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ZDoggMD

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Front lines in the ICU with COVID-19

Reality is teaching a hard reality lesson with COVID-19.

This video concerns the minority of COVID-19 patients who require intensive care and the less than 1 percent who die of the disease. The discussion about the course of the disease and treatment is possibly too technical and brutal for the general public, so watch the whole thing with care.

However, I’m hoping to spur conversations about end of life in light of the broader COVID-19 crisis and specific crisis events.

This is a tough, highly technical discussion between Dr. Zubin Damania, a blogger otherwise known as “ZDoggMD” and Barbara McClean, MN, RN, CCRN, NP-PC, an expert in Critical Care & Intensive Care medicine in an Atlanta, Georgia teaching hospital with over 100 ICU beds. The first few minutes show Barbara McClean as a compassionate caring practitioner and educator. I believe and trust what she says about the worst case (stressing, again: fortunately these are the minority!) outcomes with COVID-19.

If you want to get to the meat of the video, there’s a “philosophical discussion” about the very real, unique in this modern age, futility of CPR in COVID-19 patients whose hearts stop due to the disease at 35:00 to 41:00.

There’s also interesting information about Personal Protective Equipment (PPE) difficulty (not shortage, but the physical reality) at the segment 30:00 to 35:00 minutes.

COVID-19 is, as Ms. McLean says, an unpredictable, sometimes deadly disease. Currently, patients can go from minor symptoms to death due to respiratory failure and cardiac arrest in as little as 4 hours. There is very little success to date in attempts to resuscitate patients who “code,” whose hearts stop, while in distress due to the virus.

I can’t stress enough that we need to talk, we need to make decisions among our families and to understand that this disease takes some options, some autonomy we have come to assume are our rightful “choices,” completely off the table. This disease doesn’t care what we want.

I’m unable to turn comments back on for this post. Please post comments to my Facebook page and I will try to keep up with replies. Let’s keep this on the level of philosophy and medical ethics. I will delete political criticisms.

Let’s keep this on the level of philosophy and medical ethics. I will delete political criticisms.

Arguing Abortion on YouTube

I usually agree with this doctor. But not about abortion. ZDoggMD, Zubin Damania, has a sense of humor and a sense of balance. But today, he demands that we to “come to the center” because 1 in 4 women in the US have an abortion by age 45. “It happens.”

Well, according to the 1860 US Census, approximately 25% of families owned slaves. “It happen(ed).” Common ground was hard to find there, too.

The question is whether or not abortion ends the life of a human that is human-enough to possess the Human Right not to be killed. Are they one of us and can we kill them if they don’t threaten our lives?

The first question has been definitively answered, at least scientifically. Louise Brown was born 5 years after Roe v Wade. Serial ultrasounds showing the progression of the egg to embryonic organism to fetus were possible soon after. (I’m tempted to echo the ZDogg, “Grow up and get into the 21st Century.” But of course, I won’t.)

Answering these questions according to ethics and law can’t be addressed by science and requires a bit more discussion. Nevertheless, the trend in Western societies has been toward including all humans as rights bearers endowed with at least the right not to be killed or treated as the property of another and preventing legally sanctioned killing and enslavement, regardless of characteristics, abilities, or background.

Beyond the life of the mother, the rest of ZDogg’s arguments are the usual justification for what I call, “I want” ethics, including arguments for the “control of the woman’s body,” the health of the woman, and exceptions for rape and incest.

Nik Hoot, a 20 year old young man from Indiana, lost his feet and part of his legs and fingers to an attempted abortion, but survived to be adopted, eventually a State Semi Finals high school wrestler, and a productive member of society. His mother’s body didn’t lose limbs; his did. As he says, he has to “live with someone else’s choice.”

As to the health of the mother, how could anyone know at 12 weeks that there will be sequelae at or after delivery?

The safety of abortion is most often reported using short term data. There’s support for increased mortality and morbidity in the long term, however.

Late discovery of fetal abnormalities isn’t a good argument in favor of induced abortion, either. After 15 weeks and definitely after 20, it’s statically safer for the mother to carry to term.

I won’t even entertain arguments that crime is down because the unwanted are killed. “Minority Report” has a double meaning, here.

Here’s an article from The Atlantic – not an “anti-choice” publication, by any standard – focusing on the rape exception.

Let’s face it: the wrong human is killed by abortion justified by reason of rape or incest. If you cringe at that statement, you might want to consider why.

Edit: Comments are closed. Please comment on my Facebook page.

Beverly B Nuckols, MD

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