On Call with Dr. Pepe
Healing and Hope on the Front Line
The COVID-19 pandemic has been a stressful, life-changing and, in some cases, faith-challenging experience for everyone. I recognize that some of you who are reading this column have experienced personal loss as result of the pandemic and I extend my sympathies to you. As CEO of a Catholic hospital, one of the most stressful things to have witnessed was the discussion around how to allocate scarce resources to our fellow human beings. The Italian government reportedly recommended that health care resources be rationed to patients by age and the largest number of life years saved. Others suggested to first save those with the highest quality-adjusted life-year (QALY), which is a measure of disease burden that includes both the quality and the quantity of life lived. Imagine having to make these choices when you have taken an oath to heal and protect.
Triage and rationing protocols are necessary when there is a lack of resources, so long as those protocols incorporate sound ethical principles in the Catholic moral tradition. At Catholic Medical Center, we understand that all life has equal value. When in a disaster or crisis mode, Catholic Medical Center adopts a set of ethical norms for disaster management that is consistent with CMC’s mission and values, and is based on the Ethical and Religious Directives for Catholic Health Care Services (ERDs) and current literature on the ethics of disaster management. Discerning these matters is a collaborative effort between caregivers and leadership. The allocation of resources is based on objective measures that take into consideration the dignity of every human life, as well as CMC’s mission to provide health, healing and hope. In allocating scarce resources, we need to remember that we are united to one another as St. Paul so powerfully stated in Galatians 3:28: “There is neither Jew nor Greek, there is neither slave nor free, there is no male and female, for you are all one in Christ Jesus.”
We never ration scarce resources based on age, status, disability or someone’s definition of “quality of life.” We will always allocate resources in a fair and equitable manner and without discrimination. CMC will be guided by the principle of ethically proportionate and disproportionate means of preserving life. We will stand up for the marginalized and vulnerable. Most importantly, we will allocate these resources to those most likely to directly benefit from treatment rather than those arbitrarily considered most worthy. Lastly, we will never abandon any patient and will always provide palliative care when a decision is jointly made to end treatment.
I have never been more proud of our troops on the front line. The health care workers at CMC ran into this battle, risking their lives and jeopardizing their families. They did this because they were called to do so. We must support them in the difficult decisions that nobody wants to own. These are the men and women of the year! May God bless all of them.
Dr. Joseph Pepe is the president and CEO of CMC Healthcare System: Catholic Medical Center, New England Heart & Vascular Institute, and several subsidiaries. He and his wife reside in Manchester.