There was one bed coming available in the intensive care unit in Alaska’s largest hospital.

It was the middle of the night, and the hospital, Providence Alaska Medical Center in Anchorage, had been hit with a deluge of coronavirus patients. Doctors now had a choice to make: Several more patients at the hospital, most of them with COVID-19, were in line to take that last ICU spot. But there was also someone from one of the state’s isolated rural communities who needed to be flown in for emergency surgery.

Who should get the final bed?

Dr. ​​Steven Floerchinger gathered with his colleagues for an agonizing discussion. They had a better chance of saving one of the patients in the emergency room, they determined. The other person would have to wait.

That patient died.