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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: www.nytimes.com/triage

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

Guests:

Sheri Fink

Comments [13]

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.

https://soundcloud.com/innovationhub/bloom-empathy

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: https://www.scu.edu/ethics/ethics-resources/ethical-decision-making/a-framework-for-ethical-decision-making/ 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.

Tedly

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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