Jurisprudence

Many Hospitals Still Haven’t Canceled Elective Procedures. They Need to Do That Now.

A sign outside NewYork-Presbyterian Hospital pointing to the emergency room.
NewYork-Presbyterian Hospital is doing the right thing and reportedly delaying elective procedures.
Cindy Ord/Getty Images

Hospitals that continue performing elective procedures during the COVID-19 pandemic are irresponsible and shortsighted. In Wuhan, one study showed that 41 percent of new infections were transmitted in the hospital—to previously hospitalized patients and health care workers. If we learn anything from colleagues around the world who are forced to ration medical care, it’s that we must act swiftly to minimize unnecessary exposure to our hospitals. Patients will die in this pandemic. So will doctors, nurses, and other health care workers. Cancellation of elective procedures is an important step to help flatten the coronavirus curve.

As an anesthesiologist and medical ethicist working on the front lines of this pandemic, I’m keenly aware of the ethical dilemmas facing health care workers, like never seen in modern medicine. The COVID-19 pandemic will stress hospital resources to their breaking points. This demands thoughtful consideration about resource utilization, saving critical personnel, equipment, and protective gear for those who need them most. We cannot allow elective surgeries to use resources that should be saved for critically ill patients. It’s time to preserve as many hospital beds, intensive care beds, ventilators, and personal protective equipment as possible. Many hospitals run on very lean supply chains, choosing to maintain only a few days’ or weeks’ worth of some equipment, like N95 respirators. That means there may not be enough personal protective equipment to go around.

Operating rooms are the economic engines of hospitals across the country, and canceling procedures will admittedly cause a massive financial impact on hospitals. Each year in the United States, more than 53 million elective surgeries and colonoscopies are performed, leading to $472 billion in outpatient revenue to health care systems. As a result, some hospital administrators may delay the decision to cancel elective cases, fearing the deep financial impacts this will have on the bottom line. Finances must, however, be a secondary concern. If we wait, it will cost significant human life.