Problem
In the spring as COVID-19 swept across the United States, governors, health care organizations, and state public health departments began to implement various legal mandates from social isolation, adherence to face mask use, and management of COVID-19 patients. On March 25th, New York Governor Cuomo released the directive through the New York State Department of Health led by Howard Zucker, MD, JD, Commissioner to all Nursing Home (NH) Administrators, Directors of Nursing, and Hospital Discharge Planners, "all NHs must comply with the expedited receipt of residents returning from hospitals to NHs (Harrington, Gormley, & Schwartz, 2020). Residents are deemed appropriate for return to a NH upon a determination by the hospital physician or designee that the resident is medically stable for return" due to the need to expand hospital capacity and care for patients with COVID-19 requiring acute care. Cuomo's order stated: "No resident shall be denied readmission or admission to the NH solely based on a confirmed or suspected diagnosis of COVID-19. NHs are prohibited from requiring a hospitalized resident who is determined medically stable to be tested for COVID-19 prior to admission or readmission."
As such, the mandate barred nursing homes (Links to an external site.) from requiring incoming patients "to be tested for COVID-19 prior to admission or readmission." The directive was intended to free up hospital beds for the sickest patients as cases surged. But relatives, patient advocates and nursing home administrators have called it a misguided decision, blaming it for helping to spread the virus among the state's most vulnerable residents.
This order stayed in effect for 46 days during which time over findings revealed that 6,000 patients with the virus were placed into these facilities housing our most vulnerable. Since January 28, 2021, the number of deaths were undercounting an estimated 12,743 long-term care residents died (Links to an external site.) of the virus. At this point, the death toll in our senior living facilities in New York alone was bigger than 9/11 and Hurricane Katrina combined.
A. Would you consider this ethical issue to be a form of political malpractice? Discuss your answer.
B. What could have been done differently to prevent the ethical case of returning elderly COVID-19 patients back to the nursing home? Explain.
C. Here we have an ethical issue that involved the state government and a healthcare facility. Currently, pressure continues to open an investigation. Discuss your thoughts about the unforeseen circumstances of the COVID-19 pandemic that led to so many elderly nursing home residents' deaths and the collision of ethics, law, and politics.