“Death Panels” aren’t a joke any more

Sarah Palin was pilloried by the mainstream media for her claim that Obamacare would involve what she called “Death Panels” to decide whether or not one would receive appropriate care.  However, the coronavirus pandemic has illustrated very clearly that such panels do exist, and that the decisions they take – the priorities they assign to treatment and those who will receive it – are, quite literally, life or death choices.

In Spain, a doctor was forthright about it.

SPAIN’s coronavirus death toll has resulted in hospitals refusing to admit elderly and frail patients into intensive care unit beds in a bid to ration them for patients more likely to survive the virus.

Medical Director at Spain’s Clinical Hospital San Carlos, Professor Julio Mayol explained the country was having to prioritise different patients in the battle against coronavirus.

“Of course, we have to make decisions.

“Those that are frail, we have many communities that are not good candidates to make it through the ICU stay.

“We have to decide not to put them on ventilators, this is tough because we get a lot of pressure.

“But people understand that these are critical moments and we have to make clinical decisions like this.

“We have ethic committees providing us with counsel to ensure we make the right decision with people.”

There’s more at the link.

Italy is doing the same thing.

Dr. Gai Peleg told Israeli television that in northern Italy, patients over 60 tend to receive less treatment with anesthesia and artificial respiratory machines.

. . .

As his department receives coronavirus patients who are terminally ill, the focus is to allow patients to meet loved ones and communicate with them during their last moments despite the quarantine regulations … Peleg said that, from what he hears, patients over 60 tend to receive less treatment with anesthesia and artificial respiratory machines.

Again, more at the link.

Another part of the problem is that COVID-19 cases are so overwhelming the system that those with other ailments, even life-threatening ones, simply can’t be given the medical care they need.  Examples (click the images to be taken to the original post on Twitter):

Paramedics in New York City have been told not to bring cardiac arrest patients to emergency rooms for revival.

If an adult patient has obvious signs of death like rigor or has a do not resuscitate order, EMTs will not try to revive the patient.

In all other cases, EMS is told to limit the number of EMTs working on the person to only those necessary (to limit possible COVID-19 exposure); they must wear the proper N-95 mask, eyeshield, gloves, mask and gown. If, after 20 minutes of CPR, the defibrillator or the heart monitor shows a “no shock indicated” or a non-shockable rhythm and there is no blood circulation, CPR is to be terminated. At that point, the NYPD or medical examiner can be called to remove the body; the patient is not to be brought to the hospital.

More at the link.

At the Bookworm Room blog, the author comments:

In America, the profit motive encourages better doctors and nurses, better equipment, more beds, etc. It’s when the government steps in and limits the number of beds or other things that we start having problems.

And as noted, in socialized medicine countries, the government rations everything. There’s no profit to be had from medicine; there are only expenses and the expenses can be paid for only by taxing people. That leads to constant rationing and constant triaging.

That’s why, in England, the country with which I’m most familiar, you ended up with the deadly Liverpool Care Pathway which led to thousands of treatable elderly patients being left to die. That’s also how England openly or through subterfuge denies life-saving treatment (e.g., cancer treatment) or quality of life treatment (e.g., new hips or knees) to elderly patients. With rationing and triage, these people just fall by the wayside. I’ve told people here before about my father, in America, who got a new hip two weeks after he was told it was the only way to keep him mobile. I compared him to my friend’s nice middle-class mother, in Britain, who was told she needed a new hip and died ten years later without ever getting that hip, and having spent the last ten years of her life with extreme pain and limited mobility.

Given the stark realities of socialized medicine, and how those failings are being highlighted with COVID-19’s race through Europe, it’s disturbing to see [renewed and stronger] calls for socialized medicine.

I understand completely the desire to provide health care to anyone who needs it, and as much as they need.  However, once government is paying for it, a utility calculus comes into play.  “How much can this person still contribute to society (particularly in the form of taxes), and is it worth spending more than that on his/her treatment?”  That’s the cold, hard reality of it, even if it isn’t couched in those brutally frank terms.  Money talks, among bureaucrats and administrators as much as (if not more than) anywhere else.

Of course, there’s also the approach recommended by one German doctor.

While appearing on “The Morning Show,” Dr. Rissland was asked about whether or not drinking alcohol could kill any viruses a person may have ingested. “Yes, of course, that’s true,” Dr. Rissland responded. “And the higher the percentage of alcohol, the better it is. For example, if you are a whisky lover, then that certainly isn’t a bad idea,” he continued, while offering this bit of sage advice to pace yourself: “But of course you need to bear in mind that you can’t do that every 15 minutes, that is something else to consider.”

After being prodded a little further by the show’s cohosts who asked him if he was really suggesting folks drink high-proof alcohol, Dr. Rissland didn’t back down or attempt to clarify his remarks. Instead, he added, “”I would say it can’t do any harm although we need to remember that it’s not a guaranteed cure for the problem.”

So, even if we won’t be allowed access to treatment, we can still die in high spirits.  Cheers!



  1. my my, how rich Homo Sapiens has become, we can now afford old people, artists, scholars and others that consume more, much more than they contribute to survival (note, me, 71 years, preexisting conditions), now if times get real tough, all these drones will quickly disappear.
    My heart goes out to families who have or will lose a close older loved one. My family is one of them. IT WILL HAPPEN. Life will go on. Damn Darwin.

  2. To be fair, Peter, out of hospital CPR success rates are in the low single digits. If 20 minutes of CPR and multiple defibrillation attempts (along with ACLS medications like epinephrine, lidocaine, amiodarone etc) have not resulted in return of spontaneous circulation, the patient is dead. Not a “death panel”, which I abhor and Sarah Palin was correct, just cold, hard fact.

  3. Bells Palsy appeared the same time the isolation was being demanded. My first consultation was with a nurse practitioner. After a week, I consulted again with my doctor, who prescribed a different medication. Both consultations were by telephone, since the office is closed, and the professionals are avoiding exposure to Wuhan Flu.

    I have friends in the medical field furloughed from an empty hospital. They have nothing for them to do, yet there are probably thousands needing the service of the hospital.

    Death panels appeared, and people should be horrified. Even seemingly minor ailments may require more aggressive treatments, but those with the ailments are being told they are expendable, regardless of what may be be necessary. Who is responsible if their neglect ends in permanent problems, or death?

  4. So much misinformation. I am a retired paramedic. The rule for NYC is the same rule many have had for years. NYC is decades behind the times.

    It used to be (back in the '90's, that paramedics were not permitted to call people dead, instead being forced to bring everyone in to the hospital. It resulted in some ridiculous situations, like the time we had to transport a person whose head was no longer attached to his body. The ED doctors HATED the rule.

    With that being said, there are some facts that support this: There is nothing that a doctor can do for a cardiac arrest patient that a paramedic cannot. Doctors and paramedics take the same certification course, called Advanced Cardiac Life Support (ACLS). I was an instructor for that course for more than a decade.

    Even with that, there was a study done about 15 years ago that looked at cardiac arrest. If a person suffers a cardiac arrest that presents as asystole as a result of trauma, the odds of someone being killed in a car accident caused by the ambulance they are riding in are higher than the odds of them being successfully resuscitated.

    As a result, most systems in the US now allow paramedics to call an end to efforts and not transport to the hospital.

    That isn't death panels, that is just good medicine.

  5. My, my, my…

    Have you ever noticed that the vaunted 'noble societies' that the Left so cherish, such as the Native Americans (north-north, north, central and south, all of them) and the noble tribes of Africa, all have a quaint custom, that the Left loves, that the old will (supposedly) excuse themselves from society when they are no longer useful.

    In theory. Nobly go into the woods or on top of a rock and let death come, nobly…

    In practice? Well, the family would decide to toss granny or grandfather out and not feed them and slowly starve them to death, sometimes stoning them and chasing them out of the community, or just killing them. Eh, yer useless, time to die.

    And now… in First World nations, we are doing the same thing. Casting our old out and refusing them treatment that can and will save many.

    Over what? Over a virus that so far is trending to be, in a First World nation, no more worse than a seasonal flu. Not as worse as a really bad seasonal flu, just a seasonal flu.

    We've destroyed our economy. We've emptied out hospitals and are denying treatments to people who could recover given treatment. I'm not talking about ventilators, I'm talking about IV fluids and antibiotics to combat the secondary infections and pneumonia that may cause someone to eventually need a vent.

    My, my, my…

    Meanwhile, in NYC, the Javits Center non-flu related hospital has seen… very few patients. The hospital ship has seen… very few patients. And medical personnel are standing around with their thumbs up their butts waiting for the non-existent hordes of people who might qualify for the parameters to be admitted to the scantily few resources because NYC and NY decided to save illegals and immorals over regular normal people. And this is after they (NYC and NYState) have been told repeatedly by their own experts that they needed to prepare for a bad, very bad… seasonal flu season, like the ones that happen about every 10 years or so.

    My, my, my…

    Aren't we such a progressive society? (Use all the negative connotations related to Leftist interpretations of progressive.)

    What's next? A Great Leap Forward? A Cultural Revolution?

    Oh, wait, just like most deadly influenzas and other plagues, those two things also came from… CHINA.

    My, my, my….

  6. The American health industry rations care too, the question asked is have you been paying 25% of your wages for medical insurance?

  7. Beans, you have no idea what you are talking about. You need to get your head out of your ass. My, my, my, indeed.

  8. I have to endorse what DiveMedic said. The link goes to NBCNewYork. The headline states that cardiac arrest patients are not to be brought to the ER and that this is something that would have been inconceivable only a few days ago. Hype and BS! Reading the article reveals that the policy is about patients that are obviously dead or clearly hopeless. DiveMedic is right; this is a protocol change that is probably way overdue. I am not an expert; but, when I took an EMS class years ago, the paramedics who taught it had some words to say about the requirement in this region that rescue efforts had to continue until an MD had said otherwise.(They didn't mention missing heads, though) The New York story in another self-inflicted wound to the credibility of their reporters and editors.

  9. Divemedic. What am I not understanding about? If you are referring to denial of critical service to the old? Well, that's happening in Europe right now.

    As to changes in cardiac treatment? That's good, if indeed it's a cardiac incident. I've always wondered why there aren't more 'triage' staged ERs, instead of all patients come into the same ER.

    As to being able to pronounce without ER or DR present, that's been a serious issue for a long time. And it's not due to medical needs. It's due to people suing and winning against med services and hospitals because their now-black skinned loved one wasn't seen by a DR and therefore not dead-dead. Or other people who have obviously slipped over the edge of no return, but yet their loved ones want them to get all the treatment possible. So, because the ER or a DR didn't magically resurrect their been-dead relative, they must sue. And win. Over and over again. That carp must stop. Frivolous big-money lawsuits need to stop across the board.

    If you think my response to Corona-Wuhan-19 is cavalier, well, I just came from the store and pharmacy. Where a bunch of just off-shift medical people (DRs, Nurses, Techs) were all wandering around in their unclean scrubs with their dirty shoes and mostly not wearing masks. The one who was wearing a mask was apparently LARPing Sheila Jackson Lee as his nose was fully exposed. I asked one of the sterling med professionals why they didn't change clothes and where's their cloth coverings for their faces, and the response was, basically, "Meh, I'm not worried." Said gentlemen then threw his reusable shopping bags down on the counter… WTF, Over?

  10. The notion that a universal health care system results in so-called "death panels" is simply incorrect. It's also disingenuous to say that the number of deaths in Spain and Italy are due to a failure of their public health systems. The main cause is that these countries failed to take the necessary steps to contain and minimise the spread of the virus within the community thus dramatically increasing the number of patients needing to present to hospitals. This has resulted in health systems being overwhelmed by unprecedented levels of demand. Given this scenario, no system would be able to cope and not everyone would receive the level of care usually accorded.
    In Australia we've taken much stricter measures to minimise the spread of the virus in the community, as a result our infection rate is 1/6 the rate of the USA's per head of population.
    Australia's Medicare is a similar health system to the Europeans (namely universal health care with the option of additional private cover if desired). Medicare provides world class universal health care to all citizens. For instance, the current Covid-19 death rate in the USA is 3.7% of infections, in Australia it's 0.87%. There is also plenty of spare reserve ICU capacity should there be an unexpected spike in infections.
    There are no death panels, my wife was the General Manager of a major public hospital, so I'm well versed in this area. I also have personal experience showing that even as a public system, there is much compassion and assistance.
    As I said earlier it's disingenuous to try to link the current pandemic to a perceived "failure" in universal health care. It's actually a failure in public policies in other areas. Australia's (and for that matter New Zealand's) results prove it for the lie it is.

  11. There is nothing new about triage. It will be with us as long, longer, as long there are more needs than resources.

  12. American for-profit insurance companies deny a lot of medication and treatment. Same "death panel", different name.

  13. Still waiting for accurate numbers about this "terrible virus".
    Nothing adds up. Less than .04% of TESTED cases have resulted in death, which is worse than a regular flu, but what's the real number if you include UNTESTED people? Just curious is all. The CDC estimates for regular flu seasons are all over the map.

    Where are all the "5 minute" tests?
    If we tested people, we could put negative tested people back to work. And target treatment for positive tested people before they become bad enough to admit to the hospital.

    Where's approval for use of EXISTING medications (hydroxychloroquine and others)?
    If again, this is the mother of all virus', wouldn't it make sense to try anything? Just have people sign a waiver, if you're afraid of getting sued. Every visit to a dentist now requires a sign off for Pete's sake!

    Why hasn't Trump fired the heads of CDC and FDA yet?
    Proven incompetence on a grand scale. Criminally negligent at best. Come to think of it, who exactly has he fired throughout this entire debacle?

    There are many questions to be answered, and it needs to happen soon, or people will simply disobey any new regulations or orders (none of which will stand up in court without a declared "State of War"), en masse. I for one have decided to wait until the end of the month, out of respect for other people, but after that, I'm going back to normal if nothing has changed. And I would advise the rest of you to do the same.

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