Society of Bioethics and Medicine
WHOSE LIFE IS WORTH SAVING?
Updated: Jul 21, 2020
By - Elizabeth Badalov, Edited By - Melissa-Maria Kulaprathazhe May 27, 2020
It is no secret that hospitals across the globe are overwhelmed and understocked. Healthcare workers have had to concentrate their efforts entirely onto COVID-19 patients in desperate need of immediate care, and the stock of essential resources follows. In the throes of a pandemic, the allocation of crucial medical equipment like ventilators becomes a matter of life and death.
This raises the inevitable question: whose life is worth saving?
To alleviate stress for the healthcare professionals who have just seconds to answer this question in an emergency room or intensive care unit, hospitals have begun deploying ethics committees and publishing allocation guidelines to establish a protocol. In an ideal world, the protocol should be—at the bare minimum—fair and inclusive. However as the pandemic has shown us, the world we find ourselves in is far from ideal.
The guidelines issued in March by the University of Washington Medical Center defend “weighing the survival of young otherwise-healthy patients more heavily than that of older, chronically debilitated patients.” According to a February 2019 report by the Center for an Urban Future, “nearly 1 in 6 New Yorkers is 65 and above,” the largest share of the state’s elderly population ever documented to date. Allocation guidelines have effectively disregarded 16% of the state population. Non-elderly disabled patients go unacknowledged.
Chronically disabled patients, regardless of their age, have always been at odds with the medical profession. There is an unspoken yet undeniable societal bias that rests on false premises that disability lessens the worth of a human life. That life-sustaining treatment is an exhausting exercise in futility for healthcare professionals and patients alike. The perception of a reduced quality of life is employed as a convincing argument for reducing the supply of resources responsible for maintaining that life. Even if quality of life is not a deciding factor within these guidelines, we should think twice before demoting the disabled to a second-class medical status.
In theory, patients without pre-existing disabilities may require less resources to recover than patients who do. Thus, efficiency sides with the abled—a utilitarian approach to handling this crisis. In 2015, the New York State Department of Health created guidelines for allocating ventilators in times of crisis, permitting hospitals to take away ventilators from those who have relied on them for their long-term care. If nothing else, these guidelines instill fear, prompting higher risk individuals to steer clear of hospitals and avoiding their much needed treatment and care.
The reality is that the issue surrounding long-term ventilator use is not something that can be set aside in this time of crisis. For many patients, their ventilator is a part of their body, an extension of themselves just as responsible for keeping them alive and well as the other human organs that sustain life. There needs to be a re-evaluation of the allocation of resources, especially when they are as limited as they are now. We should not be removing essential medical equipment from those who have relied on the equipment and will continue to rely on it for as long as they are alive. This is undeniably a time of great sacrifice for many of us, but no one should have to be stripped of their ventilators, their livelihood, and with that a piece of themselves for the “greater good.”
Ne’eman, Ari. “’I Will Not Apologize for My Needs’.” The New York Times, The New York Times, 23 Mar. 2020.
“New York’s Older Adult Population Is Booming Statewide.” Center for an Urban Future (CUF).