Let’s state this coronavirus question bluntly: Is the emerging “let Granny die” puzzle a political story, an economics story or a religion story? Based on the coverage I am seeing, it appears that the safe route is to call this a “medical ethics” story.
Something tells me — based on his fierce writings about materialism, greed and modernity — that Pope Francis would insist that centuries of traditions in multiple faiths are relevant during debates about this equation.
But I understand that news organizations only have so much space and time. However, I believe this is a case where some editors are editing religious questions and voices out of stories that — for millions of people in America and around the world — are “haunted” by religion. This is, of course, what GetReligion is all about.
So here are the bare bones of the story, as covered in faith-free USA Today story with this headline: “ ‘Who lives and who dies’: In worst-case coronavirus scenario, ethics guide choices on who gets care.” The overture states:
In a worst-case scenario of ventilator shortages, physicians may have to decide “who lives and who dies,” said Dr. Ezekiel Emanuel, an oncologist and chairman of the University of Pennsylvania’s department of medical ethics and health policy.
“It’s horrible,” Emanuel said. “It’s the worst thing you can have to do.”
Respiratory therapists, who take care of patients who struggle to breathe, are aware of the pressures that comes from a swift, sudden need for ventilators
This story contains tons of valid information. However, it’s clear that the team that produced it didn’t include anyone with a background in religion reporting or debates about “whole life” doctrines in moral theology.
The only mention of faith may have been an accident — through an interview with a prominent scientist who also happens to be an articulate Christian. His faith, however, is not mentioned in this passage and there was no follow-up after his soundbite of Godtalk.
A USA TODAY analysis of cases found that two weeks after cases began to spread in U.S. communities, America’s trajectory is similar to Italy’s over the same period. …
“There’s going to be a very rough road in the weeks and months ahead of us,” Francis Collins, director of the National Institutes of Health told USA TODAY. Italy is “trying to manage the situation and make awful decisions about who gets a ventilator and who doesn’t. God help us if this happens more broadly across the world and we certainly hope that it doesn’t happen here.”
I could mention quite a few stories that fit this faith-free model. It appears that this story fits into the “cover real things” model, for some editors, and religious concerns are not real things — like politics, economics, etc. The question is whether that is an accurate statement, if the goal is to cover real decisions in the real lives of real people in the real United States of America.
So let’s look at what may be a different model. I say “may” because I no longer work in Washington, D.C., with The Washington Post waiting for me on business days at the door of my old Capitol Hill office.
Want I want to know is if the following two stories were played together — in the dead-tree pulp edition — or linked by some kind of page reference at the top or bottom of the story. Put these two stories together — link them somehow for readers — and you have something that is complete, in terms of basic journalism.
First, there is the long, detailed “secular” story, with this epic double-decker headline:
Hospitals consider universal do-not-resuscitate orders for coronavirus patients
Worry that ‘all hands’ responses may expose doctors and nurses to infection prompts debate about prioritizing the survival of the many over the one
Ah, the “many over the one.” Does it matter the age of the “one,” as opposed to the “many”? Here is the overture:
Hospitals on the front lines of the pandemic are engaged in a heated private debate over a calculation few have encountered in their lifetimes — how to weigh the “save at all costs” approach to resuscitating a dying patient against the real danger of exposing doctors and nurses to the contagion of coronavirus.
The conversations are driven by the realization that the risk to staff amid dwindling stores of protective equipment — such as masks, gowns and gloves — may be too great to justify the conventional response when a patient “codes,” and their heart or breathing stops.
Northwestern Memorial Hospital in Chicago has been discussing a do-not-resuscitate policy for infected patients, regardless of the wishes of the patient or their family members — a wrenching decision to prioritize the lives of the many over the one.
Here is the section of the story where I thought it would have helped to have mentioned the roots of some of the ethical codes — and laws — that are in play in this drama.
Health-care providers are bound by oath — and in some states, by law — to do everything they can within the bounds of modern technology to save a patient’s life, absent an order, such as a DNR, to do otherwise. But as cases mount amid a national shortage of personal protective equipment, or PPE, hospitals are beginning to implement emergency measures that will either minimize, modify or completely stop the use of certain procedures on patients with covid-19.
No religion ghosts to see here. Move along.
Later, the Post “health” team plays the “medical ethics’“ card,” with the age factor rearing its head:
Bioethicist Scott Halpern at the University of Pennsylvania is the author of one widely circulated model guideline being considered by many hospitals. In an interview, he said a blanket stop to resuscitations for infected patients is too “draconian” and may end up sacrificing a young person who is otherwise in good health. However, health-care workers and limited protective equipment cannot be ignored.
“If we risk their well-being in service of one patient, we detract from the care of future patients, which is unfair,” he said.
Halpern’s document calls for two physicians, the one directly taking care of a patient and one who is not, to sign off on do-not-resuscitate orders. They must document the reason for the decision, and the family must be informed but does not have to agree.
Raise your hand if you would like to know more about the background of Halpern. It does help to know he is the “founding director of the Fostering Improvement in End-of-Life Decision Science (FIELDS) program” at his medical school. The title of this New England Journal of Medicine article caught my eye: “Toward Evidence-Based End-of-Life Care.”
However, like I said, this “secular” article on decisions about life and death is only part of the Post equation. There is another story to consider, by religion-desk pro Sarah Pulliam Bailey (a former member of the GetReligion team). The headline on this “religion” report: “Should older Americans die to save the economy? Ethicists call it a false choice.”
The word “ethics” is in the headline, but the story is a blend of voices linked to religion and medical ethics. Here is a long passage that shows you what this approach sounds like, starting with President Donald Trump’s hopes to jump-start the American economy:
When asked why he picked Easter as the day he wants to end strict social distancing and reopen American businesses, Trump said, “Easter is a very special day for me … and you’ll have packed churches all over our country.”
As Trump was making his announcement, the Southern Baptist Convention, the largest Protestant denomination in the country, announced it would cancel its annual meeting in June, the first time it has canceled it since World War II.
“The economy is, of course, important in terms of human life and flourishing, but human life is paramount,” Russell Moore, president of the SBC’s Ethics and Religious Liberty Commission, said Tuesday.
He said he’s concerned that some people seem to be talking about human lives as expendable, while others are talking about rationing health-care resources. Such ideas go against basic Christian tenets, and Americans must uphold the dignity of every human life, Moore said.
“We cannot define people in terms of their age or their perceived usefulness,” Moore said.
Cathleen Kaveny, a professor of law and theology at Boston College, said people are talking about the economy and the coronavirus-directed shutdown in ways that don’t make sense.
“We’re talking about a planned moment of rest. We’re not talking about an uncontrolled crash,” she said. “The economy is important because it allows people to flourish. It isn’t a demigod we sacrifice human beings to.”
Faith, she said, can offer people a bigger framework for how to think about the crisis. “Faith gives you hope that this can be worked out with time, patience and ingenuity,” she said. It also offers “a sense of finitude of knowledge of science, the sense that we’re fragile.”
The bottom line: Is there a religion-free way to debate the rationing of health-care resources?
If you know anything about the history of that complex, loaded debate in American public life you know that the answer is “no.”
Journalists can cover that story now, or later. It will not go away.
So cheers — maybe — to the Post for this multiple-story approach, if that is what we are dealing with in this case. Note that the “religion” story contained a blend of secular and religious voices. The “health” story was all secular voices, from start to finish. Which story best represents this debate?
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