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Optimistic Paranoid wrote:
For all the people pooh-poohing the coronavirus and insisting it's no big deal, were you aware of the fact that in Italy there aren't enough breathing machines to treat all of the seriously ill, and doctors there are literally triaging their patients and deciding who they will treat and who they will let die?
Article from the ATLANTIC web site:
The Extraordinary Decisions Facing Italian Doctors
There are now simply too many patients for each one of them to receive adequate care.
March 11, 2020
Yascha Mounk
Two weeks ago, Italy had 322 confirmed cases of the coronavirus. At that point, doctors in the countryโs hospitals could lavish significant attention on each stricken patient.
One week ago, Italy had 2,502 cases of the virus, which causes the disease known as COVID-19. At that point, doctors in the countryโs hospitals could still perform the most lifesaving functions by artificially ventilating patients who experienced acute breathing difficulties.
Today, Italy has 10,149 cases of the coronavirus. There are now simply too many patients for each one of them to receive adequate care.
Doctors and nurses are unable to tend to everybody They lack machines to ventilate all those gasping for air.
Now the Italian College of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) has published guidelines for the criteria that doctors and nurses should follow in these extraordinary circumstances. The document begins by likening the moral choices facing Italian doctors to the forms of wartime triage that are required in the field of โcatastrophe medicine.โ
Instead of providing intensive care to all patients who need it, its authors suggest, it may become necessary to follow โthe most widely shared criteria regarding distributive justice and the appropriate allocation of limited health resources.โ
The principle they settle upon is utilitarian. โInformed by the principle of maximizing benefits for the largest number,โ they suggest that โthe allocation criteria need to guarantee that those patients with the highest chance of therapeutic success will retain access to intensive care.โ
The authors, who are medical doctors, then deduce a set of concrete recommendations for how to manage these impossible choices, including this: โIt may become necessary to establish an age limit for access to intensive care.โ
Those who are too old to have a high likelihood of recovery, or who have too low a number of โlife-yearsโ left even if they should survive, will be left to die. This sounds cruel, but the alternative, the document argues, is no better. โIn case of a total saturation of resources, maintaining the criterion of โfirst come, first servedโ would amount to a decision to exclude late-arriving patients from access to intensive care.โ
In addition to age, doctors and nurses are also advised to take a patientโs overall state of health into account: โThe presence of comorbidities needs to be carefully evaluated.โ This is in part because early studies of the virus seem to suggest that patients with serious preexisting health conditions are significantly more likely to die. But it is also because patients in a worse state of overall health could require a greater share of scarce resources to survive: โWhat might be a relatively short treatment course in healthier people could be longer and more resource-consuming in the case of older or more fragile patients.โ
These guidelines apply even to patients who require intensive care for reasons other than the coronavirus, because they too make demands on the same scarce medical resources. As the document clarifies, โThese criteria apply to all patients in intensive care, not just those infected with CoVid-19.โ
My academic training is in political and moral philosophy. I have spent countless hours in fancy seminar rooms discussing abstract moral dilemmas like the so-called trolley problem. If a train is barreling toward five innocent people who are tied to the tracks, and I could divert it by pulling the lever, but at the cost of killing an innocent bystander, should I do it?
Part of the point of all those discussions was, supposedly, to help professionals make difficult moral choices in real-world circumstances.
If you are an overworked nurse battling a novel disease under the most desperate circumstances, and you simply cannot treat everyone, however hard you try, whose life should you save?
Despite those years of theory, I must admit that I have no moral judgment to make about the extraordinary document published by those brave Italian doctors. I have not the first clue whether they are recommending the right or the wrong thing.
But if Italy is in an impossible position, the obligation facing the United States is very clear: To arrest the crisis before the impossible becomes necessary.
This means that our political leaders, the heads of business and private associations, and every one of us need to work together to accomplish two things: Radically expand the capacity of the countryโs intensive-care units. And start engaging in extreme forms of social distancing.
Cancel everything. Now.
โMar-13-2020 01:19 PM
kellem wrote:according to the cdc, this cannot yet be claimed as a fact for THIS virus.
And this is Fact:
Viruses lose significant momentum during Spring and summer, the number effected will subside drastically.
Just do your part to stay healthy and wait it out.
โMar-13-2020 12:44 PM
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