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“The 360” shows you various perspectives on the main stories and debates of the day.
What is happening
The continuing wave of coronavirus cases driven by the Delta variant has pushed hospitals in hard-hit areas of the country to their limit. Some patients arrive in overwhelmed emergency rooms to be transported hundreds of kilometers for treatment. Others suffered complications and even died while waiting for beds to open in intensive care units.
COVID-19 cases are on the rise across the country, but the hospitalization rush is mostly concentrated in states with low vaccination rates. Alabama, one of the least vaccinated states, has spent most of the last month without the availability of intensive care within its borders. Several other states have approached or exceeded the level of hospitalizations they saw during the height of the winter wave, when vaccines were not widely available.
Procedures for deciding which patients receive care first, called triage, are an integral part of every hospital’s operations during a normal day. But these practices have collapsed under the sheer volume of people requiring urgent medical attention in some hospitals. Earlier this month, the Idaho Department of Health and Welfare activated Crisis Care Standards, a high form of triage reserved for “the extraordinary circumstances of a crushing disaster or emergency. public health ”which gives hospitals more leeway to make life and death choices about which patients are treated.
Why there is debate
Currently, no public health system treats unvaccinated patients differently from vaccinated patients. But the dire situation in many hospitals across the country has led some in the medical field to raise an uncomfortable question: Should immunization status be a factor in deciding who receives care when resources are scarce?
Most public health experts categorically reject the idea, which they say goes against the fundamental principles of their profession. “In medicine, I know you don’t have prejudices against someone for their behavior,” Dr. Anthony Fauci told CNN. Others say hospitals routinely treat people who make dangerous decisions – smokers with lung cancer and drunk drivers injured in crashes, for example – and unvaccinated people shouldn’t be any different.
Some left-wing experts, on the other hand, argue that people who choose not to be vaccinated are also choosing to accept the inherent risk of getting sick or dying from COVID. They say vaccinated patients who have made the right decisions for their health and the safety of their communities should not be denied care because others have acted irresponsibly. Some bioethicists also believe that it might be possible to factor vaccine status into triage decisions to take into account a patient’s chances of survival.
And after
At the moment, conversations about de-prioritizing unvaccinated COVID patients appear to be purely speculative. Some groups of doctors and medical journals have raised the debate, but no public health authority has announced its intention to implement such a plan.
Viewpoints
Why someone is sick is not a consideration in medicine
“There’s a feeling this time around we didn’t need it, and yet we’re there again. Thus, the emotions are very understandable. But the mere fact that their behavior may have contributed to why people are sick and need access to critical care resources is not a reason to discriminate. [against] them by itself. – David Magnus, bioethicist, at Time
Vaccinated people should not have to suffer because of the dangerous choices of others
“No one is going to take a ventilator out of an unvaccinated patient to treat a vaccinated patient who is in desperate need of treatment, and that’s not what I approve of. In the real world, those decisions will be made in split second assessments upon arrival. My point is that doctors are not acting unethically by putting their finger on the scales in favor of the vaccinated – they are behaving rationally and fairly. – Ruth Marcus, Washington Post
Choosing not to get vaccinated is accepting a high risk
“It’s a free country, and you absolutely can choose not to get the vaccine. But choices have consequences, and the unvaccinated on purpose made that consequence necessary. – Trish Zornio, Colorado Newsline
Immunization status can be one of many factors in clinical decisions about patient outcome
“If not being vaccinated and having lung failure puts you at a worse chance of survival compared to someone who just arrived with asthma and lung problems but is vaccinated. many places would prioritize the vaccinated asthmatic patient as opposed to the unvaccinated lung failure patient. What they observe is the outcome and the likelihood of success. – Art Caplan, bioethicist, at CNN
Sentencing someone to death because of their vaccination decision would be extreme
“Denying access to intensive care unit care for a COVID patient who needs it would in effect impose the death penalty on some people who may have been wrong in their assessment of their own risk, or vaccine risks, or even listening to misinformation. or conspiracy theories. Death seems a pretty harsh punishment for such a mistake. – William Allen, bioethicist, at TC Palm
Many unvaccinated people are themselves victims
“Even people who resist vaccination because [they] think they will never get sick… these people were lied to by leaders they trusted. Bad information is cheap; better information is expensive. And as ugly as the Covid numbers in the South may be, the rabies might be better directed against political leaders who resist basic public health measures rather than the people who suffer from them. “- Adam Rogers, wired
Hospitals don’t deny medical care to those making dangerous decisions
“Since when do we reject patients – or charge them high additional costs – on the grounds that their own carelessness caused their illness or injury? Are those who are ready to slam the hospital door in the face of the unvaccinated ready to do the same to the injured motorcyclist who was not wearing a helmet? To the liver transplant patient who drank too much? – Jeff Jacoby, Boston Globe
Emergencies are not the place for moral judgments
“We turned a virus into a moral test. You can catch it even if you are masked, even if you have been vaccinated, but if you don’t mask yourself and get bitten you deserve to be sick. – Karol Markowicz, New York Post
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Photographic illustration: Yahoo News; photos: Mark Felix / AFP via Getty Images
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