Opinion: No hospital administrator should have to make these choices
Every little while we’re offered another reminder of why it is so important that Oklahomans from border to border and all walks of life take seriously the steps recommended to help curb spread of the coronavirus. Josh Dulaney’s story in Sunday’s Oklahoman is the latest.
Dulaney wrote about how as COVID-19 cases climb, hospital officials continue to wrestle with how best to allocate critical resources for patients near death.
Under ordinary circumstances, hospitals generally have enough of what they need to tend to the dying. The pressure placed on hospitals by COVID-19 has changed that. Last week Dr. Julie Watson, chief medical officer for Integris Health, told the newspaper that the public should be “gravely concerned” because the health system, as Dulaney reported, “may have to start prioritizing which patients receive access to vital resources based on likelihood of recovery.”
Some of these discussions were held shortly after the pandemic began. In April, the state Health Department issued its Hospital Crisis Standards of Care, a set of guidelines developed with input from physicians and other health care professionals for delivering health care if resources got tight.
Now, medical professionals are turning to lawyers and ethicists for guidance on such things as when or whether to steer medical equipment away from one patient to someone with a better chance of surviving the coronavirus.
“We hope and pray we never get to crisis standards care,” says Patti Davis, president of the Oklahoma Hospital Association. “If we get to crisis standards care, we’re talking about scarce resources.”
Under the standards of care guidelines, all patients will be considered eligible for mechanical ventilation but priority will go “to those with the highest short and long-term survival prognosis.” A ventilator may be reallocated from patients showing “a precipitous decline or a highly morbid complication which portends very poor diagnosis,” according to the guidelines, which were federally approved.
The ongoing surge of COVID-19 patients — the death toll passed 3,100 this week — is taxing hospitals across the state. Davis noted that non-clinical personnel are called on more and more to help frontline workers.
Hospital systems are assessing capacity hourly and have plans for worst-case scenarios. Mercy Hospital's president, Jim Gebhart, said the hospital has not had to ration care and, “We pray we never get to that point.”
If it does, Gebhart said, “all the area hospitals have worked together on a plan on how to best do that.”
There is a lot of praying going on in hospitals today, and not just by the chaplains tending to the sick and their families. No hospital administrator should have to make the choices being discussed. Oklahomans can help them by getting vaccinated when they get the chance, and by washing their hands regularly, watching their distance from others, and wearing a mask in public when social distancing isn’t possible. Please, do your part.
Opinion editor Owen Canfield is in his 18th year writing editorials for The Oklahoman and has spent nearly 40 years in journalism. Email Owen at firstname.lastname@example.org or call him at (405) 740-7624. Support his work and that of other Oklahoman journalists by purchasing a print or digital subscription at oklahoman.com/subscribe.