It is barely worth mentioning what a poor job 24-hour cable news media do of delivering substantive news. In real news' place we get a cloying mixture of celebrity news, personality-driven political "coverage," and bald efforts to create, or fan the flames of, mass hysteria. Common household products are killing your kids! Immigrants are coming in sweaty, brown, job-taking, daughter-raping droves! Terrorists are lurking behind the Wal-Mart! Know the 10 signs that your middle schooler is involved in a satanic gay sex orgy cult!
Cue the CNN masterpiece "Docs list who would be allowed to die in a catastrophe" from this week. The story (and its corresponding TV segment, of which I could not find a video clip) details the manner in which hospitals are prepared to respond to a pandemic or disaster that overwhelms the healthcare system. It's laden with even-handed gems like:
To prepare, hospitals should designate a triage team with the Godlike task of deciding who will and who won't get lifesaving care, the task force wrote. Those out of luck are the people at high risk of death and a slim chance of long-term survival.
Wow, this is all very shocking. Doctors – real ones, not those cool ones on House – sitting around playing god and grimly plotting the deaths of millions. Beware, America. Soon your doctor-turned-Soup Nazi will sternly point in your direction and declare "No treatment for you."
My question is how or why, in the first week of May 2008, this is news. What this story describes is a simple triage system, and it's a basic emergency management plan that every healthcare provider on the planet has – and has had for decades. Hospitals and doctors are, and have been, trained and prepared to deal with a pandemic or major disaster that would overwhelm the ability of the system to treat every single patient according to severity. In such instances, patients are treated according to their prospects for long-term survival. If a bomb levels the Superdome during a Saints game and 100,000 people show up at the hospital at once, the patients with severe and likely mortal injuries will not be treated before people who are badly hurt but can be saved with immediate care. If vaccines or medication to treat a disease are scarce, the 23 year old mother of two gets treated before the 91 year old guy on dialysis. This is not new. This is not shocking
While the CNN story darkly hints at "lists" of who gets to live and die (Blacks? Jews? Short people? Muslims? White males?) the truth is pretty banal. The list includes people over 85, patients with severe trauma, patients over 60 with 3rd-degree burns on more than 40% of their body, and people with advanced mental impairment (late stage Alzheimer's, for example). I know that this "story" is intended to provoke moral outrage, but if a catastrophe overwhelms the system I'm OK with bumping the 70 year old with 75% burn coverage to the bottom of the list. If resources become scarce, the person who is going to require $1 million worth of care and die anyway should not be treated first. Shocking, I know.
Hurricanes, earthquakes, nuclear war, and a global disease pandemic have inspired healthcare providers to make these plans long before CNN decided to report on them. Therefore one of two things is true of the coverage. It is either entirely ignorant of the fact that this is not a new phenomenon – i.e., the work of a 25 year old reporter who skidded out of Rutgers journalism school with a C average and no understanding of how to do research – or it is interested solely in shock value. Neither would surprise me and both are equally embarassing.