Even as COVID-19 hos­pi­tal­iza­tions and deaths are falling, the elderly may receive rationed medical treatment. | Pxfuel

As the coro­n­avirus curve begins to flatten across the country, state gov­ern­ments target the most vul­nerable. 

At the beginning of the COVID-19 crisis, the federal gov­ernment told Amer­icans to stay at home to “flatten the curve,” or decrease the amount of potential infec­tions so as to prevent patients from over­whelming hos­pitals.

This was all to stop the United States from suf­fering the same fate as Italy, whose shortage of medical sup­plies and hos­pital beds caused many Italians to die without receiving care, and doctors were forced to pri­or­itize the young over the old. 

But even as the rate of U.S. hos­pi­tal­iza­tions and deaths have started to decline, the medical estab­lishment and gov­erning author­ities have sin­ister plans to ration the treatment given to the elderly.  

My home state of Cal­i­fornia last week pub­lished its own guide­lines in the event hos­pitals are overrun. In a 38-page doc­ument by the Cal­i­fornia Public Department of Health, the state out­lined that hos­pitals should pri­or­itize younger patients over the old, “because they [the young] have had the least oppor­tunity to live through life’s stages.”  The directive stated that intensive care beds and ven­ti­lators should be pre­served for those with the highest life expectancy and rate of sur­vival. 

For serious cases, hos­pitals will give patients a score to determine who should receive intensive care. Those with the lowest scores — usually patients deemed most likely to survive treatment and who do not have chronic illness — receive pri­ority. Those with a lower life expectancy get higher scores.  

As the Los Angeles Times reported, “Total scores would range from one to eight, with pri­ority for ven­ti­lators given to those with lower scores. If there are not enough resources to treat all patients with the same score, the guide­lines suggest hos­pitals group patients by age — ages 12 – 40, 41 – 60, 61 – 75 and older than 75 — and treat younger people first.” 

With its new coro­n­avirus guide­lines, Cal­i­fornia is encour­aging hos­pitals to pri­or­itize the young over the old. Youth is now the golden ticket for treatment. The state calls this new con­fig­u­ration their “life-cycle prin­ciple.”

As the doc­ument states, “The ethical jus­ti­fi­cation for incor­po­rating the life-cycle prin­ciple is that it is a valuable goal to give indi­viduals equal oppor­tunity to pass through the stages of life — childhood, young adulthood, middle age, and old age…”

Cal­i­fornia is setting a dan­gerous precedent in ethics. Now a human being’s value is explicitly tied to age in this new social hier­archy, with the old paying the ultimate price.  

These guide­lines are sobering when con­sid­ering older Amer­icans are at a much higher risk of dying from COVID-19 than any other age demo­graphic. According to the CDC, 8 out of 10 deaths reported have been in adults 65 years or older. Hos­pi­tal­iza­tions for those aged 65 – 84 is as high as 59%. And for those over 85, hos­pi­tal­ization is up to 70% with the death rate as high as 27%. 

It is clear that the nation’s most vul­nerable need pro­tection and care, and Cal­i­fornia is telling hos­pitals to deny them treatment. 

As well as tar­geting the elderly, new hos­pital guide­lines could turn to a patient’s social utility in deter­mining whether they should be given treatment. This is entirely con­tra­dictory to assur­ances by the CPDH that their “life-cycle prin­ciple” is not based on social utility. 

Pul­monary and critical care physician Dr. Emily Rubin told NPR that “Some people think that people who are in a position to help address a crisis in the future if they were to recover, like health care workers and first responders, maybe should receive some sort of pri­ority in triaging scarce resources.” The idea is that hos­pitals should favor those who could go on to save lives as a result of their treatment. In essence, a hos­pital inter­prets the social utility of its patients. 

The idea of social utility as a deter­mining factor for receiving treatment is also repli­cated in California’s coro­n­avirus guide­lines. In the case of a tie between patients’ pri­ority scores, a healthcare worker will receive treatment over a non healthcare worker. In cases where a tie cannot be broken by a patient’s social utility, medical pro­fes­sionals turn to a random lottery. 

In the mayhem sur­rounding the coro­n­avirus pan­demic, the gov­ernment is now re-defining who deserves treatment. California’s “life-cycle prin­ciple” cham­pions the young at the cost of the old and sick. Only those who are deemed useful to society are to be saved under these new guide­lines.

This is an ethical dis­aster. All humans deserve equality of treatment and the right to live, regardless of dis­ability or ability. California’s Public Health Department decided that the elderly and those with chronic dis­eases have less “social utility” and therefore less reason to live. 

In the case hos­pitals are overrun, and doctors must make deci­sions on who to treat given limited resources, the medical estab­lishment should reject the “life-cycle” and “social utility” prin­ciples in favor of a first-come-first-serve method­ology, with an exception made for those most at risk of dying. Although this is not a perfect solution, and doctors will still have to make ago­nizing deci­sions, it is better than shuf­fling the old and dis­eased into a corner to die. 

As every doctor who has sworn the Hip­po­cratic Oath knows, every human life is important and should be pro­tected, no matter how old or young. Rally against California’s state-sanc­tioned vio­lence of the most vul­nerable. 

Vic­toria Mar­shall is a George Wash­ington Fellow and a junior studying pol­itics.