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Saturday, October 07, 2006

Oh No... That's Okay... You Go First...

Well I have spent hours upon hours on my schoolwork. It is way past time for me to go to bed.

The weather was absolutely beautiful...

Too nice to be inside.

But that is where I was...

a l l ~ d a y ~ l o n g.

Before I go to bed, I just thought I would share something with you guys for your own consideration...

There seems to be quite a bit of thought concerning the possibility of a flu outbreak. Something of a magnitude that hasn't been experienced in many, many years.

And the concern isn't necessarily addressing the bird flu either.

And so an ethical question is presented...

Three gravely ill flu patients -- a 10-year-old with a 30 percent chance of survival, a 40-year-old doctor with a 25 percent chance and a 65-year-old retiree with a 10 percent chance -- all need the only ventilator available to help them breathe. Who would be hooked up to the ventilator and who wouldn't?

I certainly could give up my ventilator for my child if they needed it to survive...

And maybe I could give up my ventilator for someone who would be considered more valuable to society than I am...


But if I were to die...

Who then would take care of my children?

The person who was considered less expendable and survived due to the use of my ventilator?

Somehow I don't think so.

However, putting myself aside, if my children were in need of the ventilator and health care professionals refused to give it to them...

What would I do?

Consider this scenario:

"Let's say I've got a hospital full of 85-year-olds on ventilators and I've got a 20-year-old who needs a ventilator: Do I take an 85-year-old off and give it to the 20-year-old?"

If my grandmother is on a ventilator, would she be asked to give it up?

Or would it just be disconnected and taken from her.

These questions are presented on the premise that there would be a flu outbreak of such a magnitude that there would not be enough ventilators available to treat the influx of patients that could be expected.

"With hospitals across the state already at 85 percent to 90 percent capacity, even a mild pandemic would force doctors and nurses to ration medicine and equipment based on patients' chances of survival..."

If these statistics are true, then the entire health system should be scrutinized and some hard questions asked.

Why are the number of hospital beds not keeping up with the population's needs?

Hospital management has been changing and most hospitals are no longer localized private institutions. They have grown into large national organizations and hospital "chains".

While I recognize their need to survive in the business world, I think they should recognize the business that they are in.

While the "big men in white coats" sit and ponder the answers to these questions, it would seem to me that perhaps they should put themselves in my shoes.

And your shoes too.

Since I am not in the position to discuss and write the policy guidelines for a human health institution, I would like for these "men" to consider the following...

When you make a decision that could have grave consequences for an individual and their families, would you please stop and ask yourself these questions:

Can you deny your child life?

Can you deny your grandmother life?

Are you able to sacrifice your life so that another could live?

If you are not able to answer yes to any of these questions, then I would recommend that you devise an alternative plan.

If your hospital has to buy additional equipment, or even invent new methodogies for severe respiratory illnesses, then I feel that you should be required to do so.

If you can't do that, or lack the will to even try...

Then I think that perhaps you would be one of the expendable persons and you should give your ventilator up to someone who will come up with a more workable plan.



Anonymous wolfbaby said...

and the homework pile upith.. must be that time of year...as for the flu thing.. just a tad bit scary!!!

October 08, 2006 6:22 PM  
Blogger Sue said...

To have to make a choice of who lives or dies - that's not something I could ever possibly contemplate.

Sounds like you had a very hard-working weekend. Good Luck that it all went well.

October 08, 2006 10:02 PM  
Anonymous Moof said...

We're hearing this sort of question more and more often.

How can anyone put a value on life? This life is worth more than that life ... or that person should be chosen to live at the expense of another person?

I know that in times of catastrophe, decisions have to be made ... by human beings ... who know that they have the lives of others in their hands, and are unable to give what doesn't exist ... the antibiotics, for example. Sometimes they have to make choices that end lives ... and save lives ... all at the same time. I don't want to be in that position.

If you have a room full of people, TJ ... all ages, walks of life, and they all need the ONE injection you have ... or they will die ... who will you choose? How will you choose?

Too painful and hard to think about. I just hope that I'm never ever in that sort of position.

Thank you for posting this. It's certainly something we all need to ponder on ahead of time ...

October 09, 2006 11:20 AM  
Blogger It's me, T.J. said...

Hey Wolfbaby...

The homework is making me miserable!

Hey Sue...

Who would ~ever~ want to be in that position? That would be a very tough row to hoe.

Hey Moof...

Glad you were able to stop by!

If you have a room full of people, TJ ... all ages, walks of life, and they all need the ONE injection you have ... or they will die ... who will you choose? How will you choose?

In this day and age, here in the United States of America, I think that it is ludicrous that we would *ever* be in that sort of position.

Where there's a will there's a way. And if for some reason, (such as a nuclear holocaust) that we do find ourselves in a position like that...

I think that we would know it before it happened. Hopefully we would. And in that case, I would certainly be armed with some alternative plans. And if necessary I would go back to using poultices, herbs, and the like.


For the sake of argument (which I know you love to do).

If none of my children were present, I would simply throw it away. If all of my children were present, I probably would throw it away. (How could I choose one over the other?)

But if one of my children were present, I would give it to them.

Selfish as it may seem.


October 09, 2006 8:35 PM  
Anonymous Moof said...

TJ ... dear heart, I hear you. But what about the woman across the room with the tiny baby ... the one who struggled for years to have that baby, and can't have any more, and who just lost both of her parents in a car accident?

Outlandish? Yes ... but in some way, that woman is each one of us ... and your answer proved it.

In navy Corps School, we were taught: tend to those who appear to have the best chance of survival first ... it's all you can do.

I don't know that it's "all" we can do, but I do know that I would rather be one of the dying victims which is being passed over than the person who has to choose ...

Really good post, TJ! It's a tough question.

October 10, 2006 10:13 AM  
Blogger Jan said...

Yes, isn't it a lot like triage? You divide those you can help into two groups: one needs immediate assistance and the other can wait. You also have a group that, despite help, will likely not survive. Then you treat them in that order. It is a difficult job, no doubt.

Let's pray we don't face such a situation.

October 13, 2006 2:43 PM  
Blogger It's me, T.J. said...

Hey Jan...

Glad to *see* you!

I understand triage, but I would consider triage as being a necessary evil of a catastrophic disaster.

Of course, I guess a flu epidemic could be one of those events. But I don't think it should be.


October 13, 2006 8:56 PM  

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