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Season 15 | Episode 1

Playing God: The Broadcast

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(Photo Credit: Twm/flickr)

When people are dying and you can only save some, how do you choose? Maybe you save the youngest. Or the sickest. Maybe you even just put all the names in a hat and pick at random. Would your answer change if a sick person was standing right in front of you?

In this episode, we follow New York Times reporter Sheri Fink as she searches for the answer. In a warzone, a hurricane, a church basement, and an earthquake, the question remains the same. What happens, what should happen, when humans are forced to play god?

Produced by Simon Adler and Annie McEwen. Reported by Sheri Fink. 

In the book that inspired this episode you can find more about what transpired at Memorial Hospital during Hurricane Katrina, Sheri Fink’s exhaustively reported Five Days at Memorial

You can find more about the work going on in Maryland at:

Very special thanks to Lilly Sullivan. 

Special thanks also to: Pat Walters and Jim McCutcheon and Todd Menesses from WWL in New Orleans, the researchers for the allocation of scarce resources project in Maryland - Dr. Lee Daugherty Biddison from Johns Hopkins University School of Medicine, Howie Gwon from the Johns Hopkins Medicine Office of Emergency Management, Alan Regenberg of the Berman Institute of Bioethics and Dr. Eric Toner of the UPMC Center for Health Security


Sheri Fink

Comments [26]

Laurie Walters from California

I too wondered if anyone in the large public group that was assembled to discuss the dilemmas of triage offered the idea of 'volunteers' as part of a solution. I am 71, pretty healthy, but if I had been a patient in that New Orleans hospital, especially if I was being treated for advanced cancer, or had dismal prospects due to any other condition, I would have wanted the chance to decide for myself. Letting oneself die so others can live, especially if one already had a long and good life, might feel like a good way to go. We are rarely at choice about our deaths, and my guess is some patients would have offered. I like to think that I would, but of course that is only a thought, at a safe distance. One never knows how brave one would be in the actual circumstance.

Jan. 31 2018 06:05 AM
Elizabeth Miller from Kingston, New York

Many years ago, visiting my comatose grandmother, who was dying from pancreatic cancer in a hospital, she started moaning and I saw blood on the bed sheets. I called for a nurse. She offered to administer morphine to ease my grandmother's apparent pain but explained that it would probably end her life. I chose easing her pain. It took some time for me to understand that I had made the right decision. I know that administering morphine was the humane thing to do for a woman I loved.

Jan. 29 2018 08:35 PM
Victoria from New York

Thank you Radio Lab for exploring what needs to be explored.

This episode was hard to listen to, but I'm so glad it exists.

Jan. 29 2018 03:03 PM
Sarah from CA

I observed Sheri Fink as asking great questions but being overly emotional. She was also negatively judgemental of the the medical providers in the disasters in New Orleans and Haiti which was unnecessary and even disturbing.

It is imperative to develop policies without using our emotions or focusing on individual humans and stories. Disaster triage is evidence based. There are nuances and room for flexibity as Sheri implies, but that, to, can be a slippery slope and detract precious resources such as time and brain power from a disaster.

It seems to be the human condition to place unrealisticly high value on human life. Death is inevitable and natural. Why is it considered monstrous to provide palliation to the brink and sometimes beyond of euthanasia to humans who are suffering and dying?

These sound like judgements to me of a medical school graduate who never practiced medicine and who certainly has not sat with many suffering, dying people. Once you have done so it can change your perspective about death and end if life care.

Jan. 28 2018 07:38 PM
John from Cleveland

Such drama queens. Really.

We make these same decisions every darn day, minus the heartrending crisis and the radio coverage.

Its called for-profit health insurance. An entire industr created, essentially, to deny people care. To deny them care for the worst of all possible reasons: money.

Another example? The very, very healthy percentage of Americans who desperately want to deny life saving care to their peers, and lobbied and pressured and voted to do so. At least this time out it wasn't about money alone; there were healthy doses of racism, class-ism, and xenophobia tossed in to leaven the mix.

I understand the pathos, sorrow, and guilt in the situations you describe in your broadcast. But it all seems a little artificial, like weeping at Old Yeller's death scene, in light of the cavalier way we sentence one another to die on a daily basis.

Jan. 28 2018 03:51 PM
Greg Wilson from Wilmington, DE

Thank you, RadioLab.

We need radio programming like this to remind us of the importance of story telling. We need to hear the human voice amidst our common travail & daily struggles.

I’d forgotten about the tragedy and heroism at Memorial Hospital and thank you for reminding me of what happened in such a compelling fashion.

Jan. 28 2018 02:22 PM
Brian from San Francisco

I wish she would of covered people who lost their lives because they did not have access to oxygen. The show's conclusion that it's impossible to make these kinds of choices is wrong. It's difficult to make these choices. The producers caved to the reporter's emotions and gave credence to an ethically suspect system for triage based on popularity.

Jan. 28 2018 12:51 PM
anna beth strawe

This reporter interviews a doctor who admits early on in the interview that she was never trained in the scientific triage process with evidential support that it saves the most lives. She failed her patients and she was also distressed due to her lack of training. Then she goes on to describe situations in which medical professionals failed to develop emergency plans. Unfortunately, this happens often (Hollywood, FL, Irma 2017)but is not the norm. This is irresponsible reporting since the reporter did not also show the other side: The strong majority of emergency and critical care health professionals who 1. make emergency plans, and 2. know life-saving triage procedures. Summary: a poor and inaccurate report of the expertly trained health care profession responding to catastrophic events.

Jan. 28 2018 12:35 PM
Judith Levine from Brooklyn, NY

A powerful, moving & complex program about personal and institutional decisions.

But the picture is marred by leaving out the context in which these decisions are made: that is, U.S. welfare and health care policies that allow some people to die because they have no health insurance, poor nutrition or housing, lethal working conditions etc. Black people have higher mortality rates than white people; poor women of color die in childbirth at far greater rates than middle-class white women. etc.

It was good when you challenged one of your interviewees when she seemed to be evading the question of rationing. But until we have high-quality universal health care we are deciding who will live and who will die. The only difference is that these decisions are hidden in bureaucratic language and political cant.

Jan. 27 2018 06:43 PM
Amir from Boston

Really amazing and quite visceral episode. One I’ve listened to several times and have recommended to other people, especially fellow healthcare workers.

I was just listening again and noticed you deleted the moment the oxygen-dependant woman had it taken away.. I can understand how for several reasons that might be too much or perhaps private, but wanted to say it’s also the most powerful moment of the whole episode — as she says “Oxygen!” — that drives the whole dilemma of triage to life. It’s difficult, and it’s exactly what makes it real.

Oct. 04 2017 10:26 PM
Fisher from Texas

Fascinating program, as always. But I am surprised that it never was even brought up to ask the patients what they thought.
Their take would be interesting--and varied, of course. Some might choose to give their lives for someone else. I'm certain that my mom--whom I recently lost to cancer--would have readily given up any resources devoted to her at the end of her life, if she thought she could help a disaster victim survive.

Jun. 02 2017 12:29 PM
Robert from Oceanside, CA

When I first heard this episode, I was enthralled with the ethical choices that were made, the ambiguity of those choices, and the pure human drama. I kept it in the back of my mind as the source for a project with my English 11 students, which I have finally put into place. We listened to some excerpts from the show, read some articles related to the issue, and now we are in a hypothetical situation where a tsunami has hit the west coast and our high school is a tsunami evacuation site (which, indeed, it actually is). Right now they are playing "Playing God Roulette" to get their patients, and they are debating how they will triage them and what their rationale is for their assessment.

May. 31 2017 01:54 PM

The questions asked in this episode are highly important, and thanks for bringing them up.

The prioritizing procedures described here sound absolutely horrible and terrifying, as taken from hell. The descriptions of denying the oxygen from the patient left me with the same feeling as if it was a cold-blooded murder. I would prefer a more equal and humane treatment, such as the lottery, which would feel right and fair to everybody, at the cost of reducing the "total good" measure.

To clarify: I have no complaint for the doctors involved, which tried to get the best out of these miserable situations (and are responsible for saving many lives).

As a Jew from Israel, I couldn't help remembering the Holocaust. The Nazi soldiers believed that they are purifying the human race by killing the weaker people, thus improving the total goodness in this world. A research (by a scientist whose name I forgot) made in America after World War 2 showed that these atrocities could have possibly happened in every society. The researcher showed how easy it is to persuade people into electrifying others, while seeing them suffer badly, by convincing them that the electrified people are benefited from it (the electrified people were actually just actors - a fact not known to the electrifying ones). Afterwards, the electrifying people suffered psychological problem, understanding what they have done. This all shows how dangerous it is to play god.

Mar. 25 2017 06:28 PM
Sigal from boston ma

thank you radiolab for yet another amazing episode. Chilling and powerful!

Mar. 04 2017 06:07 AM
Mike from Seattle

Don't worry about these trolls like PA, Sheri. Great work. I loved your story.

Feb. 27 2017 04:14 PM
Bethany from California

Wow, what a powerful concept. It is so easy for people to speculate but much like the episode pointed out... it is 1,000 times harder to execute. Thank you Sheri Fink for lending your voice. Completely thought provoking.

Jan. 18 2017 12:33 AM
Bob Nesbit from Augusta

I was surprised that the original God Committee story - about the beginnings of chronic hemodialysis in Seattle was not mentioned.
It would be worthy of a story of its own.

Jan. 17 2017 04:49 PM
Sheri Fink

Greetings everyone. Sheri here, the reporter in this episode. I really appreciate the ideas and critiques and am glad you all listened and are engaging on these issues. I wanted to answer Bert from PA's comment. In fact I did follow the oxygen, as you suggested, but unfortunately the Radiolab episode couldn't include every detail. I agree with you that it's important to know what actually happened with Nathalie's oxygen concentrator. And the answer is that it sat unused for days after she was disconnected from it. Also, the hospital was ultimately able to secure more oxygen and diesel. One of the important things to remember when it comes to triage is that resources can fluctuate quickly and it's important to be flexible and reassess the needs and the ability to address them. Sometimes it all seems like a zero sum game, but much more frequently it is not.

Jan. 16 2017 12:56 PM
Siri from pdx

My PBS station had this Radio Lab in soon after the Innovation Hub interview with Paul Bloom (author of Against Empathy) about how empathy sometimes leads us astray. The final Radiolab story illustrates the dilemma well.

I also think that it's wise for the decision maker--if he or she absolutely has to make those decisions--to not meet the people whose fates are being decided. That's a hard job that I'm unsure I could do.

Jan. 15 2017 07:15 PM
Dr E from Rochester NY

Very interesting program. I do understand the human desire to save everyone but when it is presented in the abstract people easily revert to very cold calculating choices that align with their valuat ion of the worthiness of others. As a palliative care physician I might approach a problem with trying to align medical choices with patient goals but that is often impossible under the conditions you presented. Traveling to poor developing countries puts the stark choices in relief and I also agree that the journalist was remiss in following her emotions. We suddenly care about the at risk individual without putting the story into perspective of how the most wealthy powerful countries denies our standards to others because the "invisible" are not worthy of putting compassionate policies into place to help these poor undeserved people. It is nauseating and elitism at its worst to step in and presume to play God without advocating for policy changes to help all.

Jan. 15 2017 07:09 PM
Donna from Florida, USA

What a horrid program, it really gives one a taste what collapse will look like. Someone said that a pregnant woman should be saved, why? The world is overpopulated, the elderly could contribute more in terms of knowledge or even, perhaps, wisdom, why do you think evolution created the menopause? Instead of focusing on how to make these horrid decisions, why don't we focus on how to curb human population by not breeding, so we do not have to face shortages and decisions like that? It is better to not yank someone out of nothingness than to murder those already here. No one can bring themselves to talk about overpopulation because "muh cute babies!" while at the same time, there is a definite campaign going on to completely normalize elderly euthanasia using the same utilitarian approach discussed in that program. We are really entering the slippery slope era, because once you have crossed the line, there is no way back, and we are a Sparta society once again.

Jan. 15 2017 12:09 PM
Christine Owens from St. Louis, MO

The academic discipline of medical ethics studies several frameworks for distributing scarce resources. These frameworks are described in the following resource: We make decisions around scarce resources all the time in our personal lives. These frameworks are useful for many levels of decision making as they raise our awareness about our values.

Jan. 15 2017 10:36 AM
Sean Watson

One part of rationing I have not heard yet is that medical devices are regulated to be as close to perfect as possibly. There could be a choice between substandard and standard not standard or nothing. Often the difference is vary slight. For insurance when expiration dates are set.
Good story.

Jan. 14 2017 05:53 PM
Bert from PA

"I followed her"

Typical journalist bias. You followed the emotional story instead of the logical story. You covered what is interesting instead of what is important.

You should have followed the oxygen, should have found the human being that was saved by withdrawing the oxygen from that patient, should have balanced the powerful emotion on one side of the decision with an equally powerful emotion on the other side.

Journalism fail.

Jan. 14 2017 02:06 PM
Tedly Melis from Flagstaff, AZ USA

J & R,

A really impactful program; thank you and all involved.

My premise as an environmental science researcher who has devoted his entire career to sorting through the data on how best to manage ecosystems and their resources vital to the survivla of Earth's species (including us), is:

How to collectively approach triage for the globe and all of its inhabitants?

I might suggest a future episode that scales the complex concepts introduced in this program, up to the questions of survival of life on this planet under the current processes that threaten us all.

Sincerely yours,

A concerned scientist and human being.


Jan. 13 2017 09:25 PM
Sonja from Boulder, CO

Did you discuss these options:

Explain the situation to those most likely to fail then asking for volunteers to end treatment.

Treat women and children first.

Develop a computer program that grades everyone on the same, very specific criteria then let the computer choose; with the backup option of a preselected three doctor panel overriding the computer?

Also, if there is a likelihood of a pregnant patient surviving, the second life & viability of the child should be considered.

Thank you.
Sonja Knaisch

Jan. 12 2017 03:16 PM

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