NYU Langone tells emergency doctors to consider who gets intubated, WSJ reports

A March 28 email from the NYU Langone Health Department of Emergency Medicine Chair told physicians to “think more critically about who we intubate,” according to a report from The Wall Street Journal.

“In Emergency Medicine, we do not have the luxury of time, data, or committees to help with our critical triage decisions. Senior hospital leadership recognizes this and supports us to use our best clinical judgment,” the email from Dr. Robert Fernia said, according to The Journal.

“For those patients who you feel intubation will not change their ultimate clinical outcome (for example cardiac arrests, some chronic disease patients at end of life, etc) you will have support in your decision making at the department and institutional level to withhold futile intubations,” the email continued.

The hospital system is not yet in the position to make those difficult ethical decisions, according to an NYU Langone Health spokesperson.

“The guidelines that were outlined in this e-mail have been in place well before the coronavirus crisis. However, given the present environment, we felt it was important to re-emphasize to our emergency medicine staff what these guidelines explicitly say, and to assure them that the decisions that they make at the bedside will be supported,” the spokesperson said in a statement to CNN.

“We take our responsibilities to patient care extremely seriously, particularly in these challenging times when our emergency rooms are a critical point of entry,” the hospital added. “In addition, and equally important, we are committed to maintaining an environment that supports our staff, and gives them the appropriate tools and guidance to make sound judgments. At the same time we want to be as transparent with them as possible as we plan for every potential situation as this pandemic unfolds, so that they know they have our guidance and support every step of the way.”

Kathy Lewis, executive vice president for communications and marketing, said in another email to staff that NYU Langone’s longstanding policy required faculty, residents and staff to forward all media inquiries to her office.

“Anyone who does not adhere to this policy, or who speaks or disseminates information to the media without explicit permission of the Office of Communications and Marketing, will be subject to disciplinary action, including termination,” Lewis wrote, according to The Journal.

The hospital also reiterated another policy dealing with staff interactions with media.

“There has always been a longstanding policy at NYU Langone Health — long before the coronavirus crisis — that stipulates the same message that was highlighted in the memo that went to staff. The purpose of this policy also is to protect the confidentiality of our patients, and our staff, particularly as we respond to this unprecedented crisis,” the hospital said in a statement to CNN. “Because information related to coronavirus is constantly evolving, it is in the best interest of our staff and the institution that only those with the most updated information are permitted to address these issues with the media. We have a responsibility to the public at large to ensure that the information they receive from our institution is accurate.”