Ethical Use of Limited Medical Resources in a Pandemic: A PanPals Chat

The only thing worse than playing God is not playing God.”

In the areas most affected by COVID-19, health systems have been unable to provide the usual standard of care to patients. This leads to heartbreaking decisions, as doctors are unable to offer ICU beds, ventilator support and hospital care to all patients who might benefit from it. How do we allocate these precious resources? What values should guide our decisions? And how can we support physicians who are forced to make these decisions, as well as the patients and families whom they affect?

On Friday, March 27th, ethicist and palliative care physician Jason Morrow joined Rachel Pearson for a special presentation on the ethics of resource allocation. We discussed a framework proposed in this New England Journal of Medicine article by physician-ethicist Ezekiel Emanuel and colleagues, which is summarised in their chart:

Unsurprisingly, Jason and Rachel as well as the PanPals community had a lot to say about this! A few highlights of our discussion included:

-Input from Dr. Ruth Berggren on triage during Hurricane Katrina: “You’re never in a vacuum, and you shouldn’t feel like you have to make rush decisions because there’s nobody to talk to. That’s almost never true.”

-Dr. Rick Hodes describing how it feels to decide which Ethiopian children will receive life-saving spine surgeries: “The thing I’ve decided is that, the only thing worse than playing God is not playing God.”

-Dr. Morrow acknowledges that you might feel bad about pushing the gentleman with the larger body type in front of the proverbial trolley: “Usual ethical standards of care still apply in emergencies.”

-Dr. Pearson thinks you have inherent value, not just instrumental value, and that the lives of healthcare workers are not more valuable than other peoples’ lives

You can watch the full chat recording online here. But what do you think–how should these decisions be made? What matters to you and your community? Please join the discussion by commenting below, or sending us a message on our “Join the Conversation” page.

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