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Who has started having advanced directives conversations? Below is what Laurie Kuhn shared with me (full credit to her!)
Laurie Kuhn wrote:How do hospital doctors and staff decide who gets potentially lifesaving treatments and who does not?
Before COVID 19, we had enough beds and ventilators--so it was first come, first serve. Not difficult. No significant ethical thought required.
But now, it would be irresponsible of primary care providers to not to get ready to make tragic decisions about who gets a ventilator.
Facing this awful dilemma, I have a mental list of patients in my head I need to call. We all do. People I have not helped develop a living will because it was not an easy discussion in a short-office-visit.
These are patients we all have. People who probably would not come OFF of a ventilator if they went on one.
Patients with significantly physical debility from a stroke, end stage COPD, pulmonary fibrosis, one lung after cancer, etc.
Perhaps we can reach out by phone call and ask them if they are doing ok. Most patients are socially isolated and have already had a lot of time to think. They usually appreciate a friendly,
Then ask if they know anyone who is sick. Ask what they would want if they get sick? Let the conversation flow from there.
Then make sure they have a living will, a power of health, and code status updated.
It is dark, but perhaps we can save people from making those tough decisions.
