In Los Angeles, emergency workers are deciding who gets taken to the hospital and who doesn’t as nearly 8,000 COVID-19 patients overcrowd its healthcare facilities.
Ambulance crews there have been instructed to not take patients with little chance of survival and to reserve oxygen use for hospitalized coronavirus patients, a directive that West Virginia University College of Law Professor Valarie Blake says raises legal and ethical questions.
“L.A. County officials have ordered EMTs not to transport some COVID-19 patients to hospitals or to administer oxygen in certain cases, as a way to preserve scarce resources in a city overtaken by the pandemic. This raises questions about EMTs’ and other providers’ legal and ethical commitments to patients. Medicare-participating hospitals and their transports are generally under legal obligations to stabilize patients in need of emergency care under a statute called EMTALA.”
“The situation is more complex where care is deemed futile, as L.A. County officials suggest it is in the cases of rationing they now mandate. The situation raises a number of concerns: Will patients, COVID or non-COVID, inappropriately screen themselves out from medical care? Can these rationing protocols be administered in a truly unbiased manner? How can providers balance their ethical and legal commitments to patients in the midst of an ongoing and worsening crisis? While these rationing procedures are worrisome and come with tradeoffs, they may well be the least worst option and, if things don’t improve in L.A., we may see even more serious restrictions in place in the coming weeks.” – Valarie Blake, Professor, WVU College of Law
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