However, Charles Camosy-a theology professor at Fordham University-emphasized that care is being limited in Los Angeles due to an expectation of a further COVID surge, and not because hospitals are already overwhelmed.
"To be clear, they are *not* overwhelmed now. This directive is in *anticipation* of having traditional capacity (no hospital ships, no converted convention centers, no cooperating facilities in other counties) overwhelmed," he tweeted.
Ghaly, explaining the county's policy of not transporting cardiac arrest victims who had not been resuscitated in the field, said that the county was "emphasizing the fact that transporting these patients arrested leads to very poor outcomes."
"We knew that already and we just don't want to impact our hospitals," Ghaly said.
Camosy noted that "[t]he phrase 'poor outcomes' is quite suggestive," adding, "it is likely that [Ghaly] and others mean that patients who are likely to survive cardiac arrest for the during of an ambulance ride are likely to be disabled in ways which lead them to judge that a limited number of beds should be given to able-bodied patients."
"If there are better explanations for this policy, I'd genuinely like to hear them," Camosy added.
However, Golder said that it is not necessarily unethical to limit care for patients with a low expectation of survival-if the situation is one of true "triage" where demand for care is great and resources are limited, and as long as patients are not denied care on the basis of age or disability.
According to studies, patients suffering cardiac arrest who are taken quickly to a hospital still have around only a 5% chance to survive and eventual discharge, she said. During a pandemic, they would essentially be competing with COVID patients for limited health care resources.
While this population may be mostly elderly, she said, it could also include younger patients-and the county's policy did not explicitly discriminate against the elderly.
"Nobody likes to see these things happen," she said. "There's always a limit on what we have available, and sometimes our demand exceeds it. And we're just there, we're there all over the country."
In the spring of 2020, Camosy was one of three scholars to warn against health care triage plans that explicitly discriminated against the disabled.
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As doctors in various jurisdictions were considering how to ration health care if hospitals were overwhelmed with an influx of COVID patients, Camosy was joined by Princeton law professor Robert George and Harvard sociology professor Jacqueline Rivers in demanding that care not be denied patients on the basis of their age or disability.
Camosy warned that many state health officials, hospital heads, and leading doctors lack ethics training and make decisions on a utilitarian "quality-adjusted life years" approach that favors younger, healthier patients and discriminates against elderly and disabled patients.
"As somebody who has studied bioethics, and who is a professor of bioethics, I know the overwhelming majority of them have virtually no ethics training," Camosy told CNA.