As a disabled person, I would like to share some thoughts with you on the subject of being a “vulnerable” person in the face of the COVID-19 pandemic.
Repeatedly we hear in the news, “Let’s protect our most vulnerable populations (elderly/disabled) by staying home!” Paradoxically, it is the most vulnerable people at overcrowded hospitals who are being denied ventilators that could help save their lives. Instead, some are handed a pen by a crying healthcare worker, and asked to sign do-not-resuscitate orders. Then the vulnerable are left to die – alone.
According to a March 25th ABC News article entitled, “As coronavirus pandemic surges, hospitals prepare for grim possibility of ‘ventilator triage,’” health care workers around the world, including in the United States, are being directed to implement wartime triage procedures to determine who is more/least likely to survive the coronavirus; to decide who will get treatment for the sake of “rationing care and supplies.”
The triage wartime strategy makes sense during a wartime crisis because physicality is needed to fight wars—that’s why future soldiers are health screened before they can become soldiers. But is the triage method fair to the disabled/elderly during non-war times? The deciding factor to save a life or let it go is based on current physical health and age.
According to a March 25th Washington Post article written by Ariana Eunjung Cha, decision makers at Northwestern Memorial Hospital in Chicago have been discussing a do-not-resuscitate (DNR) policy for infected patients, regardless of the wishes of the patient or their family members. Other hospitals, including Geisinger in Pennsylvania, regional Kaiser Permanente networks, and Atrium Health in the Carolinas, are looking at guidelines that would allow doctors to override the wishes of coronavirus patients and their families. These guidelines are being discussed to prepare for worst case scenarios of hospital overcrowding.
An eight point system developed by Dr. Scott Halpern, professor of medical ethics and health policy at the University of Pennsylvania and Dr. Douglas White, chairman of ethics in critical care medicine at the University of Pittsburg, may be adopted by hospitals throughout the nation, if needed for extreme cases. Basically, the sicker you are, the higher your number; the higher your number, the less prioritized you are to get lifesaving care. Halpern is quoted, “What is clearly needed is an independent arbiter apart from the bedside clinician to assign priority to different patients. Otherwise, you have different physicians advocating for their own patients…”. Further, patients are categorized by age: 12-40; 41-60; 61-75; 75+. People who tie in the number system for treatment will be settled by age.
Philosophical and ethical theories abound regarding right and wrong actions during this and previous similar crises. One cluster of theories, called Utilitarian theories, adhere to the philosophy of the usefulness (utility) of a person. It aims for the betterment of society as a whole. Utilitarianism is a phrase coined by philosopher/judge Jeremy Bentham, who argued that his principle of utility would create the “greatest happiness for the greatest number of people.” (Wikipedia)
This go-to utilitarian approach seems to take the stance that if the elderly/disabled were hospitalized due to the coronavirus, we might not be given a ventilator. Or, if we are, it could be taken from us and given to a younger healthier individual that is more likely to survive us. It is assumed the younger life would have a longer and better quality of life—a more “useful” life.
What makes utility, or usefulness, the top priority for healthcare officials determining who’s life to fight for? Is this approach not biased, discriminatory, and subjective? And might not the elderly and the disabled be equally as “useful” to society as a healthier person? Obvious criticisms of the utilitarian approach involve the inability to define “usefulness”.
Young, healthy people are equally deserving of life-preserving treatment as the vulnerable. I’m merely speaking to the fact that we can’t just do away with the elderly and the disabled. All of us deserve a fair opportunity for life-saving treatment during this pandemic, but there aren’t enough resources to go around.
So should hospitals implement a lottery system, or perhaps give ventilators and beds to those who arrived first, even if they have other serious health issues? There is no right or fair earthly answer. My heart goes out to ethics committee members, public health policymakers, and physicians who are having to make these heartbreaking decisions. How would I decide who to let die if I were in their shoes? The lament they must feel is unspeakable.
Equality and Value of Human Life
As a Christian, I recognize that human value—no matter our age or health condition—is not determined by bioethicists, health care workers, political or social leaders, or society in general. Our value comes from God alone. (Psalm 139:13) “For you created my inmost being; you knit me together in my mother’s womb.” God gave us life, and it is not right for another man to determine when our life expires. That is up to the Creator of man. God crafted each life equally—no matter which generation or circumstance of life we were born into. All are made in the image of God (Genesis 1:27), and therefore equal.
I have been disabled twice in my life. The first time, twenty years ago, for about five years. The second time, now. I have been unable to walk for almost two years. In between disability stints, I was a nutritionist. I think most would think I was more valuable to society when I was a nutritionist. But how can one determine that? Society needs our elderly and the disabled. How else are we to learn of wise things the elderly have lived a lifetime to gain or learn from the endurance and inspiration that disabled people like Stephen Hawking or Joni Eareckson Tada display? The elderly/disabled are not expendable—they are invaluable.
The answer to this conundrum is not found in our physical world or the methodologies being decided in who will receive treatment in overcrowded hospitals. The answer lies in the unseen spiritual realm. All of this will be okay in the end if we are followers of Jesus. If our respirator is given for another life, we will be okay. We will be at peace, and we will not be alone. We will be at peace because if we die, we will live again in a better place where this is no need for a respirator. And there will be no pain, no sorrow, no grief, no mourning, no crying, and no deadly viruses. We will be okay because Jesus makes death from this world okay. Better than okay!
Prepare Our Souls
So, doesn’t it make sense for all of us to prepare our souls for the end of our lives? Not just because of the urgency due to the coronavirus, but because we are subject to dying any and every day, no matter our age or health!
Where do we stand in our relationship with God? Jesus could come back at any time. No one knows when. Either way, if he comes back before we decide to follow him, or if we die before we choose to follow him, the end result is worse than the effects of the coronavirus, if we don’t yet know him.
The Parable of the Ten Virgins in the Bible foreshadows the return of Jesus to this earth and how some of us will be ready to go with him, and others who didn’t prepare will run out of time. The bridegroom is Jesus. The virgins represent all of us:
“At that time the kingdom of heaven will be like ten virgins who took their lamps and went out to meet the bridegroom. Five of them were foolish and five were wise. The foolish ones took their lamps but did not take any oil with them. The wise, however, took oil in jars along with their lamps. The bridegroom was a long time in coming, and they all became drowsy and fell asleep.
At midnight the cry rang out: ‘Here’s the bridegroom! Come out to meet him!’ Then all the virgins woke up and trimmed their lamps. The foolish ones said to the wise, ‘Give us some of your oil; our lamps are going out.’
‘No,’ they replied, ‘there may not be enough for both us and you. Instead, go to those who sell oil and buy some for yourselves.’
But while they were on their way to buy the oil, the bridegroom arrived [second coming of Jesus]. The virgins [people] who were ready went in with him to the wedding banquet [heaven]. And the door was shut.
Later the others also came, ‘Sir! Sir!’ they said. ‘Open the door for us!’ But he replied, ‘I tell you the truth, I don’t know you,‘ Therefore keep watch, because you do not know the day or the hour [of the second coming of Christ].”Matthew 25:1-13
I would like to suggest if you don’t yet know the Jesus of the Bible, that you read the book of Matthew. Listen to Jesus and what he has to say. His words are written in red ink. Is this person someone you could follow? His message is a message of love and humility. If you can adopt these teachings into your own life, read more of the Bible and follow his words. Repent of things you know are wrong—you won’t do it perfectly but do your best. Talk to him and ask him to help you follow him. Then be baptized (immersed under water, like in a hot tub, bathtub, river, ocean, or lake), like Jesus was. You will receive forgiveness of your sins and the gift of his Holy Spirit to help guide you. (Acts 2:38) If you read the book of Acts, you will hear stories, and learn of others who made the same decision to follow God.
“If we live, we live to the LORD; and if we die, we die to the LORD. So, whether we live or die, we belong to the LORD. For this very reason, Christ died and returned to life so that he might be the LORD of both the dead and the living. You, then, why do you judge your brother? Or why do you look down on your brother? For we will all stand before God’s judgment seat.Romans 14:8-10
Jesus died for us because he loves us. He wants us to spend eternity with him. He wants to call us sons and daughters and give us a heavenly inheritance. We all are valuable and loved – none of us are expendable.
With love, Darci