doing more than they are meant to do. They can end up becoming definitive rules for making decisions rather than serving as aids to the real decision-makers. Because of this, hospitals must be even more careful to create guidelines that cannot be used to justify bias, prejudice, or priorities in people based on “social usefulness.” We already have examples from other health care crises in history when Do-Not-Resuscitate orders served to declare that a person was not worth saving, regardless of medical prognosis. In the article, “The Deadly Choices at Memorial,” about what happened during Hurricane Katrina, we can read how hospital leadership interpreted DNR orders to mean that those with them had the “least to lose” compared with other patients if calamity struck and these patients would not wish their lives to be saved at the expense of others. It is extremely important to make sure health professionals’ efforts go for the sake of saving lives — as many as they can. And they should recognize when their efforts may be illusory. But saving lives by discounting others right off the bat is not in line with our medical or social ethics, even if it might be utilitarian. Times of disaster do not call upon us to throw out our everyday values and adopt a different form of disaster ethics. Think of the analogy between a regular season game and the Super Bowl. The rules are the same, but the stakes are higher, and the players are more skilled to face the challenge. Similarly, this moment calls on us to rise to the challenge of applying our ethics and making moral decisions when we need to most. Otherwise, after the COVID-19 crisis has passed, we may find ourselves facing an even bigger threat to society — and our humanity. As appeared in The Citizens’ Voice on April 11, 2020.
What Happens When We Run Out of Ventilators? Jewish Law and State Guidelines May Have Different Answers Ira J. Bedzow, Ph.D.
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The COVID-19 pandemic facing this city will test our country’s most deeply cherished values: respect for multiculturalism and religious freedom on the one side and the state’s responsibility to promote the common good on the other. This inherent tension is quite literally an issue of life and death. In New York City and elsewhere, hospitals are close to experiencing a shortage of personal protective equipment and ventilators, which will greatly tax the hospital system’s ability to provide care. To be clear, as of now the city’s hospitals have not run out of ventilators. Yet given the rise in the number of patients coming to the hospital each day, preparation is warranted. As hospitals develop triage protocols to prepare themselves for the time when they will need to treat too many patients with not enough medical resources, rabbis and public religious figures are grappling with the halachic answers to those same questions. And the protocols that New York City hospitals will ultimately adopt are going to clash with the position held by most, if not all, Orthodox rabbinic authorities. If two patients show up at the hospital at the same time in need of the only ventilator, both hospital guidelines and rabbis assert that physicians should use clinical judgment to determine which patient has a better chance of survival. The problem arises once a patient is already put on a ventilator. Many hospitals look to the 2015 Ventilator Allocation Guidelines, written by the New York State Task Force on Life and the Law, to help them figure out how to ration ventilators. In a crisis, hospitals continually assess patients to determine whether they should stay on a ventilator or should be removed so that someone else can have