Much ink was spilled during the COVID-19 pandemic over the use of expected life years beyond hospital discharge as a factor in allocating critical care resources. Catholic ethicists, however, generally rejected the notion of expected life years and so did not argue among themselves about it. By contrast, they did differ strongly about the permissibility of unilaterally withdrawing life-sustaining treatment from patients with poorer prognoses and reallocating it to patients with greater expected survivability. There are two distinct Catholic schools of thought on the questions having to do with reallocation: the Georgetown school and the Saint Louis school. In this chapter, I examine the arguments that the two schools have leveled at one another and propose that those arguments have not adequately engaged a deeper disagreement, namely, in the schools’ answers to the critical question: Who does the physician work for? That is, whose agent is she, or should she be? Although my sympathies lie with the Georgetown school, I also propose that it needs to reckon with a second critical question: Under crisis standards of care, when patients present at a hospital, whose patients are they? The chapter closes by considering the significance of different answers to that question.

错误:搜索内容不能为空,请输入英文关键词
错误:关键词超出字数限制,请精简
高级检索

Triage and the Patient-Physician Relationship

  • Bernard G. Prusak

摘要

Much ink was spilled during the COVID-19 pandemic over the use of expected life years beyond hospital discharge as a factor in allocating critical care resources. Catholic ethicists, however, generally rejected the notion of expected life years and so did not argue among themselves about it. By contrast, they did differ strongly about the permissibility of unilaterally withdrawing life-sustaining treatment from patients with poorer prognoses and reallocating it to patients with greater expected survivability. There are two distinct Catholic schools of thought on the questions having to do with reallocation: the Georgetown school and the Saint Louis school. In this chapter, I examine the arguments that the two schools have leveled at one another and propose that those arguments have not adequately engaged a deeper disagreement, namely, in the schools’ answers to the critical question: Who does the physician work for? That is, whose agent is she, or should she be? Although my sympathies lie with the Georgetown school, I also propose that it needs to reckon with a second critical question: Under crisis standards of care, when patients present at a hospital, whose patients are they? The chapter closes by considering the significance of different answers to that question.