Playing God

The 'Playing God' episode of 'Radiolab,' produced by Simon Adler and Annie McEwen with reporting from Sherry Fink, delves into the complex and morally fraught process of triage in emergency situations. The narrative begins with Sherry Fink's experience at the border of Kosovo and Macedonia in 1999, where she faced the harrowing task of deciding which refugees received medical attention and which were sent to the 'tent of the damned.' This experience of sorting lives under crisis conditions haunted Fink and set the stage for the episode's deeper exploration into how such decisions are made during disasters.

The bulk of the episode focuses on the harrowing events at Memorial Medical Center in New Orleans during Hurricane Katrina. As the storm hit and the hospital lost power, medical staff faced the dire situation of having to evacuate patients without sufficient resources. A makeshift triage system was established, categorizing patients into three groups based on their perceived chances of survival and the urgency of their conditions. This system led to controversial decisions, such as prioritizing healthier patients and those without DNR (Do Not Resuscitate) orders over the critically ill.

As the evacuation dragged on and resources dwindled, discussions among the staff turned to the ethics of potentially hastening the deaths of the sickest patients to alleviate their suffering. This led to the discovery, after the storm, that several patients had been administered lethal doses of morphine and sedatives. The episode recounts the investigation that followed, the ethical debates it sparked, and the lack of criminal convictions despite the evidence of euthanasia.

The episode then transitions to the aftermath of Katrina, when states like Maryland began to re-evaluate their triage protocols. Sherry Fink attended a deliberative democracy event where citizens grappled with how to make triage decisions during a hypothetical pandemic. Participants discussed various criteria for allocating scarce resources, such as saving the most lives, prioritizing those who could help during the crisis, or leaving it to chance with a lottery system. The discussions revealed the difficulty in finding a consensus on these life-and-death decisions.

Finally, Fink shares a personal story from the 2010 Haiti earthquake, where she witnessed the triage process firsthand. A woman named Natalie, suffering from chronic lung problems, was taken off oxygen due to shortages, only to be saved temporarily by Fink's intervention. Natalie's story illustrates the human cost of triage and the emotional toll it takes on those who must play God.