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Leaked Draft Letter Reveals Michigan Hospital’s Policy to Ration Ventilators

From the panic buying of paper products to the hoarding of food and other resources, the Coronavirus outbreak has changed most American’s everyday lives and activities. Speculations about how states will cope with ongoing shortages of medical equipment have also been on the rise — with worries that rationing of care would occur soon.

Rationing care could involve withholding treatment from Covid-19 patients when hospitals become to full or using the patient’s age and other factors to determine if they were “worthy” of care. 

A recent discovery from a hospital in Detroit seems to confirm those fears are valid, and raises plenty of questions about medical care and access in this ongoing epidemic. 

The letter was from one of Michigan’s major hospitals and is a draft that shows the hospital’s attitude and policy towards pandemic patients. In the draft, the hospital shares their planned policy to reserve care for those who have the best chance of recovering and simply providing palliative care for those who don’t make the cut.

The letter came from the Henry Ford Health System and was addressed to “our patients, families and community.” In the letter, the hospital details which patients would be eligible for care if rationing begins – and how those decisions would be made:

“Patients who have the best chance of getting better are our first priority. Patients will be evaluated for the best plan of care and dying patients will be provided comfort care,” the letter states.

The letter also details what would happen if ventilators or ICU beds were no longer available; illness or need is no longer the sole determining factor for receiving care:

“If you (or a family member) becomes ill and your medical doctor believes that you need extra care in an Intensive Care Unit (ICU) or Mechanical Ventilation (breathing machine) you will be assessed for eligibility based only on your specific condition,” the letter adds.

Just a few of the conditions that could prevent a person from getting this type of critical care include cancer, trauma, heart or lung disease or kidney failure. 

The hospital released a statement this week that verified the accuracy of the letter, which was not delivered to patients – instead, it was released online and to the press. The statement downplays the importance of the letter – and indicates that it is only a worst case scenario possibility: 

“With a pandemic of this nature, health systems must be prepared for a worst case scenario,” Munkarah said. “Gathering the collective wisdom from across our industry, we carefully crafted our policy to provide critical guidance to healthcare workers for making difficult patient care decisions during an unprecedented emergency.”

The draft letter leaked online last week, when it was shared on Twitter – it was later printed in full by the Detroit Free Press. The letter includes alarming statements of hospital policy, including:

“Some patients will be extremely sick and very unlikely to survive their illness even with critical treatment. Treating these patients would take away resources for patients who might survive.” 

The letter also notes that those that don’t make the cut for medical care would receive palliative and comfort measures only. 

Like many hospitals across the nation, the Henry Ford hospital is facing shortages of equipment and space; this is the only facility to date to have such a chilling policy. Others continue to cope with the growing pandemic and find ways to treat the record number of patients arriving without resorting to withholding care.


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