Monday, May 05, 2008

Well, this will set off a firestorm

Providing, of course, people actually notice it:

Doctors know some patients needing lifesaving care won't get it in a flu pandemic or other disaster. The gut-wrenching dilemma will be deciding who to let die.

Now, an influential group of physicians has drafted a grimly specific list of recommendations for which patients wouldn't be treated. They include the very elderly, seriously hurt trauma victims, severely burned patients and those with severe dementia.

I'm impressed that the subject is actually being publicly considered at all, given its nature. Our American society is inclined to pull out all the stops to treat that sick child, even where the odds are 1 in a million against a cure. We don't euthanize our terminally ill, even when it would save them from extraordinary suffering. It goes against our sense of "fairness" to say that anyone, no matter what the situation, will receive less than every possible treatment in an effort to save them.

But in reality, we do this all the time. It's called "triage", and it isn't only about choices for medical care. We are practicing a form of triage every time we decide on Option A over Option B because B is too expensive, takes to long or is simply too much trouble.

I expect that this discussion, if it becomes widespread, will be very interesting to watch play out.

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