Altruism on Your Death Bed

How badly do you want to live?

I was watching a doctor on TV weep as he spoke about having to explain to an elderly hospital patient that the ventilator she so desperately needed to live was being removed and reassigned to a younger patient whose survivability was more certain. Welcome to medicine in the age of COVID-19.

Unless things change for the better, we are most likely heading into an age of triage where doctors will have to decide who shall live and who shall die. This is not something that comes easily to people dedicated to heal rather than harm, and the moral strain this must place on them is something I cannot pretend to imagine. But there may be something we can do to help alleviate the moral dilemma doctors and nurses face. (Read “5 Ways to Be Brave Today” for more on courageous healthcare workers.)

What I have in mind is a version of a living will (a written statement in which you state your preferences regarding end-of-life medical care) that speaks directly to the shortage of ventilators in hospitals. Something like this:

I, __________, request that in the case of an insufficient supply of ventilators due to the coronavirus pandemic, any ventilator assigned to me at the expense of others be reassigned to a younger person with a greater chance of survival and of living a longer life in the event of survival. I understand that this decision will not preclude me from receiving other types of treatment and palliative care.

My example isn’t written in the required legal language, and, given the nature of quarantine, you may find it difficult or even impossible to get it witnessed and signed by a notary, but, even without these legal elements, providing doctors and hospital staff with something like this will make your wishes known and alleviate some of the moral suffering they will experience in the event of having to decide who will live and who will die.

The question is this: Will you do this?

Right now, sitting at my desk symptom-free, I am willing to sign. But what if I am in the hospital gasping for air, would I make the same decision? I’d like to think I would, but I fear I won’t, which is why I am printing out and signing this form right now and putting it with my living will. If this speaks to you, I urge you to do the same. And if someone reading this can make the language more legally acceptable, please let us know ([email protected]) how to change it.