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Thread: Message from Alaska's largest hospital. Triage.

  1. #36
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    Default Re: Message from Alaska's largest hospital. Triage.

    ^ Anti-vaxers FREEDOM terminally infringed Daniel Wilkinson's freedom.
    It really is quite difficult to build an ugly wooden boat.

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  2. #37
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    Default Re: Message from Alaska's largest hospital. Triage.

    Imagine if the US responded to the pandemic the way we responded to 9/11. Don’t know why that came to mind. Anyway, 1/500, unless yr over 65.

    https://www.washingtonpost.com/healt...re-top-stories

    The pandemic marks another
    grim milestone: 1 in 500
    Americans have died of covid-19

    At a certain point, it was no longer a matter of if the United States would reach the gruesome milestone of 1 in 500 people dying of covid-19, but a matter of when. A year? Maybe 15 months? The answer: 19 months.
    Given the mortality rate from covid and our nation’s population size, “we’re kind of where we predicted we would be with completely uncontrolled spread of infection,” said Jeffrey D. Klausner, clinical professor of medicine, population and public health sciences at the University of Southern California’s Keck School of Medicine. “Remember at the very beginning, which we don’t hear about anymore, it was all about flatten the curve.”

  3. #38
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    Default Re: Message from Alaska's largest hospital. Triage.

    Quote Originally Posted by oznabrag View Post
    Do you think it would be ethical to treat drunk drivers the same as sober drivers?
    Quote Originally Posted by Canoeyawl View Post
    If they are in the hospital, then yes.
    People don't typically drive in hospitals, drunk OR sober.

  4. #39
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    Default Re: Message from Alaska's largest hospital. Triage.

    Quote Originally Posted by C. Ross View Post
    I don’t think it would be ethical to provide different levels of care for vaccinated or non-vaccinated COVID patients who present for care.

    Waiting for the Federally-required employer vaccine mandates to land.
    Provided that options to provide care are available, I fully agree. My problem, Cris, is when (as in this Alaskan hospital) those options are overwhelmed, and triage decisions must be made. For me, it's about establishing ethical guidelines to shape a response to a tragedy of insufficient access.
    If I use the word "God," I sure don't mean an old man in the sky who just loves the occasional goat sacrifice. - Anne Lamott

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    Default Re: Message from Alaska's largest hospital. Triage.

    If you were in the water with some other people after the ship went down, and some of the people in the water with you were responsible for the ship going down, and there were not enough spots in life boats for everyone, who would get to tread water and how else would you decide?
    Speak softly and carry a mouthful of marbles.

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    Default Re: Message from Alaska's largest hospital. Triage.

    Quote Originally Posted by Jim Mahan View Post
    If you were in the water with some other people after the ship went down, and some of the people in the water with you were responsible for the ship going down, and there were not enough spots in life boats for everyone, who would get to tread water and how else would you decide?
    You’d ask who they voted for, and so would I.

  7. #42
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    Default Re: Message from Alaska's largest hospital. Triage.

    Once was more than enough, but left my Presidential vote blank.
    kg
    \"Of all the things I\'ve lost, I miss my mind the most.\"

  8. #43
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    Default Re: Message from Alaska's largest hospital. Triage.

    Ethical guidelines would dictate the the sickest with a chance to live first! In a lot of cases that would be the unvaccinated first.

    Unless a law is passed making vaccination mandatory, what you are suggesting is not ethical!

    And no I am not a anti-vaxer, I believe in science.







  9. #44
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    Default Re: Message from Alaska's largest hospital. Triage.

    Quote Originally Posted by ShorelineJohn View Post
    Ethical guidelines would dictate the the sickest with a chance to live first! In a lot of cases that would be the unvaccinated first.

    Unless a law is passed making vaccination mandatory, what you are suggesting is not ethical!

    And no I am not a anti-vaxer, I believe in science.
    I'm surprised to learn that the Law has anything to do with Ethics.

    Tell me more!

  10. #45
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    Default Re: Message from Alaska's largest hospital. Triage.

    Quote Originally Posted by ShorelineJohn View Post
    Ethical guidelines would dictate the the sickest with a chance to live first! In a lot of cases that would be the unvaccinated first.

    Unless a law is passed making vaccination mandatory, what you are suggesting is not ethical!

    And no I am not a anti-vaxer, I believe in science.

    The sickest with a chance to live.... won't necessarily correlate to a non-vaxxed individual - esp if also considering other co-morbidities. If you peruse the stories of those dying of Covid, they describe 'we've done all we can... but you're about to die of hypoxia anyway', despite the ventilator. And as we exceed available vents with demand, some choices will need to be made. Looks like Alaska already is; Idaho is shipping theirs out, but if that expands in that region, that option will evaporate, as well.

    Unfortunate we don't have something - anything at all - that would render these scenarios moot.
    There's a lot of things they didn't tell me when I signed on with this outfit....

  11. #46
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    Default Re: Message from Alaska's largest hospital. Triage.

    There's a lot of things they didn't tell me when I signed on with this outfit....

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    Default Re: Message from Alaska's largest hospital. Triage.

    Quote Originally Posted by George Jung View Post

    Rationed care!? OMG Sarah Palin was right, the dreaded death panels.

    Who knew it would be some of her very supporters that would create conditions to make death panels necessary? YCMTSU
    "Unrepentant Reprobate"
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  13. #48
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    Default Re: Message from Alaska's largest hospital. Triage.

    Quote Originally Posted by Kevin T View Post
    Rationed care!? OMG Sarah Palin was right, the dreaded death panels.

    Who knew it would be some of her very supporters that would create conditions to make death panels necessary? YCMTSU
    A bit of a conundrum for her; who do you blame? It's a Republican state.
    There's a lot of things they didn't tell me when I signed on with this outfit....

  14. #49
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    Default Re: Message from Alaska's largest hospital. Triage.

    If the law says you get to choose but in doing so you lose your rights to be seen by a doctor for any reason, (boy that broken leg looks painful) then its just a way to force compliance. If you can't change the law you don't just get to make up your own. If you want everyone to get vaccinated make it mandatory.

    The same unethical argument was use to say paramedics should not have to care for gay people because they might have aids.
    Healthcare, just as justice needs to be blind.

  15. #50
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    Default Re: Message from Alaska's largest hospital. Triage.

    ^Seems some folks are reaping the whirlwind. You pays your ticket, you get your ride.

    ETA: Reply was to the good Dr.
    "Unrepentant Reprobate"
    Lew Barrett



  16. #51
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    Default Re: Message from Alaska's largest hospital. Triage.

    All from a disease which many of those dying don't believe exists too.
    If I use the word "God," I sure don't mean an old man in the sky who just loves the occasional goat sacrifice. - Anne Lamott

  17. #52
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    Default Re: Message from Alaska's largest hospital. Triage.

    Quote Originally Posted by George Jung View Post

    nope, no bell curve.


    Hospitalizations for Covid-19 have continued to surge across Idaho, and are now running nearly 40 percent above the previous peak of the pandemic, according to federal data. The state health department said that St. Luke’s Health System, which has a network of hospitals across the state, requested that the crisis standards be expanded statewide.

  18. #53
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    Default Re: Message from Alaska's largest hospital. Triage.

    Quote Originally Posted by ShorelineJohn View Post
    If the law says you get to choose but in doing so you lose your rights to be seen by a doctor for any reason, (boy that broken leg looks painful) then its just a way to force compliance. If you can't change the law you don't just get to make up your own. If you want everyone to get vaccinated make it mandatory.

    The same unethical argument was use to say paramedics should not have to care for gay people because they might have aids.
    Healthcare, just as justice needs to be blind.
    No, it was NOT.

    The argument against paramedics treating gay people is wholly and completely different.

    In that case, an entire region's health care system was not being overrun by people too stupid to get vaxxed.

    Sorry.

    You still haven't explained to me the positive ethical aspect of allowing people to die because there's a Moron Horde intent upon dying and taking as many with them as possible.

    You likely don't feel that way about school shooters. . . Which reference is, I admit, at least as ridiculous as comparing anti-vaxxers to AIDS victims.

    Now, UNDER NORMAL CIRCUMSTANCES, sure, treat everybody.

    These are not normal circumstances, and one of the central abnormalities is that there simply is not enough care to go around, and the central reason for the shortage lies squarely on the shoulders of the Moron anti-vaxxers.

    Also, my dear friend, you should be aware that the study of Law is an entirely different field from the study of Ethics, though those two disciplines do scrutinize one another very closely.

    Asserting that something is not Ethical merely on the basis that it is illegal . . .

    Anyway.

    All the best from Texas. Moron Central for many folk.

  19. #54
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    Default Re: Message from Alaska's largest hospital. Triage.

    Quote Originally Posted by ShorelineJohn View Post
    If the law says you get to choose but in doing so you lose your rights to be seen by a doctor for any reason, (boy that broken leg looks painful) then its just a way to force compliance. If you can't change the law you don't just get to make up your own. If you want everyone to get vaccinated make it mandatory.

    The same unethical argument was use to say paramedics should not have to care for gay people because they might have aids.
    Healthcare, just as justice needs to be blind.
    While I personally believe that healthcare availability is "the next closest thing to a right"...under the US Constitution and the Bill of Rights, there is no mention of healthcare being an inalienable right for all citizens. It's not a "right" in a legal sense.

    It still hurts to think of turning people away, but if the situation occurs that medical professionals have to make choices, then.... ?????

  20. #55
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    Default Re: Message from Alaska's largest hospital. Triage.

    Quote Originally Posted by TomF View Post
    All from a disease which many of those dying don't believe exists too.
    Seems as if they are manifesting; "there are none so blind as those who refuse to see."
    "Unrepentant Reprobate"
    Lew Barrett



  21. #56
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    Default Re: Message from Alaska's largest hospital. Triage.

    I think a catastrophe of insufficient access that's crisis-managed using some ethical criteria is better than one which isn't.

    But that neither are exactly "good." Particularly when the catastrophe itself is, by now, voluntary.
    If I use the word "God," I sure don't mean an old man in the sky who just loves the occasional goat sacrifice. - Anne Lamott

  22. #57
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    Default Re: Message from Alaska's largest hospital. Triage.

    I would have said ''self-inflicted''
    It really is quite difficult to build an ugly wooden boat.

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  23. #58
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    Default Re: Message from Alaska's largest hospital. Triage.

    Perhaps "self-​infected"
    "Unrepentant Reprobate"
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  24. #59
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    Default Re: Message from Alaska's largest hospital. Triage.

    Allowing someone to die because they are not vaccinated is just as unethical.

    I do understand your belief that they are stupid, I do in fact share that belief, doesn't mean I get to impose my standard on others.

    The law and ethics in a free and open society do go hand in hand. It is NOT ethical for the GOP to push the big lie. Why because we had a free and open election. To try and go around laws that protects peoples healthcare is not ethical, it just not.

    Not everyone that is not vaccinated is Trucker Carlson and they should not have to prove to you they are worthy of healthcare.

  25. #60
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    Default Re: Message from Alaska's largest hospital. Triage.

    Quote Originally Posted by Alan H View Post
    While I personally believe that healthcare availability is "the next closest thing to a right"...under the US Constitution and the Bill of Rights, there is no mention of healthcare being an inalienable right for all citizens. It's not a "right" in a legal sense.

    It still hurts to think of turning people away, but if the situation occurs that medical professionals have to make choices, then.... ?????
    It was not written in to your constitution because it was practically non-existent and undeliverable.
    I consisted of chaining those with mental health issues to a wall and amputating bits without anaesthetic or basic hygiene.
    There is archaeological evidence that the First Peoples were better at it than the settlers.
    Edited to add: P.S.
    There are those universally ignored words ''for the general welfare''
    Last edited by Peerie Maa; 09-16-2021 at 03:05 PM.
    It really is quite difficult to build an ugly wooden boat.

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  26. #61
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    Default Re: Message from Alaska's largest hospital. Triage.

    So, no treating drug overdose cases, drunk driving accidents, people hurt snow skiing.... where do we stop it?

    Kevin
    There are two kinds of boaters: those who have run aground, and those who lie about it.

  27. #62
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    Default Re: Message from Alaska's largest hospital. Triage.

    It's pretty obvious that, even if one wants to deny treatment, people have to be treated equally. That means you take in the un-vaxed. Guilt trip 'em, make them understand that their selfishness is literally killing other people, but you gotta treat 'em.
    "If it ain't broke, you're not trying." - Red Green

  28. #63
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    Default Re: Message from Alaska's largest hospital. Triage.

    You'd think, but if this pandemic takes off, we will get into rationing of care. Not as a punishment - but from simple lack of capacity.

    And I'd point out - getting infected simplyl because you don't want to get vaxxed - doesn't equate well with someone who gets hurt in an accident - something that isn't avoidable ($hit happens) unless we all stay in our basements, wrapped in bubble wrap. *If* I could get a vax that would protect me from a serious accident, or skiing injury - I'd do it. We have a vax for 'one thing', not the others.
    There's a lot of things they didn't tell me when I signed on with this outfit....

  29. #64
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    Default Re: Message from Alaska's largest hospital. Triage.

    Quote Originally Posted by Breakaway View Post
    So, no treating drug overdose cases, drunk driving accidents, people hurt snow skiing.... where do we stop it?

    Kevin
    That's not what I'm saying at all. Sorry, but no.

    What I'm saying is that if there's such a massive explosion of drunk driving accidents, or drug overdoses, or etc. that quite literally there isn't any more space in the ICUs of hospitals for anyone else...

    If those hospitals have been putting off diagnostics and treatment for other people for months and months ... in order to open up more space for the wounded drunk drivers and the overdose victims ... and medical staff are not merely burning out, but in no small numbers dying from some mysterious condition they catch while treating these victims ...

    .. If those hospitals have had to pull in freezer trucks to deal with all the dead. Crematoria are literally stockpiling bodies of dead drunk drivers because they can't be burned quickly enough.

    And if for upwards of 18 months we've been suffering through this ... as the drunk drivers and drug addicts explain that they aren't dying, they aren't putting any strain on resources. They have a Constitutional Right not merely to die in such ways, but to require others to become drunk drivers and drug addicts too, while denying that those characteristics even exist ...

    ... and for the last 8 months, a miraculous thing has emerged to help over 95% of such alcoholics and addicts to never take that fatal risk again, and even if they fall off the wagon, virtually all of them will kick their addictions with a couple of weeks of mild rehab... And this thing has been promoted with an UNPRECEDENTED in lifetimes push of education and funding and free-distribution and etc to remove any possible barrier to accessing it...

    I'm saying that if those people not only refuse to access that miraculous prevention thing, but do their damnedest to delegitimize it so that others won't. And at the same time continue to come to the hospitals when they're busted up in drunken car accidents or OD episodes ...

    I'm saying that when there's GOT to be a choice made, because the fooking drunk drivers and addicts have so overwhelmed the hospitals that SOMEBODY is going to die for lack of access to treatment ...

    At that point, I think that the chemotherapy patients should be permitted to get their chemo first. And the stroke patients. And the people with ruptured appendixes. And maybe the women needing emergency C-sections, or the guys whose gall bladders have just exploded.

    I don't think that's unethical. I think it's horrifying to have to make such choices, and that it would be LESS unethical to have enough access to care that everyone - from the routine emergency patients to the drunk drivers and addicts - could get the care they needed right away. But that's not where Alaska now is. Or Idaho. Or various other places. Alberta announced overnight that it's about 10 days away from the system facing exactly those choices here in Canada - because Alberta's got a high preponderance of COVID deniers, anti-maskers, and anti-vaxxers.

    People are dying now, who aren't having COVID emergencies, because of the COVID pandemic - and it's needless death. This isn't hypothetical anymore. There are no more reserve resources to bring in.
    If I use the word "God," I sure don't mean an old man in the sky who just loves the occasional goat sacrifice. - Anne Lamott

  30. #65
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    Default Re: Message from Alaska's largest hospital. Triage.

    Well stated, TomF; you oughtta be in 'policy'.....


    Kevin, it's a strange hill you've chosen to defend and die on.
    There's a lot of things they didn't tell me when I signed on with this outfit....

  31. #66
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    Default Re: Message from Alaska's largest hospital. Triage.

    Quote Originally Posted by Breakaway View Post
    So, no treating drug overdose cases, drunk driving accidents, people hurt snow skiing.... where do we stop it?

    Kevin
    All of those people get treated because there would be ICU beds available just as there was pre-pandemic. The problem now is that there are 70 plus million people in the US who have not gotten vaccinated and 99 percent of all hospitalizations due to covid are amongst the unvaccinated.

    There is an FDA approved vaccine which pretty much reduces the need for hospitalization. Hospital ICU beds are running at 100% to 145% over available capacity so your parent's heart attack goes untreated, that drug overdose may go untreated unless they can Narcan the OD'ed in the hallway, but a lot of folks with non-Covid issues that may benefit from an ICU bed are being turned away.

    So as it stands now the 30% who steadfastly refuse vaccinations are making those who are looking out for their fellow citizens and getting vaccinated and wearing masks can go pound sand should some other medical emergency befall them. Yeah, that's the way to do it, lets follow the lead of the science deniers and let them call the shots. (pun not intended).
    "Unrepentant Reprobate"
    Lew Barrett



  32. #67
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    Default Re: Message from Alaska's largest hospital. Triage.

    Quote Originally Posted by ShorelineJohn View Post
    Allowing someone to die because they are not vaccinated is just as unethical.

    I do understand your belief that they are stupid, I do in fact share that belief, doesn't mean I get to impose my standard on others.

    The law and ethics in a free and open society do go hand in hand. It is NOT ethical for the GOP to push the big lie. Why because we had a free and open election. To try and go around laws that protects peoples healthcare is not ethical, it just not.

    Not everyone that is not vaccinated is Trucker Carlson and they should not have to prove to you they are worthy of healthcare.
    OK.

    The Big Lie is unethical,but so far it's not been shown to be illegal.

    So there's that.

    Hypothetical for you:

    A State has 1,000 ICU beds, and barely enough staff to keep them served.

    In the normal course of events, 600 are in use. The staff has to work hard to keep the wheels greased, but the system produces enough that it works OK.


    A health crisis arises.

    All of a sudden, there are no ICU beds, and the staff is ragged and dazed, yet still determined.

    There are no ICU beds because of the Big Lie.

    At the same time, 350 Morons are being confronted with the fact that if THEY don't get an ICU bed, they're dead.

    I assert that in this hypothetical situation, there is no way, no ethical choice one can make that is going to save those 350 people.

    They chose to ignore the fact that they were exposing themselves and others to a potentially deadly disease, despite repeated warnings and the fact that they almost certainly know someone who has been directly affected by that disease.




    As a student of ethics, no matter how casual or advanced you may be, you must be familiar with the case of the swimmer in trouble in a rip.

    It's generally accepted that the ethical choice is NOT to dive in and try to help him, no matter how well-trained you may be, because the odds against success are astronomical, and the most likely outcome is TWO deaths by drowning.





    Meanwhile, back at the ranch, Little Jimmy falls out of a tree, sustains life threatening injuries and needs an ICU bed stat, or he's cashing in his chips today.

    Just before Jimmy gets to the hospital, Moron #672 kicks off the coil in the ICU, and departs this world for his wretched and well-deserved reward.

    Is it ethical to put Jimmy ahead of the 350?

    If #672 maybe didn't die that day . . .

    The thorniest ethical questions are by definition those that require pain from everyone.

    They're thornier still when one of the parties clearly caused the problem.


    When there's a huge bar fight, do we prefer that the instigators pay, or do we put the screws to the bystanders?


    Do we need to have King Solomon threaten to cut the baby in half?

  33. #68
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    Default Re: Message from Alaska's largest hospital. Triage.

    Truly, I wouldn't wish a COVID death on my worst enemy. I'd wish a vaccination on them, though.
    If I use the word "God," I sure don't mean an old man in the sky who just loves the occasional goat sacrifice. - Anne Lamott

  34. #69
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    Default Re: Message from Alaska's largest hospital. Triage.

    Quote Originally Posted by TomF View Post
    That's not what I'm saying at all. Sorry, but no.

    What I'm saying is that if there's such a massive explosion of drunk driving accidents, or drug overdoses, or etc. that quite literally there isn't any more space in the ICUs of hospitals for anyone else...

    If those hospitals have been putting off diagnostics and treatment for other people for months and months ... in order to open up more space for the wounded drunk drivers and the overdose victims ... and medical staff are not merely burning out, but in no small numbers dying from some mysterious condition they catch while treating these victims ...

    .. If those hospitals have had to pull in freezer trucks to deal with all the dead. Crematoria are literally stockpiling bodies of dead drunk drivers because they can't be burned quickly enough.

    And if for upwards of 18 months we've been suffering through this ... as the drunk drivers and drug addicts explain that they aren't dying, they aren't putting any strain on resources. They have a Constitutional Right not merely to die in such ways, but to require others to become drunk drivers and drug addicts too, while denying that those characteristics even exist ...

    ... and for the last 8 months, a miraculous thing has emerged to help over 95% of such alcoholics and addicts to never take that fatal risk again, and even if they fall off the wagon, virtually all of them will kick their addictions with a couple of weeks of mild rehab... And this thing has been promoted with an UNPRECEDENTED in lifetimes push of education and funding and free-distribution and etc to remove any possible barrier to accessing it...

    I'm saying that if those people not only refuse to access that miraculous prevention thing, but do their damnedest to delegitimize it so that others won't. And at the same time continue to come to the hospitals when they're busted up in drunken car accidents or OD episodes ...

    I'm saying that when there's GOT to be a choice made, because the fooking drunk drivers and addicts have so overwhelmed the hospitals that SOMEBODY is going to die for lack of access to treatment ...

    At that point, I think that the chemotherapy patients should be permitted to get their chemo first. And the stroke patients. And the people with ruptured appendixes. And maybe the women needing emergency C-sections, or the guys whose gall bladders have just exploded.

    I don't think that's unethical. I think it's horrifying to have to make such choices, and that it would be LESS unethical to have enough access to care that everyone - from the routine emergency patients to the drunk drivers and addicts - could get the care they needed right away. But that's not where Alaska now is. Or Idaho. Or various other places. Alberta announced overnight that it's about 10 days away from the system facing exactly those choices here in Canada - because Alberta's got a high preponderance of COVID deniers, anti-maskers, and anti-vaxxers.

    People are dying now, who aren't having COVID emergencies, because of the COVID pandemic - and it's needless death. This isn't hypothetical anymore. There are no more reserve resources to bring in.
    Gittem' Tom!

  35. #70
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    Default Re: Message from Alaska's largest hospital. Triage.

    Principle or no, decisions will have to be made, and will. Are there legal protections in place for those having to make them?

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