The Art of Dying

Fighting for life, preparing for death

L.S. Dugdale
L. S. Dugdale is a physician and ethicist at Columbia University in New York City, and author of the forthcoming The Lost Art of Dying.

In late April, Plough’s Susannah Black spoke with Dr. L. S. Dugdale, a medical ethicist and physician at Columbia’s New York-Presbyterian Hospital. The conversation gives vivid insight into the challenges involved in working through the pandemic in one of the hardest-hit cities in the world.

Plough: Can you describe your work? How has what you do changed over the last couple of weeks?

Dugdale: My non-pandemic clinical life is as a primary care doctor. I also direct the Center for Clinical Medical Ethics at Columbia University, which focuses on the doctor-patient relationship and ethical issues in the care of patients. I’ve been . . . well, I’ve been busy in the last few weeks.

Early on, I mostly saw patients in an extension of the ER who were concerned they might have coronavirus but who were less sick. Then word got out that if you were sick but breathing okay, yes, you might have coronavirus, but you should probably just stay home. So the only people coming to the hospital were really ill. I found myself in the ER, taking care of the many, many patients being admitted.

Can you talk about the ethical challenges that doctors have faced?

There’s been a push by hospitals in anticipation of potential shortages to come up with policies guiding allocation of ventilators or other scarce resources. We’ve had rigorous discussions, scoured literature, spoken with other institutions. Fortunately the situation has never, so far, been quite that dire in New York; we prepared for something that didn’t happen as severely as it might have. That’s what you hope for, when you make those kinds of preparations.

Continue reading at Plough Quarterly.