"Geisinger's policy for heroic measures on COVID-19 patients is still in development but will mirror our well-established obligations and policies to do what is right for our patients in similar end-of-life situations," the statement said.
"A critical part of the policy will be consultation with patients and families to discuss the course of treatment in the event of life-threatening complications," the statement continued. "We do not plan to override patient or family wishes, but rather our goal is to have these conversations proactively with families early on during treatment so there is uniform understanding of care that is safe and compassionate for patients, families and staff alike."
Northwestern Medicine, which includes Northwestern Memorial Hospital in Illinois, also told CNN in a written statement on Thursday that "similar to many health systems around the country and the world, we are conducting internal discussions on how to care for patients with COVID-19. At this time, we do not have any changes to patient care policies to announce."
Some other large hospital systems have been discussing issues around do-not-resuscitate orders, The Washington Post reported Wednesday night.
"It's true that there have been discussions abroad about how physicians must prioritize patients -- and it's my understanding that those will still be on a case-by-case basis," Dr. Darria Long Gillespie, senior vice president of clinical strategy at Sharecare and a clinical assistant professor at the University of Tennessee School of Medicine, wrote in an email on Wednesday.
She added that she does not foresee a universal do-not-resuscitate approach for all COVID-19 patients, which ignores age and baseline health, on the horizon.
Nancy Kass, the Phoebe R. Berman professor of bioethics and Public Health and deputy director for public health at Johns Hopkins University in Baltimore, told CNN that she doesn't think blanket DNR orders for coronavirus patients would be appropriate, with some important caveats.
"A blanket DNR order is not helpful in this situation, nor for other situations going forward because I think it opens the door to DNR orders for subgroups of patients or patients with particular conditions being reasonable policies and I don't think that makes sense," Kass said.
Kass added, though, that she thinks that patients shouldn't have the right to request medical care that doctors think is not likely to be helpful in any circumstance, not just related to coronavirus patients. It's a longstanding debate in medical ethics, she said.
In the United States, Kass said that she thinks systems often err on the side of allowing families to request "a remarkable number of things" that physicians may not necessarily believe could help a patient -- and that conversation is particularly relevant to the COVID-19 response since medical personnel are put at great risk due to shortages of protective equipment.
The fact that the conversation is occurring because of a lack of staff and equipment in this country "is stunning" and "unsettling," Kass said.
"It is really unsettling because you know it's one thing to feel like your loved one died from a horrible disease, or nobody could do anything and that is so deeply sad," Kass said. "But people would not have the same kind of anger they might have when they feel, on some level, that this might have been preventable had people only had the right equipment."
'A Significant Shortage of PPE'
World Health Organization officials warned during a media briefing on Wednesday that globally there is a "significant shortage" of medical supplies.
"We need to be clear: The world is facing a significant shortage of PPE for our frontline workers -- including masks and gloves and gowns and face shields -- and protecting our health care workers must be the top priority for use of this PPE," Dr. Maria Van Kerkhove, WHO infectious disease epidemiologist, said during that briefing.
All elements of the supply chain for supplies appear to be under "extreme strain," Dr. Mike Ryan, WHO executive director of health emergencies program, said during the briefing.
"There are problems in the supply chain all along that chain. The simple issue is demand," Ryan said. "There are shortages of PPE, shortages of ventilators and other products for the medical response to COVID. We also have to avoid shortages in other medical supplies, as supply chains come under strain."
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