UNLIMITED

The Atlantic

An Ethicist on How to Make Impossible Decisions

Arthur Caplan, NYU’s chief medical ethicist, discusses the tough calls doctors have to make on how to ration care.
Source: Aleksandra Michalska / Reuters

Tents are now strewn across Manhattan’s Central Park—a field hospitals in the literal sense—that resemble the convalescence wards of the 1918 flu pandemic. They sit a stone’s throw from some of the world’s most expensive real estate. Not to mention some of the world’s most luxurious brick-and-mortar hospitals.

In these tents, on the cots that sit less than six feet apart, it is expected that millionaires will lie beside people without a penny to their names. Care will be allocated based on where it can be the most useful and do the most good.

This is not a type of health care that most Americans are accustomed to. But already, rationing is upon us.

If you are one of the 7.6 million people in New York City, you are advised by city officials to stay home until you become short of breath. Typically, this is a sign of being on the brink of a critical illness. It means a respiratory infection has spread into the lower airways, and it could quickly progress to the point of needing supplemental oxygen or intubation and mechanical ventilation. But, at this point, medical care—prior to the point of becoming short of breath—must be rationed. Clinics and emergency departments cannot currently handle being filled with people who, sick as they may be, do not yet clearly require hospitalization.

New York, like other states, does not yet have enough hospital beds, masks, or diagnostic tests for the coronavirus to accommodate all who might need one. Certain rationing decisions are already being made, including which surgeries can be considered “elective” and canceled, and which cannot.

Perhaps most ominously to the thousands of New Yorkers at home wondering just how short of breath is “short of breath,” we also do not have enough ventilators. By Governor Andrew Cuomo’s estimate, the state will need around 30,000 in coming months. We have about 5,000. Some new ventilators are being made, but this cannot happen quickly enough to meet that sort of demand.

You’re reading a preview, subscribe to read more.

More from The Atlantic

The Atlantic27 min read
Best of How To: Identify What You Enjoy
Listen and subscribe here: Apple Podcasts | Spotify | YouTube | Pocket Casts This episode, from our first season, called How to Build a Happy Life, features host Arthur Brooks in conversation with the psychotherapist and Atlantic contributing writer
The Atlantic5 min read
The Price of Humiliating Nicolás Maduro
For many years, Venezuelans understood instinctively what was meant when someone invoked la situación in conversation. The rich started leaving the country because of la situación. One would be crazy to drive at night, given la situación del país. Th
The Atlantic5 min read
The Hysterical Crypto Bubble Somehow Became Respectable
Until now, the phrase crypto winter meant that cryptocurrency traders were facing hard times: a period of tumbling and depressed prices that had to be weathered until the good times returned. Today, though, the cryptocurrency industry is enjoying an

Related Books & Audiobooks

pFad - Phonifier reborn

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


Alternative Proxies:

Alternative Proxy

pFad Proxy

pFad v3 Proxy

pFad v4 Proxy