What Rubenfeld was referring to was the onus on patients to be prepared (by way of advance directives, proxies etc.) in order to assist medical staff in the allocation of precious hospital resources. In many countries during COVID, the demand for life support exceeds supply. Having your plans spelt out and your representatives in place is not only a clever thing to do, it could even be argued to be an ethical obligation in this time of great
need. Equally, why not complete a ‘I Bequeath the Python’ end of life planning guide (available on the Exit Interational website)? Take this opportunity to get all your papers together in one place.
In this time of COVID, advance directive plans might wisely include a number of extra considerations such as whether or not you wish to go to hospital, even if your oxygen levels are dropping and you are recommended active ventilation in an ICU. Or perhaps you want passive ventilation, if it means you can stay at home. If you are hospitalised, for how long would you want to be kept alive on ventilation? Do you have a limit? And would you want to stay on ventilation if your other organs (eg. kidneys) began to fail? These are all real life COVID scenarios.
In some ways, COVID is the greatest incentive we have to getting one’s house in order and it is a good time to give consideration to the concept of informed ‘assent’. (This notion was alluded to earlier in the discussion of physician or medical life -sustaining treatment orders).