While many have noted that independent services like Uber and Lyft are changing the way we view transportation and taxi services, they might be changing the way we look at ambulance rides as well. The New York Times reported that many lower-to-middle class people who lack immediate access to a car — or just can’t drive due to their current state — will choose Uber over ambulances almost every time.

This is a jarring reflection of how expensive quality medical care is in the United States. Many survey respondents said that a $1,000 ambulance ride would put them in debt, and they couldn’t afford the medical bills that come with getting immediate help. Uber and Lyft are often faster, and they don’t cost a fortune to call.

Despite the dangers surrounding the practice, some medical professionals are praising it.

“Don’t reflexively call an ambulance,” Harvard Medical School researcher, Anupam Jena, said. “Ambulances are for emergencies. If you’re not having one, it’s reasonable to consider another form of transportation.”

That brings up the question: what is an emergency, exactly? Some people fail to realize their lives are in danger until its too late, and that Uber ride to the hospital might be the last one they take.

Drivers have also brought up discomforting aspects of the situation, from feeling responsible for their sick passengers lives to sanitary concerns. Cars and upholstery are harder to rinse and disinfect than ambulance interiors, and many drivers use their vehicles for personal use as well.

“If someone leaves bodily fluids, it’s up to me to clean,” Jamie, an Uber driver, said to Buzzfeed. “I drive my kids in the car. I don’t want deathly ill people in my car, to be honest.”

There’s also legal issues surrounding the practice, which has led to heated debates about what will happen if a lawsuit occurs. Law professor Veena Dubal remarked about the strange practice in an interview, saying:

“What it says is something awful about the state of health insurance, that it’s so expensive to get to the hospital via ambulance. It means this is a new, weird, privatized way that people are dealing with emergencies, and the drivers aren’t equipped to deal with those things, and they’re taking on risks that they’re unaware of.”

While there haven’t been any lawsuits regarding Uber-ambulances, Dubal remarked that there will likely be one in the future. Until then, the argument of whether to call an ambulance or a Lyft is ongoing.