The Father-Daughter Dinner Dance: A Waltz With Ethics and COVID-19
2020; Lippincott Williams & Wilkins; Volume: 96; Issue: 12 Linguagem: Inglês
10.1097/acm.0000000000003523
ISSN1938-808X
Autores Tópico(s)Optimism, Hope, and Well-being
ResumoWe’ve been in self-isolation for the last 10 days. Someone’s turning on the TV or radio or accessing social media to get the latest news on the COVID-19 virus. I had to close my car wash business. Not an essential service? I guess some people don’t really love their cars. I am in the kitchen chopping carrots. It’s stir-fry tonight. Lennie likes to watch me cook because I’m terrible at it. Watching her dad fumble with a knife is comic relief in stressful times. Bad news has a tendency to scaffold. Today, in addition to the usual despair surrounding this pandemic, we are told that there might be a shortage of ventilators. In Italy, doctors are making decisions on who gets lifesaving help and who doesn’t when supplies are limited. How on earth does one decide who gets a ventilator? Lennie is matter of fact. “Prioritize young people for sure over old.” “But why? I mean, I get it, but do we not value older people?” “Of course we do! But the young ones have a better chance of surviving. And plus, they have barely lived their lives. Old people have at least had a chance.” I gaze at her sitting at the kitchen table, phone in hand. She did an honors degree in philosophy. “Alright then, what about a young person with a chronic health issue and a perfectly healthy old person? Who gets the ventilator?” She looks up at the ceiling with a slight furrow in her brow. “Still the young person. Oh wait, how much will the young person’s illness cost? Like, their medications. Do we have to spend hundreds of thousands of dollars a year just to keep them alive? If that’s the case, then maybe it should go to the old person.” There is a price on life. Quick, hand me the calculator. “They are stable. They need medication, but they live productive lives.” “Then the young. Always the young, actually. Even with a chronic illness.” The sanctity of life in a pandemic becomes algorithmic. Let’s take age out of the equation: “Okay, what if there were two people who were identical ages. One has a mental illness, the other does not.” “For sure, the person without a mental illness.” That was fast. I try to stop my eyes from widening. Is there a way to make decisions about life or death that doesn’t devalue those who are vulnerable? “What if the other person has diabetes? One person with mental illness and one with diabetes.” “The one with diabetes.” “Why?” She is becoming defensive. “Uh, because. . . . Oh, I don’t know! Why are you asking me?” “You took philosophy! How does one decide whose life is worth more? Also, why shouldn’t the person with mental illness get a ventilator?” “I don’t know! I just think if someone is crazy. . . .” “I work every day. I contribute. What if that was me? Who gets the ventilator?” Silence. I am stable now but what if I wasn’t and needed a ventilator? I can’t help sounding a little wounded. “I mean, what about a lottery system? I deserve a chance.” Dinner is going nowhere. Why can’t I chop and talk at the same time? Maya walks into the kitchen. She gives me a quizzical look, sensing something is going on between me and our daughter. “What! Dinner’s still not ready!” “Well, Lennie has killed me off. . . .” “Dad! Stop!” “It’s true! I don’t get a ventilator because I have a mental illness. Everyone else gets one before me.” Maya laughs and leans on the counter. “Really, everyone? Oh, honey, sit back and watch me save you.” She is smiling with her eyes. “Lennie, if you had an obese woman and a slightly pudgy guy with a mental illness, who would get the ventilator?” “Mom!” She sighs deeply and speaks slowly. “Okay, on the news, I heard that overweight people don’t do well. Even old people recover better. This is a pandemic. The guy with mental illness gets the ventilator.” Triumphantly, Maya slaps the counter with her hand, “Aha! See, Yonas, you’ll be fine. Just don’t gain any more weight.” She playfully pokes my stomach, grabs a handful of chopped carrots, and saunters out of the kitchen. Lennie puts her phone down. “We also need to consider the person’s occupation.” “Their job? Why would that matter?” “Because doctors and nurses—no matter what age or illness—should be saved first because we will need them to care for us. They need to live.” “Uh-huh.” Operationalizing life and death feels eerily similar to the utilitarian conversation you have with your business manager when trying to balance a budget. “And scientists too. Because they will help find a cure. . . . They have skills that the average person doesn’t have.” I suddenly realize that we don’t even bother paying lip service to the concept of equity during a pandemic. The Pandemics! Stay tuned for scenes from our next episode of Elites and Their Ventilators— save us so we can save you! “So, a doctor or scientist who is old, regardless of preexisting conditions, with a belly should get a ventilator before a young kid with no chronic illness just out of university who finished a degree in philosophy or whatever degree that won’t find cures. . . .” Lennie laughs and gives my arm a hug. Her way of physical distancing. “Dad! Can you just finish making dinner? If we all stay home, we won’t have to worry about any of this stuff.”
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