In a Nightmare Scenario, How Should We Decide Who Gets Care?

The Political Scene | The New Yorker

The New Yorker

President, Barack, News, Politics, Wnyc, Obama, Lizza, Washington, Wickenden

4.3 • 3.9K Ratings

🗓️ 23 March 2020

⏱️ 19 minutes

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Summary

In northern Italy, doctors were forced to begin rationing ventilators and other equipment—a nightmare scenario that could become a reality for medical staff in the United States soon; New York has projected ventilator shortages in the thousands per week. David Remnick talks with Philip Rosoff, a professor of Medicine at Duke University and a scholar of bioethics who has studied rationing. Rosoff believes medical institutions must also consider the needs of those who can’t be saved, and suggests that hospitals should stock up on drugs to ease suffering at the end of life. Rosoff notes that the U.S. medical system puts an emphasis on “go for broke” care at all costs, and is poorly prepared for those kinds of decisions, which leave hospital workers with an acute sense of “moral distress.” “If we’re smart, we would have institutional guidelines and plans in place ahead of time,” Rosoff says. “The way not to make [a rationing decision] is to make it arbitrarily, capriciously, unilaterally, and at the bedside in the moment.”

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1:11.6	This is the Politics and More podcast. I'm David Remnick.
1:16.4	In northern Italy, doctors were forced to begin rationing ventilators and other equipment,
1:22.2	scarcity of essential supplies, decisions about who gets resources, and who won't. It's a nightmare scenario. And it could
1:30.4	come true here, too. Last week, New York Governor Andrew Cuomo demanded that the Army Corps of
1:35.8	Engineers begin building field hospitals in New York, essentially repurposing existing buildings
1:42.2	all out of the fear that ICU's in New York could soon be overwhelmed.
1:47.6	Dr. Philip Rossoff is a professor of medicine at Duke University, and he specializes in bioethics.
1:54.5	Dr. Rossoff, we've been watching, as the Italian healthcare system has been absolutely overwhelmed by COVID-19, what kinds of choices
2:03.3	are doctors there having to make when faced with so many patients in critical condition?
2:09.0	Well, a typical scenario would be having a finite number of intensive care unit beds,
	...

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