Washington state and hospital officials have been meeting to consider what once was almost unthinkable — how to decide who lives and dies if, as feared, the coronavirus pandemic overwhelms the state’s health care system.
“We don’t want to do it. We don’t think we should have to do it,” said Cassie Sauer, chief executive of the Washington State Hospital Association, which along with state and local health officials has been involved in refining what Sauer called a “crisis standard of care” — essentially guidelines to health care officials on who should receive treatment and who should be left to die.
“If we have to do this, then we want to do it in a fair and rational and thoughtful way,” Sauer said.
Dr. Vicki Sakata, the senior medical adviser to the Northwest Health Care Response Network, said a group of medical officials and other experts have been discussing how the state would deal with a crisis that overwhelmed the medical system. She prefers to add the word “planning” to the idea of “crisis standard of care” because, in her mind, the goal is to avoid a crisis in the first place.
That said, the state is prepared to act if it has to and has developed guidelines that will be implemented across the system, from the bedside doctor to hospital systems.
“We will do it as a state under an ethical framework that is part of the state plan,” she said. “It will be overseen by an objective team who has been thoroughly briefed on the protocols and processes, and will be undertaken in a transparent and equitable manner.
"But, make no mistake, it will not be pretty,” said Sakata, who is a practicing emergency medicine physician. “That’s why we are taking the steps we are taking now, the social distancing, the hand washing, all of that, so sometime down the road nobody is left having to decide who gets resources, and who doesn’t.”
Sakata said her network, which comprises 15 Western Washington counties, has been working on crisis standard-of-care planning since 2012, and wanted to assure the public all efforts and resources are being aimed at managing the COVID-19 outbreak so the health care system doesn’t collapse under the strain of too many patients at once. (cont)