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With an anticipated shortage of ventilators for patients with coronavirus disease 2019 (COVID-19), hospitals, physicians, and nurses may have to make an unprecedented decision: should they withdraw or withhold ventilators from some patients and use them for other patients who have a better chance of survival? It is not uncommon for care teams to decide against initiating or continuing mechanical ventilation when such treatment would not achieve a patient’s goals or directives. COVID-19 presents a different case: patients who do not receive a ventilator could benefit, perhaps living for many additional years, if they receive short-term mechanical ventilation. Denying patients such treatment, against their wishes, most likely will result in their death, but it will also make this scarce resource available to other patients who are more likely to survive if they receive ventilator support.
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Corresponding Author: I. Glenn Cohen, JD, Harvard Law School, Griswold Hall Room 503, Cambridge, MA 02138 (firstname.lastname@example.org).
Published Online: April 1, 2020. doi:10.1001/jama.2020.5442
Conflict of Interest Disclosures: Dr White receives grant support from the National Institutes of Health/National Heart, Lung, and Blood Institute.
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