Life-and-death decisions may be forced upon doctors in states that are battling a high number of coronavirus cases, due to a critical lack of hospital beds and ventilators.
While some health care systems have foreseen this and set priority guidelines for allocating their precious resources, others may leave it up to the attending physician — leaving patients at the mercy of both.
"My father was larger than life," Jade Roth told CBS News' Dr. Tara Narula. Her father, former theater director Jerry Roth, was scheduled for a March 19 elective heart surgery when the New York City hospital where it was expected to take place canceled his elective surgery on March 16.
The 78-year-old died of heart failure at a different hospital on March 21. Jade Roth said she believed the cancelled surgery precipitated some of his quick decline, though she noted that was a "subjective view."
"I wanna be very clear that there are always hard decisions to be made, and I don't see that there's any blame here," Roth said.
Doctors around the country are grappling with the ethical and moral crisis the pandemic has put them in. Dr. Joseph Smith, medical ICU director at Eskenazi Health in Indiana, said that "as a physician, it's nauseating."
"Just the mere idea that we would… take a step back and say that one person is more likely to survive than the other, so we should provide the intensive care to the person that's more likely to survive… that is a very difficult thing," he said.
New York cardiologist Dr. Evelina Grayver was brought to tears on her video diary while explaining the experience of having to tell relatives of patients that she "no longer can provide that critical care that your family member may need."
"I'm not God. I'm far from God," Grayver said. "I'm just very limited in resources."
SUNY Upstate Medical University's COVID Incident Commander Dr. Stephen Thomas said "administrators like chief medical officers" and other leaders were working to create a "fair and transparent" system using objective evidence, to alleviate the burden of attending physicians.
Thomas helped build a triage team responsible for creating a blueprint for the allocation of resources at the university medical center.
Similarly, a professor of medicine and medical ethics at UPenn, Dr. Scott Halpern, helped write guidelines that are being used in most Pennsylvania hospitals to decide how to fairly allocate resources like ICU beds and ventilators.
"Everyone gets assigned a priority from one through eight, where one is the highest priority," he explained. "And then we let the supply on a given day… determine how many people get those resources."
Halpern said factors like age only factor in as "a last resort tiebreaker," and maintained that no other "personal character" such as race, gender or disability were factored in.
When asked about the choice left to attending physicians at hospitals that lacked an impartial system, Halpern said he thought "it would be hard to overstate the potential stress that this decision-making really requires."
"It is a truly impossible choice," he said.