Since coronavirus took off, we’ve known the day was coming when hospitals in the United States would have to decide who gets ventilators and who … dies. A top hospital in New York City took a step toward that on March 28, when its head of emergency medicine sent out an email announcing that ER doctors should “think more critically about who we intubate.”
ER doctors, Dr. Robert Femia wrote, have “sole discretion” in making intubation decisions, and NYU Langone Health will back their decisions to “withhold futile intubations.” Placing the decisions solely in the hands of ER doctors goes against New York state guidelines, which recommend that hospitals put such decisions in the hands of a triage officer or committee rather than the doctors directly treating the patients. “In Emergency Medicine, we do not have the luxury of time, data, or committees to help with our critical triage decisions,” Femia wrote.
According to a hospital spokesperson, this is not new policy but a matter of reminding doctors of existing policy, and the hospital is “not at the point in which these judgments need to be made within the current scope of care.”
Some NYU Langone doctors told The Wall Street Journal they weren’t happy about the policy. “As a doctor, I don’t know how to make the call,” one said. According to another, “Asking ED physicians to make snap judgments about how well a patient will do based on little to no information is a tremendous burden to place on them.” Those doctors spoke anonymously for good reason: the hospital also reminded doctors not to talk to the media without permission.