Sort of a facile response but we'll at least consider VA ECMO if we think the benefits outweigh the risks. E.g., a person in worsening cardiogenic shock because

Sort of a facile response but we'll at least consider VA ECMO if we think the benefits outweigh the risks. E.g., a person in worsening cardiogenic shock because of a usually reversible insult (e.g., severe stress cardiomyopathy, or a refractory ventricular arrhythmia) has a very good chance of surviving the acute hospitalization but if I'm worried they will die tonight (even if they'd be fine 2 days from now after some recovery time) then will discuss VA ECMO with the people who actually do it for a living. VA ECMO's complications are a consideration in that calculus. That's the kind of decision where I think an observer could argue (especially if things go well) that there was a non-trivial chance that the patient would have survived without ECMO.