There are several philosophies of ethics, consequentionalism, values clarification, utilitarianism, moral absolutism, situation ethics, ethical realism, ethical hierarcicalism, principle ethics, and cognitive moral development. In this case there are two that make sense to use. One is utilitarianism which is the action that has the best result for the most people is the ethical action and the other is ethical realism which is that the ethical choice is the choice that is the lesser of the two evils.
With those definitions in mind, it seems that Memorial Hospital may have made ethical choices. Sometimes we confuse moral with ethics and that seems to have happened in this case as it will be seen during this discussion. The stakeholders in these decisions are many. They include the patients, the families, staff, physicians, hospital, stock holders, community, and the healthcare system. Each of these have a need for the right decisions to be made but each also has a need for the decisions to be made to suit their personal needs to.
Those making the decisions had to ignore all of that and make these decisions based on the best thing for the most people. There has been much criticism of the decisions that were made by the staff at Memorial Hospital in the wake of Katrina but no one can know what it was like there. The situation was worse than anywhere else in the sense that they had live very ill patients in a dark building in the sweltering heat with no fresh water, flooded floors, backed up sewage and sewer water surrounding them on the ground. They were alone, and they had no idea how long that would continue.
The staff had not slept in days and things were getting worse fast. Thirty four patients died during and after the storm and there is speculation that many were euthanized. In any public health emergency there are difficult decisions to be made. Scarce resources force the decision of who should get those resources and who will not and what do you do about the ones who will not? In this kind of a case, present recommendations are that the resources go to those who are most likely to survive (Douglas, White, Mas, 2009).
This is called the utilitarian approach. When this kind of decision is made, groups such as the elderly and those with functional impairment are likely to receive resources first. Remember, there is no wishful thinking here. These are decisions that if not made will assure that no one survives. There are certainly other ways to look at these issues for example what are the most life years saved, what are the most number of lives you can save, and who has the best chance to live (Douglas, 2009)?
In the case of Memorial Hospital, there were mothers and babies, elderly, extremely ill patients who could not get out of bed, patients on ventilators and one case that everyone talks about, the 350 pound bedridden patient that was young but could do nothing to help himself. At first, everyone believed that all the patients, staff, and visitors would be rescued but it soon became clear that was not the case. The decision of who would be rescued had to be made. Their first choices were babies and new mothers. This seems to be a very ethical decision under all of the mentioned points.
Once the new mothers and babies as well as a few of the younger patients were evacuated, evacuation came to a halt for awhile. Physicians ordered that only major treatments take place and that IV fluids not be used unless dire. Why? One of the reasons is the fact that the staff was exhausted and in order to allow them to sleep in shifts there had to be less treatments. This is one of the many decisions. All treatments could have been continued but staff would not have survived and the patients who were most likely to survive would not have received all of the treatment they needed.