The Toughest Triage

"Never before has the American public been faced with the prospect of having to ration medical goods and services on this scale," say coauthors Robert Truog, Center Director, and Christine Mitchell, Center Executive Director

Center Director Robert Truog, Executive Director Christine Mitchell, and Harvard Medical School Dean George Daley are coauthors of a March 23 perspective piece in the New England Journal of Medicine entitled, “The Toughest Triage — Allocating Ventilators in a Pandemic.”

“Although shortages of other goods and services may lead to deaths, in most cases it will be the combined effects of a variety of shortages that will result in worse outcomes. Mechanical ventilation is different. When patients’ breathing deteriorates to the point that they need a ventilator, there is typically only a limited window during which they can be saved. And when the machine is withdrawn from patients who are fully ventilator-dependent, they will usually die within minutes. Unlike decisions regarding other forms of life-sustaining treatment, the decision about initiating or terminating mechanical ventilation is often truly a life-or-death choice,” write the authors.

Read the full article in NEJM.