An Oakland University William Beaumont School of Medicine professor took to the Wall Street Journal in defense of medical professionals making difficult life-and-death decisions in the time of COVID-19.

Jason Wasserman, Ph.D., associate professor, Department of Foundational Medical Studies and Department of Pediatrics, OUWB, wrote a letter to the editor that appeared in the April 1 issue of the paper.

His letter, “Triage Is the Moral Choice in an Emergency,” was in response to an op-ed published March 26 called “Rationing Care Is a Surrender to Death.” 

That piece, written by Allen C. Guelzo, a senior research scholar in the Princeton University’s Council of the Humanities and a visiting fellow at the Heritage Foundation, asserts that there should be more emphasis on manufacturing ventilators and less on developing plans for how the existing supply will be used.

“People have become too accustomed to taking the easy way out of dilemmas, and too comfortable with making excuses for killing when the only offense of those we kill is the possibility of inconvenience,” Guelzo wrote in the Journal.

“Americans are better than that,” continued Guelzo. “Ventilators are not simple to manufacture, but neither were Spitfire fighter planes at the beginning of the Battle of Britain. Improvise, innovate, imagine.”

Wasserman said he generally took issue with Guelzo essentially minimizing the difficult decisions that medical providers are having to make at this time — as the number of people with COVID-19 grows and the quantity of available ventilators decreases.

“I thought he was not only sidestepping the difficulties of having to make those decisions, but that it was offensive to those on the frontlines to suggest they are ‘retreating to death’ when they are forced to make them,” Wasserman said. 

“A line I wrote, but that the editors cut, put it:  He's basically just describing the water to those who are drowning in it.”

By responding to Guelzo’s op-ed, Wasserman said he “hopes to have suggested that issues of justice and fairness are some of the most difficult that we face because we want to live in a world where there is enough of everything for everyone.” 

“But this pandemic has shattered that illusion,” Wasserman said. “I always warn the students that when it comes to questions about scarcity, people have a strong urge to try to wiggle out of them. But that keeps us from having to confront the tough questions. And when we can't wiggle out of those anymore, if we haven't thought through how to deal with them, then we’re in a really bad place.

Wasserman said he also wants people “to understand that if we don't create a system for fairly distributing scarce resources, that is, by default, also a choice about how we are going to distribute them, only it will be done on a random, ad hoc basis and will generate even worse, more regrettable outcomes.”

“I want people to understand that no one is enjoying having to make these tough decisions,” Wasserman said. “Everyone wishes we weren't in this situation. But we are and we have to confront it. Doing so isn't a retreat as Guelzo suggests, it's an act of moral courage.”

The topic of rationing ventilators has gained increasing attention as the pandemic grows. The Washington Post, for example, recently had a story entitled “Hospitals consider universal do-not-resuscitate orders for coronavirus patients.”  

Pro-life outlets like LifeSiteNews.com have furthered attention on the topic with headlines such as “Experts: Universal do-not-resuscitate orders are unethical, un-American, unnecessary.”

But Wasserman, who has been helping craft ethics guidelines and conducting ethics consultations for local health organizations, said such discussions in the media don’t necessarily capture the reality of the tough decisions.

“This has been such a distressing time for health care workers and the ethicists that are involved in having to plan for running out of life-saving medical equipment and supplies. I don't know anyone who is not approaching this with solemnity,” said Wasserman. “No one wants to be in this position, but we have to make hard choices to avoid even worse outcomes.”

He said it was nice to have his letter published in the Journal because he believes it helps provide balance to the discussion and represents “the ethical work that physicians and ethicists are doing right now to the public.”

“There is going to be a lot of distress and trauma as a result of having to make these decisions and we don't need people piling on, particularly when their criticisms don't match the reality of the situation,” he said. “I'm happy to be able to contribute in some small way to shaping that narrative in a more positive direction.”

For more information, contact Andrew Dietderich, marketing writer, OUWB, at [email protected]. 

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