The Triage. Who Should Evacuate First?

Over the course of the past few weeks, I have greatly enjoyed reading Sherri Fink’s book. The content is something that I find to be incredibly relevant in the career field that I’m hoping to pursue. I know that it is important to understand the ethical ramifications of the decisions that you’re making as a healthcare provider, and faith is something that has strong influences on the ethics and morals that each person holds. It is important to think about these different medical ethics questions in the terms of everyday life, but what must it be like to have these ethics really tested in an emergency situation? I believe that Five Days at Memorial gives valuable insight on what it must be like to have those ethics and morals questioned. For this blog post, I will be evaluating the intersection between how disability is viewed in the Bible, along with how disability is viewed in the book. Firstly, it is important to note that I was initially going to begin with the ethics of euthanasia. It is at the forefront of the book, whether or not they made the right decision in actively ending the lives of the patients they were caring for. I think that it is important to first look at what the lives of these patients would look like after the events of the hurricane took place, along with how they were treated while still alive, and then to focus on whether or not it is justifiable to end their lives. 

The first thing we can analyze is the triage system that was put into place. In a normal United States emergency department (see graphic above), the worst off would become the highest priority, with the patients that were the healthiest and most stable to be seen after. In the hurricane aftermath, Memorial Hospital decided to take on a more “war-esque” triaging system. The patients that were the healthiest were evacuated the earliest, and were also provided the best medication and care. “The able bodied were leaving, not the sick,” (Fink, 206). The mentality behind this was that the healthier were more likely to survive or have a better quality of life after the storm, and that there was not a point in wasting the good material on those who would not make it. This distribution of resources exemplifies the clear favoritism shown towards those who would be able to live a “traditionally” good life after Katrina. For a quick recap of the relevant events on those not getting evacuated, there was a certain set of patients (most of which were elderly, but it is important to note that they were NOT in hospice care), that passed away during the aftermath of hurricane Katrina at Memorial Hospital. A group of them were found with lethal cocktails of versed and morphine in their system. Different hospital staff working the storm were also able to provide evidence that a few of the doctors and nurses decided to end the lives of patients they did not believe would be able to make it, or patients that they did not believe would be able to have any quality of life. This is a clear indication that Dr. Pou, the primary physician wrapped up in this legal battle, did not believe that these patients would have lives that could provide worth to themselves or to society in the aftermath.

With this textual evidence, it is easy to deduce that the value of the lives of the healthy were put above the sick, and that resources were clearly partitioned to those who would be able to live able bodied lives later on. Shifting over we can take a look at how the Bible would respond to this. Unsurprisingly, the Bible has contradicting views on disability as a whole. (To gain more of an insight of disability in the bible: https://theculturetrip.bibleodyssey.org/articles/disabilities-in-the-bible/). In Leviticus 21, God told Moses that anybody considered disabled should never offer up anything to Him, which lines up more with the way disability is presented in the book. This provides a scriptural example where the events at Memorial would be Biblically justified, because those who are more able to serve the Lord in this context are prioritized over those who are or were on the track to being disabled, therefore they would "deserve" more resources. In Deuteronomy 28, God curses those who do not follow His word, and one of the many punishments offered up is becoming disabled and sick. This is another piece of scriptural evidence that God does not think that disabled people are as beneficial or as valuable to a society as the able bodied are.

If the events at Memorial are only compared to these two pieces of scripture, it is clear to see that they were justified in prioritizing the sick after the healthy. However, it isn’t as simple as just looking at these two passages.

In contrast, Matthew 9, along with other gospels that were analyzed, has multiple stories of those who had great faith get healed from their ailments. In one passage, Jesus Christ even raised a follower from the dead (https://www.biblegateway.com/passage/?search=Mark%205%3A21-43&version=NIV). This is incredible, and portrays that those who are faithful to God will be healed of all diseases and disabilities. Personally, I imagine the sick and the disabled followers of Christ are some of the most devout of us all, considering they were dealt an awful deck of cards and still manage to have faith in the Lord. I believe that the Gospels make us look at the events of the book in a completely different light. Just because they wouldn’t be able to live the life of an able bodied person does not mean that their life means less in the eyes of the Lord. The disabled being prioritized last was a decision that is not at all justified within the words of the New Testament. In Hans Reinders’ article about how Christians should view the disabled, he is adamant that Jesus preaches disability should not be viewed as a punishment from the Lord, but instead should be viewed as learning more about how God moves through different people. I think that this is an important topic, as it clarifies that sick and disabled people are meaningful parts of society, just like any able bodied person. Viewing it in this way makes it fairly clear that the triaging system within Memorial Hospital is most likely not something that aligns with scripture. No person should be put above another just because they are able bodied, and it is an ethical grey area to allocate the resources away from those who are disabled, or those who would be facing a disability in the future.