Ask Dr. Land: Is it permissible to ration health care in a medical crisis?

Question: Is it ever permissible to ration health care in a medical crisis? If so, under what moral circumstances should it be allowed?

Richard Land
(Photo: The Christian Post/Katherine T. Phan)

Unfortunately, it appears, that despite the best efforts of our elected leaders and the heroic efforts of the medical community, the coronavirus pandemic may very well create a tidal wave of seriously ill patients that will simply overwhelm the capacity of some local hospital facilities to adequately meet the needs of all the critically ill patients who seek treatment.

If and when that happens, what are Christian doctors, nurses, and hospital administrators to do? What does Christian morality allow them to do? Historically, in modern Western civilization when there is such a crisis and there is insufficient life saving care available to treat all patients who are imperiled, a triage system is implemented.

A triage system assigns highest priority to those critically ill patients who most immediately require medical care if they are to have any hope of survival and recovery. The second group in triage are those patients who do not have life threatening illnesses or injuries and thus can wait for medical treatment to become available. This second group is triaged and seen as care becomes available.

The third triage group comprises those patients who are deemed to have sustained mortal injuries or their illnesses have progressed to the state where they have an almost certain probability of dying even if they were given the treatments that are given to group one. The patients in this group are the ones labeled “do not resuscitate” because of their almost certain terminal status and are merely made as comfortable as possible until they expire.

Now, as Americans, of whatever faith, we all pray that it does not come to that in any of our hospitals during the “Great Pandemic of 2020.” But if and when this sad and lamentable state of affairs does eventuate in some of our hospitals, American culture is not at all prepared to react in as Christian way as we would have earlier in our history.

The most crucial question that must be asked when confronting a triage model is “what are the criteria being used to make the decision to relegate some patients to the ‘do not treat’ category as opposed to receiving the urgent care they desperately need immediately?” Any evaluative criteria other than the individual medical condition of each patient must be rejected as prejudice and a denial of the innate dignity of each and every human being. Of course, no racial, ethnic, or gender discrimination must ever be used to disqualify someone from treatment.

Unfortunately, because of the significant inroads of the nefarious and treacherously named “quality of life” ethic in our culture, which argues that some lives aren’t as worth living as others, it would apply categories such as advanced age or mental or physical challenges in patients in any age group. Such thinking is starkly utilitarian, morally repugnant and the antithesis of the Gospel of Jesus Christ, which assigns equal and reverential value to each and every human life as made in God’s image (Gen.1:26-27).

Each of us, even in our fallen state, bares the indelible image of our divine Creator, which means each and every human being is different in kind, not merely degree, from the rest of creation and must be recognized and treated with sacred, reverential value.

If the criteria used in triage take value points away from anyone purely based on their age or their lack of some cognitive or physical skills, then it is founded on a pagan value system and must be rejected with vigor and fought in court if necessary.

Pope John Paul II warned us that “a culture of death” was loose in Western civilization and was running rampant in the academy and other places of culture influence. Where does such a repugnant “moral” ethic lead? Concerning a proposed California law legalizing assisted suicide five years ago, Los Angeles Catholic Archbishop Jose Gomez wrote the following: “Once we start down this path, once we establish in law that some lives are not as valuable as others . . . there will be no turning back. The logic of doctor assisted suicide does not stop with the terminally ill.” Unfortunately, Archbishop Gomez is absolutely right. Where such laws have been passed, the right to die all too quickly under societal pressure becomes an “obligation to die” or a “duty to die.”

Allow me to close with the following example of how serious this issue has become in our society. Dr. Ezekiel Emanuel is the “poster boy” for the so-called “quality of life” ethic’s morbid fascination with death. Dr. Emanuel, President Obama’s health care advisory, a chief architect of Obama Care and its “death panels” which rationed care, is also the most prominent member of former Vice President Joe Biden’s Health Care Advisory Team. Dr. Emanuel has stated in the Atlantic Magazine that he wants to die at age 75 (he is currently 63) and that we should all desire the same thing. He described the elderly as “feeble, ineffectual, even pathetic.” He has strongly advocated rationing health care to people simply as a function of their chronological age. The irony here is that Joe Biden is 77, so according to Dr. Emanuel former Vice President Biden should already be dead.

This is serious business — deadly serious. We must strongly oppose the devaluing of the elderly and the mentally and physically challenged in this time of the “Great Pandemic of 2020.”

Otherwise, barbarism’s death culture will ever more rapaciously devalue human life like one of the horsemen of the Apocalypse.

Dr. Richard Land, BA (magna cum laude), Princeton; D.Phil. Oxford; and Th.M., New Orleans Baptist Theological Seminary, was president of the Southern Baptists’ Ethics & Religious Liberty Commission (1988-2013) and has served since 2013 as president of Southern Evangelical Seminary in Charlotte, NC. Dr. Land has been teaching, writing, and speaking on moral and ethical issues for the last half century in addition to pastoring several churches.

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