect way to choose who gets lifesaving
    treatment. At times like these, society may be more forgiving of utilitarian decision making.” We should be ashamed to live in a world where we are ill-prepared to fight a pandemic. Even more so, we should make sure to hold those accountable for the lack of response and lack of supply for our healthcare workers.
    Furthermore, it is scary to consider once antivirals or vaccines can be given out who will receive these first.

  2. This is a very polarizing article to read and comprehend. Only a few months ago, lives were drastically different, especially in the context of one’s profession or daily job. This especially applies to doctors, nurses, and other medical experts, that now face a completely different work day than many of them have ever experienced. With the rise of a global pandemic in the United States, these medical professionals must now to decide over specific patients receiving essential equipped ventilators and beds to aid their condition. It is a sickening reality that they must ask and decide the answer to a question that hurts one way or another in trying to help and heal patients. However, it is a reality that we must now come to face. In my opinion, I do agree in ignoring a lottery system in making a based decision over patients. It would highly increase the chances of negatively effecting the amount of recovering cases in centers nationwide, which is certainly not what our healthcare really wants to suffer through. A patient with a higher chance and position of being able to successfully recovering from these resources should be the ones deemed enough to receiving this care, as it this would positively impact healing virus victims. This system has been implemented in centers and hospitals globally as other countries with virus outbreaks have been adapting to help numbers of infections and deaths go down. It is a decision that is certainly not easy in making or viewing from an outside view, but it is a decision that could positively impact the timetable for our country to flattening the COVID-19 virus.

  3. The article states a big issue that is affecting the United States and the world is facing today as a result of the COVID-19 pandemic. As the number of cases are rapidly increasing everyday, badly affected states like New Jersey and New York are seeing an increase in deaths everyday. For example, New Jersey had an single day death tally of 275 people today, which is the single highest increase (https://thehill.com/homenews/state-watch/491821-new-jersey-surpasses-1500-deaths-were-not-at-any-plateau ). With the cases getting out of hand, the article asks a question that is on everyone’s mind: who do we save? There is a shortage of ventilators and doctors will have to make the ethical decision of choosing which victims will get the ventilators or treatment first, and the choices made will now not matter about money or status. Memos sent to the doctors set up utilitarian guidelines, which points to giving the supplies or ventilators those who have the highest chances of surviving and who still has the most amount of lifespan to live. I think this brings up a different aspect to the business of medical help because we would normally prioritize helping those with money or status, who can have an influence in these types of situations and therefore get treatment fairly quickly. We are so used to seeing status and money getting others to the front of the line of treatment, but this is different and takes away the bias of the selection process and gives healthy people a chance to get treatment. In my opinion, this is how all treatments should work and things like race, status, and money should not matter because the things that the world is facing is going to cost people live if one does not act soon.

  4. The question that this article posed is a question that holds a lot of weight behind it, yet it is a question that people will not admit that they have asked themselves. With the rapid spread of the coronavirus, there are people of all ages are impacted, with deaths mainly concentrated in people with previous health conditions and the elderly. Countries like Italy are making decisions on who gets to live and who is going to die. The health officials were faced with a difficult decision and were told to use utilitarian principles. It is unfortunate that they have to make this decision but also it is crazy that they have given themselves the right to decide who is going to receive treatment that could save their lives. When the article talks about the people who get to live the youngest person is not always the best pick. The decision seems to be weighing on if the person has experienced enough life or not. The idea that doctors are responsible for this choice goes against their belief and the purpose of the work they do. The ethical beliefs of the people in charge of the decisions being made are questionable. The purpose of the medical field is to heal and help people but to decide whether or not the rest of someone’s life is something very unreasonable. Everyone should be given the same amount of effort when it comes to saving their lives. This is just the same as any other discrimination in my opinion because this decision is being made based on a person’s potential.

  5. The New York Times article, “Who Should be Saved First? Experts Offer Ethical Guidance”, written by Austin Frakt describes the ethical concerns that have emerged since the manifestation of the coronavirus. I found this article to be very inciteful about what is going in the world right now because this virus is impacting so much more than I originally thought it was. The amount of people being infected and needing hospitalization is way more than hospitals and healthcare workers can handle at the moment. Hospitals only have a certain amount of beds, ventilators, and workers that can accommodate their patients. With the coronavirus intensely reproducing, there is simply not enough supplies and workers available to stabilize the situation. Because of the shortage in these categories, the United States healthcare system is faced with a difficult challenge: who should be saved first? The ethical dilemma that these systems are faced with now is challenging and there are many aspects that hospitals must consider when caring and treating coronavirus patients.

    When dealing with this dilemma, many have established a utilitarian approach to their decision-making process in order to make ethical decisions. The utilitarian approach involves “[directing] care toward those most likely to benefit the most from it” (Frakt). I think this approach is the best way to handle the shortage of supplies at the moment. If there are two patients and one has a better chance to survive than the other, regardless of age, than the medical device and treatment should be applied to the person who has a better chance of surviving. It would be a waste of supplies and time if the treatment were catered to the person that does not have a strong chance of surviving the virus and would lead to the other person that had a better chance to potentially get sicker. Initially, this type of approach can sound morbid because of the harsh circumstances surrounding the situation. But during this pandemic the harsh reality is that treatment needs to be “[directed] to those with the greatest chance of survival and the longest remaining life [span]” (Frakt). When the healthcare system incorporates the utilitarian approach in their decision-making process, they are choosing to utilize the most ethical approach towards dealing with this unfortunate pandemic.

    The article makes a point to highlight the importance of prioritizing the health and safety of healthcare workers during this time. When the health and safety of healthcare workers is valued, “the number of lives saved [will be maximized]” (Frakt). While the rest of the world is actively trying to avoid the virus at all costs, healthcare workers are forced to come face-to-face with it every day. They are risking their lives daily for the sole purpose of making a contribution towards the demise of this virus. The shortage of medical supplies, specifically masks and gloves, has caused healthcare workers to be dangerously exposed to the virus. In hospitals, “masks are being rationed or reused, and some hospital workers are even using novelty rain ponchos to protect themselves” (Dosani). Healthcare workers are doing all that they can to protect themselves without the proper equipment being available to them. This is not sanitary at all. One hospital in New York, where the amount of coronavirus cases is the highest in the United States “estimated a third of its doctors and nurses are home sick with the virus” (Dosani). The safety and health of healthcare workers at this time needs to be prioritized in order to help put a halt to this pandemic. I don’t think enough is being done to prioritize healthcare workers because they have had to participate in unsanitary practices to help protect themselves from the virus.

    Austin Frakt also points out that although social status and financial considerations are not supposed to be a factor towards treatment and accessibility to supplies, it is still happening. Today I listened to a podcast by the Wall Street Journal & Gimlet, “Dr. Anthony Fauci on How Life Returns to Normal”, where Dr. Fauci stated that he and the White House correspondents get tested numerous times a day to ensure they do not give the virus to the president. I think that this is completely absurd because there is a shortage of coronavirus tests, and they are being wasted by repeatedly giving tests to those who interact with the president. Even with the shortage, social status comes into play with receiving limited resources because “NBA players who are asymptomatic are getting tested” (Zillgitt). Although everybody says that social and financial status does not come into play with access to treatment, this pandemic has shown that it does. I think this is dangerous because there are people who actually have symptoms and can’t be tested- yet people with money can get tested even though the exhibit no symptoms.

    Ashley S. made it a point in the comments to say that we should be ashamed to live in a country that isn’t prepared to fight this pandemic. I respectfully both agree and disagree with what she stated. I do agree in the sense that we should have been better prepared, and the government should have taken action way sooner than they did. But there was no way for anyone to know how bad this situation would have escalated. When this first started, I thought that it was people just overreacting and that the flu was worse than the coronavirus. As it turns out, I was wrong. We need a bunch of supplies and are unable to get them, but we shouldn’t be ashamed because in economic terms, the supply cannot fulfill the high demand. Nobody was prepared for this to happen, therefore manufacturers only produced what they believed what could sell, they were not prepared to produce products to meet the expectations of a pandemic.

    In conclusion, while dealing with the coronavirus pandemic hospitals and healthcare workers are forced to abide to ethical decision-making practices. The people who have a better chance of surviving will be chosen over those who do not. The shortage of supplies has made it difficult for all parties involved. The people who are taking care of coronavirus patients are getting sick and dying because they are around them and lack the proper equipment to protect themselves. Shortage of supplies results in people not being able to get tested for the virus. It has been shown though if people have money, they can get tested. The coronavirus has brought about so many issues that the world was not ready to face yet.

    References:

    Dosani, Sanya. “Health Care Workers Are Begging for Masks. Is the President Listening?” The New York Times, The New York Times, 6 Apr. 2020, http://www.nytimes.com/2020/04/06/opinion/health-care-workers-PPE-coronavirus.html.

    Frakt, Austin. “Who Should Be Saved First? Experts Offer Ethical Guidance.” The New York Times, The New York Times, 24 Mar. 2020, http://www.nytimes.com/2020/03/24/upshot/coronavirus-rationing-decisions-ethicists.html?referringSource=articleShare.

    Linebaugh, Kate, host. “Dr. Anthony Fauci On How Life Returns to Normal.” The Journal, The Wall Street Journal & Gimlet, 07 Apr. 2020. https://open.spotify.com/episode/5SB7tM3tn6E6LDV0RB7huQ?si=x_pZ9EIPR7eYsmEkreYYMg

    Zillgitt, Jeff. “NBA Draws Ire as Players Tested for Coronavirus amid National Kit Shortage.” USA Today, Gannett Satellite Information Network, 21 Mar. 2020, http://www.usatoday.com/story/sports/nba/2020/03/19/coronavirus-nba-draws-ire-players-tested-amid-national-shortage/2872987001/.

  6. This isn’t about age or what you do or whether you have children. Whatever your level of functioning is before you require a ventilator to keep you alive. When you have extra bed capacity, resuscitating a person because the loved ones can’t let go of you is acceptable. The spread of the coronavirus, there are people of all ages are impacted, with deaths mainly concentrated in people with previous health conditions and the elderly. Countries like Italy are making decisions on who gets to live and who is going to die. However, doctors need to do whatever they could do to the same people’s lives. Even if they know that the patient is an elder or have bad health conditions. All the world understands that it is hard to help everyone, especially with the low supplies and equipment. however, still, it is not fair to choose who lives and who dies. Every one of those patients has loved ones that are looking forward to him/her to get better. It is really scary to think about being sick and they are choosing who is more valuable to give the vaccine to. COVID-19 came to our lives and made us see and learn things that we had never thought that it will ever happen in 2020.

  7. With the ongoing COVID-19 pandemic, many hospitals find themselves running out available ventilators for patients. thus, they are left with the decision to ultimately play God, and decide which patient gets to live and which patient is not so lucky. I am sure that this is a doctor’s worst nightmare, as they do not want anyone to die and they want to try and save as many people as they possibly can. The people who are most at risk of contracting the virus are those who are over 65 and those that have underlying health conditions, some people unfortunately fit into both categories. Despite these people more susceptible, I think that, like the article states, the doctors would be more likely to take a person who is 20 to have the ventilator opposed to someone who is 50 due to the 20 year old not living as long, and having more potential in life. I do not feel like this fair to either person, but it seems to be the way that the world is shifting due to the pandemic. Meanwhile, many popular American manufacturers are trying to do their part and helping to create ventilators and I even had read somewhere that a scientist had created a ventilator attachment piece that would allow two people to share the same ventilator and not have to fight who lives or dies. So there does seem to be a light at the end of this horrible tunnel after all.

  8. When first encountering this article the title alone was enough to peak my curiosity. The concept of deciding who gets to live and who dies has been around for a very long time. This can be seen throughout history in stories about war, or even by the entertainment industry. I have always found this topic very interesting because to me it is like playing God. Why should anyone be able to say who dies and who lives? I was always taught that life is extremely precious, and by saving one person over another, puts both parties at the mercy of the person making the decision.
    Despite this, I have always had the philosophy that a doctor or health care worker should choose to save the life of the person who has the highest likelihood to live. This may be because of my interest in war, but it has still always been my rule when presented with this topic. A medic in a warzone is always taught if they know that someone is beyond being saved they need to move on to someone they know can be saved first. This is because they can not be using the precious time and medical resources they have on someone that is most likely not going to make it.
    An example of people in the world having to make this harsh decision is the doctors in Italy. Due to the COVID-19 pandemic that is affecting most of the globe, countries such as Italy have had to make the decision on which patients get ventilators and which ones do not. Doctors and medical professionals in Italy have come to the conclusion to use their limited ventilators on the young patients that have a higher chance of recovering, rather than the older patients. This is because the virus seems to be much more deadly in individuals over the age of 60. The doctors have had to make the tough decision on which lives to save since they do not have enough resources to save them all.

  9. There shouldn’t be a time where doctors are picking and choosing who get to live and who gets to die. However, that is the harsh reality at this point. With limited rooms and resources and an everyday escalating number of cases where patients need care are getting too much for hospitals to handle. It really does hit home when a doctor would say, “It would be irresponsible at this point not to get ready to make tragic decisions about who lives and who dies,” At a time where doctors must choose which life is more valuable at the moment is an unfair task to complete. A researcher even asked, “Is a 20-year-old really more valuable than a 50-year-old, or are 50-year-olds actually more useful for your economy, because they have experience and skills that 20-year-olds don’t have?” which is a fair and definitely a hard question to ask. Although unfair to the people that are dying at this very moment, it seems to be the new norm that doctors are unfairly going up against. It is everything they are going against when they signed up for this kind of job. At this moment, we see a lot of production and manufacturing companies switch up their product market and provide ventilators to hospitals to hopefully make it easier on them. Although in a tough spot right now, there seems to be hope that this thing will get by soon and everyone contributing will make this a lot easier.

  10. I found this article very interesting. When I read the title of this article I knew there was going to be a debate between who would be saved depending on age, ethnicity, social status, and such other factors that can create a bias. One thing stuck out to me which was very interesting about the article. “a British researcher said, “There are arguments about valuing the young over the old that I am personally very uncomfortable with,” adding, “Is a 20-year-old really more valuable than a 50-year-old, or are 50-year-olds actually more useful for your economy because they have experience and skills that 20-year-olds don’t have?”(Frakt). I found it interesting because I looked at this differently. 50-year-olds only have 15 more years in the workforce while 20-year-olds have 45 years left and they have a higher chance to survive. When I am looking at this article I try to think critically and not let emotions take over because emotions won’t help in a situation where we are trying to save as many lives. I like the utilitarian approach the article is taken because this situation is not black and white, there is no right or wrong per say. The utilitarian approach makes it easier for resources to be utilized at its max capacity and takes away the stress from the doctors deciding about life or death. The only things are that there is still going to be bias and special treatment for the high net worth individuals like basketball players, actors, and more. “Key is to be transparent about the principles, save as many lives as possible, and ensure that there are no considerations such as money, race, ethnicity or political pull that go into the allocation of lifesaving resources such as ventilators,” said Dr. Tom Frieden. I believe it is the right set mindset of trying to save as many lives. Furthermore, in a MedicalNewsToday article talks about the allocation of Ventilators.

    “[W]hen a hospital is placed in the unavoidable but tragic role of making decisions that may harm some patients, the use of a committee removes the weight of these choices from any one individual, spreading the burden among all members of the committee, whose broader responsibility is to save the most lives.”
    – Dr. Robert Truog, et al.

    Dr. Robert Truog is the director of bioethics at Harvard and stated that the burden should be distributed because doctors are having to deal with the impossible decision of who should live and die.
    In short, I believe that the utilitarian approach is a good step into taking a situation where resources cannot be wasted and need to be maximized. I agree with the idea of spreading the burden and letting all members of the committee take part in the decision.

    https://www.medicalnewstoday.com/articles/allocating-ventilators-during-covid-19-what-is-fair#Who-should-make-the-decision?

  11. It’s actually really scary that people have to be chosen on who can or can not make it but it’s the reality that we have to live with during the circumstances. Even hypothetically we can think about how we can do things if we were in the shoes of the people that have to make the decision. As humans we always look to be in control but with Covid-19 we are not and not being in control makes us dangerous. We become fearful of the outcomes because we only come to know how the virus works by losing human life. Fear causes us to do drastic dangerous things like for example now many are fearful of going to hospitals regardless if they have the virus or not because they are afraid they would not come out alive. This creates dangerous situations because infected individuals would find all the help they need to get better at hospitals.
    The front lines that are helping like our doctors and nurses are helping patients and to imagine that they are losing patients rapidly each day and to also decide on top of that who they can determine would survive is difficult. Those decisions would be testing constantly the mental strength of the nurses and doctors. Families out there are also losing loved ones each day as Covid-29 keeps spreading and it’s only gonna keep infecting others. Having to determine if a younger individual is more valuable than an older individual is not easy and we are gonna have to learn to empathize with those decisions. No type of life is worth more than another but these difficult decisions are gonna keep occuring and there would be some PTSD formed by the people who make those decisions.

  12. This is a very tough conversation to have, it is even tougher to be the person who must make the decision because no matter what you choose you are always going to receive backlash from your choice. Personally, I think there is no such thing as the right choice in a situation like this. Especially since we have received a little taste of what is going to happen very soon in the U.S. I am referring to the shortage of tests that we have right now and based on that we are already deciding who should receive the tests and who should not. It is already difficult dealing with this problem and most of the patients are not in critical condition but now we can only imagine the physical and emotional stress that it will have on people when they have to decide who gets a ventilator or a ICU bed when a majority of the patients are in a critical condition. If we just forget about the patients for now and think about how the people who have to make the decision will be affected after the pandemic passes. The article suggest that they have a group of individuals whose only task is to make these tough decisions, but I can guarantee there will be situations where the doctors and nurses may have to make these decisions by themselves. Many of the people who are in these situations may never recover from this pandemic and may also begin to suffer from PTSD. This is only if we are talking about ventilators and ICU beds but if we were to factor in a vaccine or a cure then things will become even more complicated. I think that it is difficult to tell people to make their decisions without considering social status, financial status, race, ethnicity, etc. Even when you do not want to consider them subconsciously you are always thinking about those things even during our everyday lives you probably think that to you those things don’t mater and that is probably true to a certain extent but they factor in our everyday decisions. For example if you were in line for hours and some regular person were to cut in front of you then you would be furious and probably cause a scene but lets say a celebrity like Leonardo DiCaprio cut the line I can promise you that most people would be okay with it and just let it happen. Basically the best we can hope for is for the situation to get better before we get to those dark times but the situation is going to get worse before it gets better and we need to do anything in our power to be prepared for it.

  13. America was not prepared for the outbreak of the coronavirus. There are currently 500,000+ cases of coronavirus in the U.S. There are not enough medical supplies and personal protective equipment. Ventilators are also crucial because of the symptoms of coronavirus, and many states are low on supply. This has led many to think, what if we have to choose, who gets the hospital bed? Or who gets to use the ventilator? This is a heartbreaking and scary decision, that doctors and nurses never want to make. It is scary to think that the health care system can not guarantee that everyone will be cared for, simply because America was unprepared and never expected such a pandemic to occur.
    This article describes who is more like to get the ventilator and hospital bed. To maximize health, the ventilators and care would be given to the people who would most benefit from it. It would go to those who would be more like to survive the virus, it would go someone who doesn’t have health conditions, rather than someone that does. It would also go to someone more valuable, who would have a longer life. It would go to a 20 year old, who has a long life ahead of them, rather than an 80 year old. The goal is to save as many lives as possible. This is sad and scary to know that this is happening in our world. The health care system is making great efforts to keep everyone safe and healthy.

  14. I thought that I understood the severity of shortage of supplies during this pandemic but it is clear that I was very unaware. I knew that supplies such as masks and gloves are scarce among the public; it’s extremely difficult for the average citizen to find “Pandemic Supplies” during this time. But I did not realize that the hospitals and facilities that are taking care of the sick are also running out of supplies at this time. There are so many cases of COVID-19 that the hospitals are running out of rooms and beds to treat these patients; and the worst part is that these numbers are only set to grow exponentially before they start to fall. Some companies, such as Home Depot, are sending face masks out to the first responders in order to help combat this shortage but that is not likely to solve the problem. The thought that they are choosing who gets proper supplies and treatment between patients is scary to me as it must be extremely hard for the first responders to have to decide who will get what. I am happy to see that most agree that who gets these supplies should not be based on financial status as I thought that was bound to happen. But I was wrong and it seems everyone is coming together to just focus on getting everyone healthy. I am not sure that I agree with a Utilitarian approach as I believe that it is just too simple of a way to decide without much thought or emotion. A system that reflects the organ transplant system sounds like it would be the best idea. But sadly we do not have the time to come up with such a formula along with its parameters. Nor would we have time to enter each patients’ information (we are now well over 1,000,000 cases worldwide) based on the set parameters into this new system. I see why some may gravitate towards the utilitarian approach. We are very short on time and supplies; I just don’t agree with it from an ethical standpoint.

  15. The difficulty of the situation from a medical standpoint is that there are not enough supplies, not enough beds to sustain the growing population of people afflicted with COVID 19. The issue, as the article and several other comments point out is the ethical dilemma of having to pick and choose of, “who lives and who dies”. This isn’t something new, but the scope of the number of an individuals coming in every day and having to pick is what’s new. Granted, these would be hypothetical situations to say the least but First Responders have been tasked with similar instances in the past.

    There is no real way to value the worth of one human life compared to the next. Philosophically, yes, there is. But it ultimately comes down to each individual’s sense of morality, utilitarian ideology and possible anecdotal stories. The healthcare workers that are on the front-line of this situation have a duty to save as many individuals as they can and to provide the best care to those that may possibly be able to come out on the other end of this. From the outside, I think it is truly hard to judge what is the right or wrong choice. I just hope that at the end of this, those that are faced with these tough decisions come out alright.

  16. I want to start this out by saying our medical professionals deserve the utmost respect, not just these times but all the time.
    Despite these unfortunate times, I agree wholly on this utilitarian idea in ethics. I’m not saying older people do not have a lesser right to life than a younger person, they both have the same right to life that is equal to each other. However, during these harder times, the emphasis should be on who is a safe bet to cure vs someone who is not. In the military world, it is the same thing, we see this through one of the most accurate depictions of world war two, Saving Private Ryan. In the opening scenes, we see a combat medic moving from person to person on who they can save. The idea is simple if we spend time on this person who is more at risk at dying there’s a higher chance that instead of losing one life, it is two. Lets boarded those numbers to encapsulate the numbers across the state, sure some will be cured but a lot less than the number of deaths. When it comes to these circumstances money should not be a topic in the talk of how to save a life. Yes, it’s the green that makes the world go round but when the world stops because of a pandemic so should the conversation of money. It is at that point you are putting a monetary value on a person’s life. During this outbreak there has also been an increase in demand for blood, people who were sick before fighting an underlined disease did not just wake up the next day cured. Let’s not forget the care givers who may possibly come out after this with some mental illness caused these decisions their making. Look it’s a tough situation no matter how this is looked at, its devils advocate at its core. Hopefully, after this well see how much we need more medical professionals in the field and how we can try to make medical supplies more accessible.

  17. The world was wholly unprepared for a pandemic. Almost nothing about our economy as a nation can support a quarantine, most business have already folded under the immense stress on the market. Supplies are scarce as our main producer of those supplies has been shutdown, and the price for these highly demanded medical supplies only increases as they become rarer and the economy falls deeper. With no supplies, healthcare workers do not only have the necessary equipment to treat everyone, they also lack the supplies needed to protect themselves from sick patients, which has lead to the disproportionate amount of healthcare workers being affected by the virus. With not only a shortage of supplies but a growing number of patients and doctors leaving work due to illness, it is easy to see why precautions and protocol was proactively put in place regarding what to due when we must choose who receives healthcare. It is not a decision that can be taken lightly, and is not one that should be considered at the last minute. The unfortunate choices and sacrifices that have to be made have been laid out in advance in order to apply the most practical and ethical solution. Right now, especially in Italy, a utilitarian methodology is being used to decide who will receive healthcare over others. This means that supplies and care are being given to those that can make the best use out of it. This can mean, for example, giving care to an overall healthier 20-year-old than a more sickly 50 year old. There are ethical concerns no matter which methodology is taken, because at the end of the day, some people will be denied from receiving lifesaving healthcare. The fact that we do not have the capacities to support a pandemic on this scale means that these situations will and have already arose in Italy, who have been denying older patients care for a while now, as critical healthcare supplies are short in supply. It won’t be long until this spreads into our own country, the lack of infrastructure and supplies are global and it is only a matter of time before we are at full capacity.

  18. This is… tough. To start off, I agree that health workers need to be prioritized — these people are the ones that we need the most in this time. The next part is a bit tougher. The article does pose a good contradiction to the common answer of “we should prioritize the young”. They used the example of “we should save a 20 year old over a 50 year old due to having more possibilities” but they pose that the 50 year old could possibly be more valuable due to the knowledge he’s accrued.

    As messed up as it sounds, I think the details of the coronavirus make this decision easier. We know that the younger population has a better chance of recovering from this disease — this has especially been seen in countries like Italy, which has a huge older demographic. I think our main goal should be to save as many as possible. This means that if it comes down to having one bed between two people, the person with the higher chance of survival should get the bed. If that means it’s a 20 year old versus a 60 year old, then I think the 20 year old should get it, since we believe that their chance of survival is higher in the first place. This question obviously becomes harder as the age gap decreases — this is where we will have to view more details. It’s crazy that we have to discuss something like this, albeit, necessary.

  19. This article was a very captivating read as people I know have been effected by the virus. I agree that health workers need to be the priority as they will be the ones to save the rest of us. However the next part of the article poses an idea which is harder to swallow. I do not agree with the idea of saving people 50 and over instead of saving the young. Yes, someone over 50 may have added more value in the past but their impending future is generally valueless, the prime of their work lives are over, they have generally accomplished everything productive they could. This dilemma is highly argued because the counter is generally centered around the lack of experience and current success. However, I believe in the future, so I strongly believe that saving someone younger is more important.

    The argument is extremely opinionated and somewhat cruel but with the rise of Covid-19 a platform for the argument has been created. It is evident that younger people have a better survival rate than older people which would put less stress on the economy as less would be spent on medical expenses. Regardless of the ethics of the discussion, it is an important one to have as the world is facing the same problems. The main goal should be to save as many lives as possible, unfortunately that is impossible and the world must come to a conclusion on how to preserve the future.

  20. It is extremely disheartening to hear how people in the age group of 50 and up are being treated in hospitals preceding COVID-19.The article describes how ethicists believe that the most ethical way of dealing with COVID-19 patients is with a “utilitarian” approach. Essentially, a “utilitarian approach would maximize overall health by directing care toward those most likely to benefit the most from it” (Frakt). In other words, if an elderly woman with an underlying issue was hospitalized due to the Coronavirus and a college student with no underlying issues was hospitalized due to the Coronavirus, most likely the college student would receive the ventilator. In theory, a utilitarian approach makes sense as typically, a college student would have more life to live versus someone in their 90’s. However, I also feel like who are we as humanity to decipher who is worthy of life? I do understand that desperate times cause for desperate measures, on the other hand, I have a hard time understanding how one life can be worthed more than the other.

    The question presented is whether or not it is ethical for hospital’s to decide who they think deserves COVID-19 treatment based on age? While there are numerous opinions brought by ethicists in favor of age being the deciding factor, I have to say that I disagree with the elderly being limited to resources just because they are older. I can only imagine the immense amount of pressure doctors and hospital workers are enduring while trying to get a handle on the pandemic. However, I think that as America aims to control the effects of the Coronavirus, we must also consider providing the elderly with resources just as we would any other age group. The reason I say this is because COVID-19 has been significantly spread by the younger generation. According to The New York Times, “In Arizona… people ages 20 to 44 account for nearly half of all cases” (Bosman and Mervosh). As a result, the younger generation are the ones who are spreading COVID-19 cases unknowingly. There are many young adults who are going out only when necessary, but a majority are hanging out for leisure and entertainment purposes and then coming back home to elders. My question to ethicists is why should elders have to suffer, as a result of those who do not desire to listen to the “stay at home” mandate?

    I think less focus and emphasis should be put on who gets COVID-19 treatment. Instead, I think more focus should be put on establishing stricter policies and mandates to prevent our elders from getting infected in the first place. I view age being a factor for Coronavirus treatment similar to the way I would if hospitals determined who gets access to COVID treatment based on one’s ability to pay hospital fees. If it is unethical to not treat someone because of their financial status, isn’t it just as unethical to not treat an elder because of their age status? I think America should reexamine the way in which they are providing treatment and establish stricter orders, so we can be less likely to infect our elders because their lives deserve saving too.

    Works Cited

    Bosman, Julie, and Sarah Mervosh. “As Virus Surges, Younger People Account for ‘Disturbing’ Number of Cases.” The New York Times, The New York Times, 26 June 2020, http://www.nytimes.com/2020/06/25/us/coronavirus-cases-young-people.html.

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