Life and death decisions are an expected — and it should go without saying — extremely difficult part of the medical profession.

Two people are brought into the emergency room. One is the victim of a serious gunshot wound and the other a terrible car accident. In a matter of moments, the physician on duty has to determine the extent of the injuries, the life-threatening nature and, quite possibly, who has the best chance of survival so that resources can be used most efficiently.

That may sound like a rare scenario … and maybe it is, until a pandemic sweeps through your community and our state.

And for those who would dismiss the likelihood of small, rural communities being faced with such gut-wrenching decisions they may want to hold that thought. Even while local emergency rooms and staffing may not be facing a crisis situation, that’s not true elsewhere.

More than 90 percent of the hospital ICU beds are in use in Alabama, Arkansas, Florida, Georgia, Mississippi and Texas. Kansas is doing a little better with 73 percent of the ICU beds in use as of mid-week.

That can create a serious dilemma for healthcare professionals. Scott County Hospital is no different than any other rural provider which must transfer heart attack and other major trauma victims to facilities better equipped to handle these patients.

However, when a heart attack victim arrived at the emergency room recently, it was another eight hours before that individual could be Lifewatched as local medical staff tried to locate an available ICU bed.

That kind of a delay, as a local physician pointed out, is obviously life-threatening and can lead to health issues.

Idaho, which has one of the lowest COVID vaccination rates in the nation, has enacted a Crisis Standards of Care Plan which allows hospitals to ration health care. In other words, hospitals can make their intensive care unit rooms available for those patients they think are most likely to survive. Those without a life-threatening condition may see their treatment delayed.

That is a harsh reality which other states and healthcare providers have been forced into by this pandemic. It’s a situation which, it can reasonably be argued, could be avoided if more people were responsible enough to get a vaccine and take precautions when around vulnerable individuals.

While hospitals have guidelines to follow in the event they are forced to take such drastic measures, why shouldn’t an individual’s vaccination status be part of the equation?

A COVID patient without a justifiable health reason, who is not vaccinated and is occupying an ICU bed, made a conscious decision to put themselves at risk. That can’t necessarily be said of the heart attack victim or the person who is involved in a serious accident.

That’s neither cruel or heartless. It’s pragmatic. It’s no different than deciding whether to prioritize the care of a 95-year-old on life-support over that of a 15-year-old faced with a life-threatening situation.

If someone has tried to do the right thing to protect themselves and others by taking the vaccine they shouldn’t have to wait in line behind someone who opted to ingest bleach or horse dewormer.

Of course, it’s easy to bluster about “personal freedoms” and promote conspiracies about Bill Gates that are popular on right-wing Facebook posts and among conservative pundits.

It might interest some of those audience members to know that during the past five weeks, five conservative radio hosts who were very vocal COVID deniers, anti-vaxxers and anti-maskers have died of the virus.

You can guess how many of them refused medical care when their ignorance became a matter of life or death?

The battle cry of “personal freedom” turns into a whimper when the Grim Reaper is knocking at the door. The response would be no different from the 47 percent of men who voted for Donald Trump last November and say they refuse to get vaccinated.

One’s perspective take a dramatic turn when they are hooked up to a ventilator and fighting for every breath of life.

When interviewed, how often have those same anti-vaxxers offered the advice that, “If I had this to do over again I wouldn’t change a thing”?

Sorry, but we don’t feel any remorse for those individuals who died because they chose “personal freedom” over “personal responsibility.” We feel no empathy for the individual who had access to a life-saving vaccine, but instead heeded the advice of conspiracy nut cases who didn’t want Bill Gates tracking their every movement.

What’s regrettable is that these are the people filling ICU beds, draining healthcare resources and wearing down overworked health professionals while a physician in a rural community is desperately trying to find a hospital with bed space for a critically ill patient who didn’t have a choice.

It’s probably a good thing that we aren’t the ones deciding who gets a bed and who doesn’t.

What some call personal freedom, we refer to as Darwin’s natural selection. In the end, perhaps it’s just a different path toward the same outcome.


Rod Haxton is publisher of The Scott County Record. He can be reached at

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