The Guidelines Mean Me

Earlier this month a consortium of influential physicians issued a first, a set of guidelines to be used in a pandemic or similar disaster. To put it bluntly the following groups would not be treated: the very elderly, seriously hurt trauma victims, severely burned patients and those with dementia. The idea is not to just let some people die, but to insure that scarce resources, meaning equipment like ventilators, medicines, as well as doctors and nurses, are not only used to best advantage but in a uniform, objective way.
The physicians involved in drawing up these guidelines came from top universities as well as from government agencies such as the Centers for Disease Control, the Department of Homeland Security, the Department of Health and Human Services. Their suggestions get down to the nitty gritty. For example, those who won’t get life saving care include people with a severe chronic disease such as advanced heart failure, lung disease or poorly controlled diabetes. I am in one of those group. I have several lung problems. They are under control, but in a traumatic situation without medications I suppose it could soon become acute. Add to this the reality of the circumstance, in emergency conditions, with a shortage of personnel since many people would be needing attention, the triage nurse or doctor could or could not make a mistake about my condition and judge it worse than it is, and with the few seconds he or she would have to make a decision regarding my fate, just be the catalyst for me to have X numbers of days left. It’s one thing to watch reruns of M*A*S*H and see Major Hoolahan faultlessly triage and decide what happens to each incoming wounded, it’s another to transpose that kind of activity to real life. So, while nothing is for certain, and I may be borderline, the fact is that there is great likelihood those guidelines mean me and I may well be among those who would not receive care. Regardless, I do think these guidelines are an achievement. Certainly mistakes will be made, they are inevitable in a way and occur with or without guidelines. Still the fact that they exist and that (whether or not they would directly affect me) they are sound ought to be hailed by many. Sure, it is a grim subject, one none wants to really draw attention to or discuss, but it is a necessary one. The rationing of medical care when it is based on income is one thing–and of course indirectly happens anyway by leaving out those who cannot afford certain medical insurance or procedures–but the allotment of resources where they can do the most good is this side of wisdom. If that means me, then I must accept it, not only in the name of those who might be saved, but also because given whatever shape I may be in, it may be a treatment I myself would not want, a set of consequences I would deem undesirable. I can only hope that if this is how I am to go, as a result of the guidelines for a pandemic or disaster, that by then what I am trying to do before I go, is finished. And should there be a mistake, with me or with anyone, may it be one that allows the decision makers to refine the guidelines and make them a better gauge of who is not to receive treatment.