A disturbingly divisive and unethical memo outlining patient treatment priority guidelines for a North Texas group of hospitals was quietly toned down this week after intense backlash.
The memo from the North Texas Mass Critical Care Guideline Task Force suggested that vaccine status should be a key factor in determining whether a patient should be given a bed in the Intensive Care Unit (ICU) or receive treatment with a ventilator.
A spokesperson for the group, Dr. Mark Casanova said, “We’re trying to decide how to explain this addition to the public,” according to a report by The Dallas Morning News.
But while they toiled with their problematic policy which set guidelines that are generally followed by the area hospitals, a Chicago doctor and assistant professor at the University of Chicago, William Parker unraveled it for the public on Twitter.
The leaked North Texas memo on using vaccination status in ventilator rationing is ethically incoherent and deeply problematic.
Point 3 is fine, but it’s completely undermined by points 1 and 2
A short 🧵on why together these make no sense (1/4) pic.twitter.com/NaLmXkdvDX
— William F Parker, MD, PhD (@WF_Parker) August 19, 2021
Looking at each point individually, he gave his analysis of why he called the policy “ethically incoherent” and “deeply problematic.”
1. makes the argument that COVID-19 infection + vaccination status can be used prognostically. This is potentially consistent with saving the most lives if used in a formal predictive model of survival. However, this is immediately undermined by the next point (2/4)
— William F Parker, MD, PhD (@WF_Parker) August 19, 2021
Parker argues that the memo seeks to “punish” the unvaccinated based on subjective standards.
2. says doctors are supposed to somehow, at the bedside, discount the predicted mortality to account for subjectively assessed “accommodations”.
this makes it clear that the point is to punish the unvaccinated, regardless of their probability of survival
(3/4)— William F Parker, MD, PhD (@WF_Parker) August 19, 2021
Ultimately, he likens the policy to a “pay to play” scheme that would allow the doctors to ignore the unvaccinated patients and opt instead to “perform lucrative elective surgeries and procedures.” The exact type of care Parker points out is the first to be set aside during a crisis.
Finally, this protocol could be used to justify allowing COVID patients to die to free up the capacity to perform lucrative elective surgeries and procedures.
The first step in Crisis Standards of Care is postponing these procedures until the surge is over
(4/4)— William F Parker, MD, PhD (@WF_Parker) August 19, 2021
Casanova later softened the harsh memo in an interview with local media, calling the memo a mere, “homework assignment.” He said that vaccination status should just be one of the factors taken under consideration when making a triage decision.
Similar disturbing news of unethical treatment of unvaccinated people has come out of Alabama this week where a doctor sent out a shocking letter to his patients explaining that he would no longer see unvaccinated patients effective October 1.
“I cannot and will not force anyone to take the vaccine but I also cannot continue to watch my patients suffer and die from an eminently preventable disease,” the letter read, according to a report by Fox News. “Therefore, as of October 1st, 2021, I will no longer see patients who have not been vaccinated against Covid-19.”
Many take issue with the position of these types of shocking statements that claim unvaccinated people should be treated essentially as second-class citizens.
Bioethicists and theologian Charlie Camosy commented on “Fox News at Night,” saying, “This sounds like something close to a civil rights violation.” While agreeing with the overarching sentiment that people should get vaccinated, he recognizes that even if they don’t they are guaranteed equal protection under the law.
(Video Credit: Fox News)
“Speaking as a medical ethicist, it is one thing to base something like transplants on who is most likely to survive, but this doctor is doing social engineering,” Camosy explained to host Shannon Bream. “He is basically saying I want this outcome in society, one I happen to agree with, and then refusing to treat patients under his care as a result of that. That violates every canon of medical ethics.”
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