The COVID-19 catastrophe is about to require Americans to make tough decisions for how to allocate scarce resources that can determine life and death.
This is especially true with ventilators and beds in intensive care units. Many hospitalized patients in ICUs are dying of cancer or advanced irreversible dementia, or are on ventilators because of irreversible heart, lung or liver failure. In a large proportion of these kinds of cases, the physicians caring for the patient recognize that death is imminent, but treatment continues, often because families are unwilling to recognize the inevitable.
Americans value their autonomy in such situations, so persuading families to forgo further medical treatment is challenging and often elicits considerable anger. Doctors understandably tend to avoid these difficult conversations if