I am thinking out loud here. I have just been on a walk with a friend--6 feet apart; masked (scarfed in my case). We started talking about the wrenching decision a cousin of hers had to make. The cousin's 70-year-old brother, who lived in a group home and had a severe speech defect, was in the hospital with coronavirus. Doctors had called her, the sister, for permission to put her brother on a ventilator since he was fighting any attempt to put anything on his face and couldn't articulate his wishes. Brother and sister weren't close; she didn't know what to do. My friend is a doctor; so is her husband. They couldn't make a decision for the cousin, but they talked her through what might happen given his current health. The cousin called the next day; her brother had died before she could get back to the doctors with her decision.
Ventilator decisions are ones families, ICU doctors and nurses are faced with every day. As coronavirus cases keep spiking and ventilator availability may not be able to keep up with need, hand-wringing discussions are taking place in medical circles: How, if it comes down to it, to make the decision of who gets one and who doesn't.
The decisions health professionals may have to make may get down to one of life's basic ethical questions: what is a life worth? More specifically in this time of the corona, whose life takes precedence when it comes to ventilator decisions. What a time we are living through--not only a pandemic but a crisis of supply (of both machine and medical personnel)--that we may have come to a point where medical professionals have to make decisions like this.
My friend and I talk about directives we have given our families--our spouses, our grown children--about what we want done should we suffer debilitating diseases and not be able to make resuscitate decisions for ourselves. The question we debate on our walk is whether these directives--written months or years ago and meant as guidance during a personal health crisis that affects only us and our loved ones--apply to today's situation. What if we become ill with coronavirus and become sick enough to need aid in breathing. Do we want medical personnel to make the decision about whether a machine should breathe for us--possibly at the expense of someone else. Where do we want our loved ones to draw the line. What do we want them to tell the doctors and nurses overseeing our care? "Yes, do anything to save her," or "No, she feels she's lived a good and long life, and she wants you to use your resources for someone with their future still ahead of them."
We ended our walk in total agreement on what we want to tell our spouses and grown children. But when I got home and brought up the question, my spouse had a very different answer.
It is a very personal decision. I would never tell anyone beyond my grown children and spouse what I want done. There is no right or wrong here. But there is some thinking to do. If it should come down to it, our children deserve guidance from us.