Patient family: Can’t you get 15 more ventilators from somewhere else?

Clinician response: Right now the hospital is operating over capacity. It is not possible for us to increase our capacity like that overnight. And I realize that must be disappointing to hear.

Patient family: How can you just take them off a ventilator when their life depends on it?

Clinician response: I’m so sorry that her condition has gotten worse, even though we are doing everything. Because we are in an extraordinary time, we are following special guidelines that apply to everyone here. We cannot continue to provide critical care to patients who are not getting better. This means that we need to accept that she will die, and that we need to take her off the ventilator. I wish things were different.

New York State does, in fact, have guidelines for ventilator allocation, written in 2015. They recommend that hospitals appoint triage officers or committees — made up of experts who do not have clinical responsibilities for the patients at issue — to make the difficult calls, thus easing the moral burden on the men and women on the ground. Who does and doesn’t get a ventilator, and for how long, will depend on a range of criteria, from the overall health of the patient to how well the patient is doing at that particular moment.

I’ve spoken to a number of doctors who said they’re comforted by these guidelines. There are clear rules to follow.

But Stephen Xenakis, a psychiatrist and retired brigadier general who has spent decades treating veterans, says that rules aren’t sufficient to inoculate first responders from psychological suffering.

“We have rules too, in the military,” he told me. “Rules of engagement. And you may follow the rules of engagement, and everyone around you may say that you followed the rules of engagement. But after the incident occurs, you ask yourself, ‘Did I make the right decision?’ Because the outcome was not acceptable, was not digestible.”

Or it’ll be something even more nuanced than that. The outcome may be acceptable — that is, reconcilable — in the moment. But not later on.