"Death Panels" aren't a joke any more

Sarah Palin was pilloried by the mainstream media for her claim that Obamacare would involve what she called "Death Panels" to decide whether or not one would receive appropriate care.  However, the coronavirus pandemic has illustrated very clearly that such panels do exist, and that the decisions they take - the priorities they assign to treatment and those who will receive it - are, quite literally, life or death choices.

In Spain, a doctor was forthright about it.

SPAIN's coronavirus death toll has resulted in hospitals refusing to admit elderly and frail patients into intensive care unit beds in a bid to ration them for patients more likely to survive the virus.

Medical Director at Spain's Clinical Hospital San Carlos, Professor Julio Mayol explained the country was having to prioritise different patients in the battle against coronavirus.

"Of course, we have to make decisions.

"Those that are frail, we have many communities that are not good candidates to make it through the ICU stay.

"We have to decide not to put them on ventilators, this is tough because we get a lot of pressure.

"But people understand that these are critical moments and we have to make clinical decisions like this.

"We have ethic committees providing us with counsel to ensure we make the right decision with people."

There's more at the link.

Italy is doing the same thing.

Dr. Gai Peleg told Israeli television that in northern Italy, patients over 60 tend to receive less treatment with anesthesia and artificial respiratory machines.

. . .

As his department receives coronavirus patients who are terminally ill, the focus is to allow patients to meet loved ones and communicate with them during their last moments despite the quarantine regulations ... Peleg said that, from what he hears, patients over 60 tend to receive less treatment with anesthesia and artificial respiratory machines.

Again, more at the link.

Another part of the problem is that COVID-19 cases are so overwhelming the system that those with other ailments, even life-threatening ones, simply can't be given the medical care they need.  Examples (click the images to be taken to the original post on Twitter):

Paramedics in New York City have been told not to bring cardiac arrest patients to emergency rooms for revival.

If an adult patient has obvious signs of death like rigor or has a do not resuscitate order, EMTs will not try to revive the patient.

In all other cases, EMS is told to limit the number of EMTs working on the person to only those necessary (to limit possible COVID-19 exposure); they must wear the proper N-95 mask, eyeshield, gloves, mask and gown. If, after 20 minutes of CPR, the defibrillator or the heart monitor shows a "no shock indicated" or a non-shockable rhythm and there is no blood circulation, CPR is to be terminated. At that point, the NYPD or medical examiner can be called to remove the body; the patient is not to be brought to the hospital.

More at the link.

At the Bookworm Room blog, the author comments:

In America, the profit motive encourages better doctors and nurses, better equipment, more beds, etc. It’s when the government steps in and limits the number of beds or other things that we start having problems.

And as noted, in socialized medicine countries, the government rations everything. There’s no profit to be had from medicine; there are only expenses and the expenses can be paid for only by taxing people. That leads to constant rationing and constant triaging.

That’s why, in England, the country with which I’m most familiar, you ended up with the deadly Liverpool Care Pathway which led to thousands of treatable elderly patients being left to die. That’s also how England openly or through subterfuge denies life-saving treatment (e.g., cancer treatment) or quality of life treatment (e.g., new hips or knees) to elderly patients. With rationing and triage, these people just fall by the wayside. I’ve told people here before about my father, in America, who got a new hip two weeks after he was told it was the only way to keep him mobile. I compared him to my friend’s nice middle-class mother, in Britain, who was told she needed a new hip and died ten years later without ever getting that hip, and having spent the last ten years of her life with extreme pain and limited mobility.

Given the stark realities of socialized medicine, and how those failings are being highlighted with COVID-19’s race through Europe, it’s disturbing to see [renewed and stronger] calls for socialized medicine.

I understand completely the desire to provide health care to anyone who needs it, and as much as they need.  However, once government is paying for it, a utility calculus comes into play.  "How much can this person still contribute to society (particularly in the form of taxes), and is it worth spending more than that on his/her treatment?"  That's the cold, hard reality of it, even if it isn't couched in those brutally frank terms.  Money talks, among bureaucrats and administrators as much as (if not more than) anywhere else.

Of course, there's also the approach recommended by one German doctor.

While appearing on "The Morning Show," Dr. Rissland was asked about whether or not drinking alcohol could kill any viruses a person may have ingested. "Yes, of course, that's true," Dr. Rissland responded. "And the higher the percentage of alcohol, the better it is. For example, if you are a whisky lover, then that certainly isn't a bad idea," he continued, while offering this bit of sage advice to pace yourself: "But of course you need to bear in mind that you can't do that every 15 minutes, that is something else to consider."

After being prodded a little further by the show's cohosts who asked him if he was really suggesting folks drink high-proof alcohol, Dr. Rissland didn't back down or attempt to clarify his remarks. Instead, he added, ""I would say it can't do any harm although we need to remember that it's not a guaranteed cure for the problem."

So, even if we won't be allowed access to treatment, we can still die in high spirits.  Cheers!

Peter