Back when I taught English courses to college freshmen, occasionally our class discussions would veer toward some of the dangerous challenges that face our globe, such as climate change and nuclear holocaust. These catastrophes were merely hypothetical to my young students, and in some respects they were to me, as well.
Nevertheless, as I considered the potential for disaster that haunted their future lives, I sometimes reflected on how fortunate I was to be much closer to the end of my life than to its beginning.
Now we’re facing a catastrophe that is anything but hypothetical. If the coronavirus pandemic has less potential for disruption than does climate change, it has much more immediacy. People are dying right now, and many more will die before we see the far side of this disaster.
And because our nation was largely unprepared for the pandemic and the federal response has been late and slow, life-or-death scenarios that were once hypothetical are now real. Medical supplies—especially ventilators—are limited, and doctors and nurses are beginning to face moral choices about who lives and who dies. Bioethicists are developing protocols to help them make those decisions.
The ethical considerations are too complex to develop here, but the dilemma can be easily depicted: Two patients need the same ventilator. One is young and otherwise healthy, he has a wife and two kids and he is just about to graduate from medical school. With a ventilator he has a good chance to survive.
The other one is essentially healthy, but he has a body compromised by the years that he has accumulated during the course of a reasonably long and fortunate life. His chances of surviving on a ventilator are fewer, and if he does survive, he has much less life ahead of him.
In other words, me.
The choice is less obvious than it appears, but in practical terms, doctors and nurses will not have time or energy to sort out the philosophical niceties of their decisions. I suspect I’d be out of luck.
Dan Patrick, Texas’s lieutenant governor, is fine with this. In fact, he recently said that he—at 70—would be willing to die to get the economy churning again and that other seniors should be willing to do the same.
I’m a few months older than Patrick. I don’t necessarily share his confidence that he—or I—will feel quite so self-sacrificial when it actually comes to the point of death. Still, his point is well taken. The life-or-death decisions that doctors and nurses will have to make should be informed by what some ethicists call a “save-the-most-lives” strategy. This will often mean sacrificing the old and infirm for the sake of the young and healthy.
So I’ll take on a little of Patrick’s bravado: Unless I lose my nerve, count me in; take the ventilator.
But I would like you to do me a favor though.
I’ve written several columns in support of physician-assisted suicide, a civilized way for people to take some control over the way they leave this world and with how much discomfort. It’s not an idea that Americans take to readily.
In fact, I suspect that Lt. Gov. Patrick doesn’t believe in physician-assisted suicide. But when an official of his status suggests a rationale for letting the old die in favor of the young, he is obliged to consider the wishes of those he is so readily willing to sacrifice.
Many people fear dying more than they fear death. According to writer and physician Sherwin Nuland dying is rarely a peaceful passage. More often than not it is a miserable, prolonged, painful event devoid of grace or dignity. And clearly suffocation is among the more dismal ways to die.
So help yourself to my ventilator and may its recipient have as long and fortunate a life as I have had. But use the IV already in place to give me a peaceful, fast passage to whatever lies beyond. My ghost will be grateful.
Certainly it’s a drastic measure, but these are drastic times.
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ABOUT THE WRITER
John M. Crisp, an op-ed columnist for Tribune News Service, lives in Georgetown, Texas, and can be reached at jcrispcolumns@gmail.com.
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