Post-Roe ‘confusion’ helped defeat Kansas pro-life amendment

Washington D.C., Mar 24, 2020 / 02:30 pm (CNA).- In Italy, which has the most deaths from coronavirus, some doctors have said they have had to overlook older patients to focus on younger ones who are more likely to survive as the virus overwhelmed the healthcare system.

In the US, states and hospitals are considering how to distribute healthcare if demand for limited resources exceeds what can be provided. Worldwide, there are 332,930 confirmed cases of Covid-19, and 14,509 deaths. Of those, 31,573 cases are in the US, where there have been 402 deaths due to the virus.

Colorado adopted a Crisis Standards of Care Plan in 2018 as guidelines “to assist healthcare providers in their decision making with the intention of maximizing patient survival and minimizing the adverse outcomes that might occur” when healthcare needs “far surpass” what is available.

“It’s very military-style triage,” Dr. Matthew Wynia of the University of Colorado Anschutz Medical Campus told The Colorado Sun’s John Ingold. “If we get hit that hard, we are going to have some very difficult decisions to make. And we can’t wait until then to get ready for that … it would be irresponsible not to plan right now for a huge surge of patients.”

Colorado’s crisis standards of care would be activated only after the governor declares a public health emergency, and even then, it would implemented locally, depending on the conditions in individual counties or communities.

Among the goals of the state plan is to “minimize serious illness and death by administering a finite pool of resources to those who have the greatest opportunity to benefit from them”.

Guiding ethical elements of Colorado’s plan are stewardship of resources, duty to care, soundness, fairness, reciprocity, proportionality, transparency, and accountability.

It focuses especially on fairness, proportionality, solidarity, and being participatory.

The Colorado guidelines say healthcare providers should be fair to all the affected “without regard to factors such as race, ethnicity, socioeconomic status, disability or region that are not medically relevant.”

With regard to solidarity, the Crisis Standards of Care Plan says that “all people should consider the greater good of the entire community.” It adds that for transparency and accountability, “the community, healthcare providers, and emergency management agencies” should be engaged during the process.

Dr. Charlie Camosy, an associate professor of theology at Fordham University, last week discussed with CNA the principles that should be used as doctors might face choices over healthcare distribution.

“There are virtually no universally agreed-upon principles to do this–excepting, perhaps, the idea that health care providers, first-responders, law enforcement, and others primarily responsible for the day-to-day functioning of the polity should get priority,” he stated.

For Catholics, he said that serving “the most vulnerable first” is a fundamental principal.

“Those people are Christ to us in a special way and we will be judged according to how we treat them. We don’t think about, say, how long they might stay on a ventilator vs. how long someone we might encounter next week might stay on a ventilator. We also don’t think about how long they might have to live if the treatment is successful vs. how long other someone we might encounter next week might live if their treatment is successful.”

He added that it makes sense among limited resources “to treat those first who are most likely to benefit from the treatment. And there may be a disproportionate number of younger people in the former category. But that is not the same as deciding that we ought to prefer the young to the old because they have longer to live.”

While the US bishops’ Ethical and Religious Directives for Catholic Health Care Services do not directly address resource allocation during crises, they do note that “Catholic health care should distinguish itself by service to and advocacy for those people whose social condition puts them at the margins of our society and makes them particularly vulnerable to discrimination: the poor; the uninsured and the underinsured; children and the unborn; single parents; the elderly; those with incurable diseases and chemical dependencies; racial minorities; immigrants and refugees.”

The directives add that “in particular, the person with mental or physical disabilities, regardless of the cause or severity, must be treated as a unique person of incomparable worth, with the same right to life and to adequate health care as all other persons.”

In Washington, advocates of persons with disabilities have filed a complaint saying that crisis care guidelines issued by the state health department are improperly discriminatory.

“There’s been a long history of people with intellectual, development mental disabilities having our medical care denied,” Ivanova Smith, one of the complainants, told NPR. “Because we’re not seen as valuable. We’re not seen as productive or needed. When that’s not true. We have people that love us and that care for us. Many people with disabilities work and they do amazing things in their communities but they need that life saving care.”

Attorneys representing the Thomas More Society and the Freedom of Conscience Defense Fund published a memo March 23 urging that “policies rationing care on the basis of disability or age … would violate federal law regarding invidious discrimination.”

“Anticipated longevity or quality of life are inappropriate issues for consideration. Decisions must be made solely on clinical factors as to which patients have the greatest need and the best prospect of a good medical outcome. Therefore, disability and age should not be used as categorical exclusions in making these critical decisions,” the memo concludes.

Peter Breen, vice president of the Thomas More Society, commented that “The horrific idea of withholding care from someone because they are elderly or disabled, is untenable and represents a giant step in the devaluation of each and every human life in America.”

Other possible criteria for healthcare distribution during crises include first-come-first-served, or a lottery system.

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Bishop Thomas Daly of Spokane. CNA file photo. / null

Spokane, Wash., Aug 26, 2021 / 14:02 pm (CNA).
Bishop Thomas Daly of Spokane wrote on Tuesday that Catholic schools in the diocese will be expected to comply with the state’s vaccine mandate,… […]

Washington D.C., Jan 9, 2019 / 05:23 pm (CNA).- President Donald Trump has threatened to stop sending federal money to the state of California for wildfire recovery, a move that Catholic aid workers say could dramatically impact thousands of California families trying to rebuild their lives.

“Billions of dollars are sent to the State of California for Forest fires that, with proper Forest Management, would never happen,” Trump wrote in a tweet Wednesday.

“Unless they get their act together, which is unlikely, I have ordered [the Federal Emergency Management Agency] to send no more money.”

The fire season in California in 2018 was the state’s worst on record, with thousands of structures destroyed and nearly 90 lives lost. An unusually dry autumn contributed to the severity of the fire season.

About 6,650 people in California have successfully applied for FEMA assistance to the tune of nearly $50 million in aid, according to the latest available numbers from FEMA. That assistance can be used for essential home repairs and other necessities not covered by insurance.

It’s not yet clear whether Trump has the legal authority to order FEMA directly to cut funding for California, but the Sacramento Bee reports that the president does have to power to refuse to declare a state of disaster in California during or after future fires.

The Washington Post reportedly reached out to FEMA for comment, but received only an automated reply saying the agency is unable to respond to general press inquiries due to the partial government shutdown. The agency has said that individuals can still apply for aid while the government is shut down.

California’s newly-elected governor has called on the Trump administration to double federal funding to manage the state’s forests.

Kevin Eckery, spokesman for the Diocese of Sacramento, told CNA that though he suspects the president’s words were a political message directed at California’s new governor, the impact of defunding FEMA completely could be devastating.

“It’s sad that whatever politics are involved here are being directed at these families that really need our care, concern, and our help in order to rebuild,” Eckery told CNA.  

“You take an emergency that affects thousands and thousands of families in northern California, billions of dollars in property damage, that began on federal land with the possible involvement of a public utility, and then try and say, ‘No, this is all about California forest management processes’…I’m kind of dumbfounded,” he said.

“In terms of toying with people’s livelihoods and their concern about rebuilding, it becomes even more strange when you realize that this is a community that is probably one of the few places in California where a majority of voters supported President Trump.”

Eckery explained that in the case of a natural disaster, for the most part the state has the primary responsibility for operations along with their partners in local government. FEMA can then underwrite grants and low-interest loans to help provide aid from outside the state; for example, if a state needs large amounts of concrete for levies, not all of which can be sourced in-state.

If Trump were actually to carry out his threat to defund FEMA, thousands of families trying to rebuild that would be affected, he warned.  

The Sacramento diocese is making schooling available for free for 30-40 students affected by the fire, Eckery said, and Catholic Charities is engaged in case management to match families with resources so they can do their own rebuilding.

“We’ve moved from the emergency stage to the recovery stage,” he said.  

“People need to understand that even though the Camp Fire is out of the day-to-day headlines, it still burned down a community of 35,000 people. And so that is a lot of hurt, and those people need and deserve our help.”

Republican Congressman Doug LaMalfa, whose district includes much of northeastern California, wrote in a press release that he expects the president to keep his promise to help victims of the fires.

“Although I share the President’s great frustration with California’s choking regulations from the stranglehold environmental groups have on the state, as well as the inaction on federal lands up until this Administration…threats to FEMA funding are not helpful and will not solve the longer term forest management regulatory problems,” he wrote.
 
“These are American citizens who require our help.”

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