(3/27 UPDATE: Professor Cunningham, happily, tested negative for the new coronavirus.)
Professor Cunningham invited me to share this letter he sent out to many colleagues:
Does anyone know Allen C. Guelzo, a “senior research scholar in Princeton University’s Council of the Humanities?” If so, please tell him to stop it.
In his article on WSJ this morning, referring to the plans we have been discussing tirelessly for weeks now, he asserts: “…people have become too accustomed to taking the easy way out of dilemmas, and too comfortable with making excuses for killing with the only offense for those we kill the possibility of inconvenience. Americans are better than that. Ventilators are not simple, but neither were Spitfire fighter plans…Improvise, innovate, imagine.”
Someone, please, who can tell him to stop or publicly rebuke him with argumentation, do so. Those of us working long hours in our hospitals do not have time to. While this shoddy reasoning obscures the point and is sloppy, scaremongering editorial writing, it may improve his profile. But there is no time for self-interested slop. He is correct in the sentiment, one can charitably grant him, that these are profound moral problems. But they aren’t manufacturing problems. And they are urgent.
He ignores that everyone wants more ventilators, more hospital beds, more adequately trained health care providers, more PPE, and so on, in the event the situation becomes so dire that we need far more resources than anything we have had in the past. The work that we are doing to plan for crisis conditions and appropriately operationalize triage protocols for making allocation decisions is predicated upon the assumption that this is the way to save the most lives under conditions Guelzo appears to assume, in his unwarranted optimism, are readily preventable. We all hope they are prevented. The question still remains, what if they are not? Then what do we do?
And he uses the dreaded “killing” language that is so common in debates about physician-assisted suicide. While I think it is misplaced there, it is at least respectable to use it, and rightly frames important thinking about that area of moral reasoning. But no one is killing anyone in triage protocols. Healthcare professionals are trying to reduce overall morality levels (=saving lives) and provide palliative care for those who are dying of their serious illnesses, traumas, or this dreadful disease.
So, someone please tell him to cut out the cheap moral grand-standing. We need reasonable, thoughtful people to educate the public on why triage is necessary, how everyone who works in hospitals is frantically trying to avoid using it, and how government officials and lay public might help. And this education needs to be done in ways that work against the backfire effect, which is likely to manifest strongly if we enter into triage conditions and the public learns more about the work.
My apologies for cluttering our inboxes with this screed. But I am at home wearing a mask I’ve had on since yesterday because I have moderate symptoms and I’ve been exposed to people who tested positive. Now I must quarantine until my test results are back. That means no loving on my kids; washing or sterilizing everything I touch in my house, car, etc; fear for my family; and so on.
Be well. And please, someone, put Guelzo in his place. We need your help.
If you find this email worth sharing, you have my permission to do so. Anywhere.
-Thomas
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Thomas V. Cunningham, PhD, MA, MS
Bioethics Director, KP West Los Angeles
Faculty, Loyola Marymount Bioethics Institute
ASBH 2020 Program Committee Chair
6041 Cadillac Avenue
Los Angeles, CA 90035
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