Will the number of Covid hospitalizations in the USA increase to the point that hospitals will not treat high-risk patients?
This was one aspect of Sweden’s policy.
In fact, Swedish hospitals simply euthanized or ignored Covid patients who were either too old or too obese.
This was because resources (ventilators) were supposedly too scarce for them.
To be fair, advanced care for such patients might have been futile anyway.
https://www.wired.co.uk/article/sweden-coronavirus-response-experiment
Even more worrying, evidence has emerged that many sick elderly patients were effectively automatically denied access to treatment, to avoid hospitals being overwhelmed. One March 17 FHM directive to Stockholm hospitals stated any patients over 80 or with a body mass index above 40 should not be admitted to intensive care, because they were less likely to recover. Other reports describe sick care home residents being administered a palliative cocktail of morphine and midazolam, because the homes were not equipped to administer oxygen, something some doctors have described as ‘active euthanasia.’
In fact, non-Covid patients in Sweden who required hospital care were likewise essentially sentenced to death by pain killer.
“People were triaged out of healthcare and given ‘No Hospital’ notes on their journals, before they got sick. And this was not only for patients who were suspected of having Covid-19. A person who got a urinary tract infection and required hospitalisation, for example for IV antibiotics or fluids, would not get that care either. They received palliative medicine instead.”
For these reasons, and because Sweden does not test the dead for Covid, actual deaths may be higher in Sweden than has been recorded.
That is saying something, because deaths in Sweden have been remarkably high.
Is a policy of euthanasia for both Covid and non-Covid patients who require hospitalization the path that the USA is on?
Key to this question is just how different Sweden’s policy was from that of other countries.
On the whole, although there were no official lockdowns, Swedish Covid policy was really not so different from those of other countries.
However, Swedish authorities did discourage mask wearing and kept schools and restaurants open.
This seems to reflect the “herd immunity” strategy, the idea that Covid symptoms for most (young, healthy) people would be mild and flu-like.
The hope was that the disease would pass rapidly through the healthy population, while unhealthy people were sequestered.
Hence, the Swedes use coded language, for example, that they are “running a marathon” whereas the rest of the world is “running a footrace”.
It reflects an overconfident attitude toward a disease that still confounds and mystifies experts.
But again, aside from that, is often overlooked that the Swedes actually did take so many of the standard precautions adopted all over the world.
There is a great difference also between the quality of the healthcare system in Sweden and healthcare in the USA.
Sweden has a first-class healthcare system, arguably the best in the world.
In contrast, in much of rural America, the medical infrastructure often consists of clinics.
Importantly, in rural areas of the USA, it seems that many people are not taking any precautions.
So it is conceivable that euthanasia — officially or not — will be the necessary policy as the US healthcare system comes under unbearable strain.
The direction of an unchecked pandemic is toward exponential growth, and that is now happening in the USA.
Desirable or not, a policy of involuntary euthanasia is an obvious and perhaps inevitable outcome of not taking precautions.
However, just as the Swedes adopted a herd immunity strategy but deny it, the Americans may engage in euthanasia yet pretend that they aren’t.
Notably, in engaging in euthanasia, Americans might not use pain killers for Covid patients.
Americans would perceive this as a waste of money.
Dosing patients with high levels of painkillers that makes them overdose or makes it impossible for them to survive “active euthanasia”.
Not trying to aid dying patients while humanely providing them with palliative care is “passive euthanasia”.
http://www.bbc.co.uk/ethics/euthanasia/overview/forms.shtml
Active and passive euthanasia
In active euthanasia a person directly and deliberately causes the patient’s death. In passive euthanasia they don’t directly take the patient’s life, they just allow them to die.
This is a morally unsatisfactory distinction, since even though a person doesn’t ‘actively kill’ the patient, they are aware that the result of their inaction will be the death of the patient.
Active euthanasia is when death is brought about by an act – for example when a person is killed by being given an overdose of pain-killers.
Passive euthanasia is when death is brought about by an omission – i.e. when someone lets the person die. This can be by withdrawing or withholding treatment:
Withdrawing treatment: for example, switching off a machine that is keeping a person alive, so that they die of their disease.
Withholding treatment: for example, not carrying out surgery that will extend life for a short time.
Traditionally, passive euthanasia is thought of as less bad than active euthanasia. But some people think active euthanasia is morally better.
Technically, death without palliative care is not euthanasia, it’s “dysthanasia” — “bad death”.
Total neglect and abandonment of a suffering patient would be “passive dysthanasia”.
This is what Americans might end up doing as an unspoken policy.
At this point, they have little choice.
One can imagine how this would work:
Hospitals would have a special room near the ICU where they wheel in patients.
Patients would go in, but they would not come out.
There would be no equipment in that room, and the physicians would never enter it.
The coronavirus pandemic might be a turning point in terms of the acceptance of euthanasia in the USA.
Liberals champion euthanasia or “death with dignity” as a matter of personal choice.
Libertarians likewise argue in favor of euthanasia, adding that euthanasia can be in the greater interest of society.
http://www.bbc.co.uk/ethics/euthanasia/infavour/infavour_1.shtml#h5
Forbes magazine is reliably conservative and is predictably opposed to euthanasia.
However, Forbes does have a libertarian streak that shows itself now and then in social and cultural issues.
Every now and then there is an editorial in Forbes that argues against futile medical interventions, citing the enormous cost and extended suffering of such a policy.
The proposals range from increasing access to hospice care to legalizing euthanasia in the USA.
30% of all Medicare expenditures are attributed to the 5% of beneficiaries that die each year, with 1/3 of that cost occurring in the last month of life.
In the Archives of Internal Medicine, a study asked if a better quality of death takes place when per capital cost rise. In lay terms the study found that the less money spent in this time period, the better the death experience is for the patient.
Currently, one percent of patients accounts for more than 20% of US healthcare spending. Despite efforts to provide hospice services to people near the end of life, many people are not admitted to hospice until just days before their death.
One force against palliative care and euthanasia is progress in medical research.
Much of the experimental work on potential new drugs and medical procedures is conducted on patients who are otherwise terminally ill.
It is a utilitarian policy that could appeal to any ideology.
More importantly, palliative care and euthanasia, insofar as they deprive pharmaceutical companies of subjects for human experimentation, would be opposed by an entrenched lobby.
A conservative argument against euthanasia is that it devalues human life despite obviating the inevitable loss of quality of life.
However, many conservatives — and libertarians, and populists — during the coronavirus pandemic have argued that Covid kills old people who are going to die soon enough.
Normally, conservatives would argue that such an of argument would “demoralize” society, and undermine the entire value system.
How would it feel if one was old or diabetic or overweight or asthmatic or had heart disease and everyone was saying that you are going to die soon anyway?
After all, 37% of Americans are supposedly in those high risk groups.
Moreover, how does it affect people to say such ruthless things?
In normal times, almost nobody would say or even think such a thing.
For example, the effects of slavery might last for generations on those whose ancestors were enslaved.
But the ill effects of slavery might even be more dire for the descendants of slave owners.
They would have a certain inherited coldness, arrogance and hauteur.
They would also have a certain laziness and complacency, and they would lack curiosity, imagination or ambition.
These qualities would spread throughout society, so that even the lower classes would manifest a self-righteous sense of entitlement.
Here one thinks of the English and their inability to live in or adopt to the real world after their postwar imperial eclipse.
Inevitably, one should expect change and innovation in social conventions in the aftermath of a pandemic.
After all, it was the HIV-AIDS crisis that brought about same-sex marriage.
HIV-AIDS killed 35 million people, and still kills about three-quarters of a million every year.
Yet HIV-AIDS is no longer a pandemic largely because people altered their behavior.
Importantly, those who did not adopt to the reality of HIV-AIDS simply died.
This divergent behavior and its consequence had a strong “demonstration effect”.
https://en.wikipedia.org/wiki/Demonstration_effect
Demonstration effects are effects on the behavior of individuals caused by observation of the actions of others and their consequences. The term is particularly used in political science and sociology to describe the fact that developments in one place will often act as a catalyst in another place.
The new behavior became habitual.
People then forgot that they had altered their behavior.
It was proposed during the HIV-AIDS crisis that if gay men could get married and settle down, on the weekends they would stay home and watch TV instead of going out on the town.
To some degree, that is what happened.
Because of the exponential growth of pandemics, small changes have a great effect.
Altering marriage customs might have been one small change that made all of society safer in terms of HIV-AIDS.
But there is amnesia about this history.
On the one hand, liberals imagine that same-sex marriage was motivated by a desire for “marriage equality”.
Isn’t this just like the way liberals imagine the shift to renewable energy is all about fighting global warming?
In 2008, the price of oil rose to $147, and countries reacted by developing renewable resources — for the sake of energy security.
On the other hand, cultural conservatives lament same-sex marriage as a radical abomination.
Yet marriage, like religion, is a conservative institution that buttresses the status quo.
Historically, political radicals and revolutionaries opposed marriage and religion, not as inherently evil but because those conservative institutions make social change less possible.
Isn’t this just like the way conservatives fear immigration?
Eventually, the descendants of immigrants who are culturally conservative and enterprising — like Asians and Hispanics — will eventually become the core of the conservative establishment.
Likewise, euthanasia might become an accepted practice that liberals will celebrate as a victory of personal freedom and dignity.
Indeed, once it is an established custom, perhaps someday conservatives will argue that voluntary euthanasia is a matter of “personal responsibility”.
But the real motive for eventually legalizing euthanasia might be the coming financial strains on the healthcare sector and perhaps stress on the American economy more generally.
Americans screwed up and let the pandemic rage and this undermined the economy and healthcare, and so Americans could no longer afford not to have euthanasia.
But it won’t be remembered that way.
