The ethics of who gets COVID-19 care, who doesn’t

Coronavirus
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DENVER (KDVR) -- American doctors may soon face the same difficult choices Italian doctors have already been making about which patients are given the best chance of survival.

As the U.S. death toll from the COVID-19 outbreak surpasses 1,000 victims, it’s become clear parts of the country may soon run out of hospital beds and ventilators for all of its critically ill patients.

“I hope that we don't have to get to the point where we have to remove ventilators from folks,” said Govind Persad, an assistant law professor with the University of Denver Sturm College of Law.

Persad co-authored a paper in the New England Journal of Medicine about the bio-ethics of which patients to prioritize when hospitals don’t have enough supplies for every patient.

“The two most important factors are saving the most lives and making sure that the people we save are able to survive after they go off the ventilator,” said Persad.

He said researchers determined the No. 1 priority patient for health care workers should be fellow health care workers.

“One of the most likely shortages we're going to see is not so much technical equipment, but shortages of trained respiratory therapists, docs, nurses.”

Persad said getting recovered medical professionals back on the front lines will be key to saving other lives.

He emphasized it shouldn’t be the wealthy or well-connected who getter better access, as has happened with COVID-19 testing, but those who truly have the best odds of survival.

That’s why, he added, a first-come, first-serve model doesn’t work either.

Patients already hospitalized but with a poor prognosis may have to be abandoned for newer patients with potential for a better health outcome.

"I think it's likely that at some point we're going to have make some of these hard decisions,” said Persad.

He pointed out that by canceling elective surgeries at area hospitals, Colorado doctors have already made some life and death decisions because postponing procedures -- be it for cancer or heart patients -- can sometimes lead to worse outcomes, including death.

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