The COVID-19 pandemic has raised a host of ethical challenges, but key among these has been the possibility that health care systems might need to ration scarce critical care resources. Rationing policies for pandemics differ by institution, health system, and applicable law. Most seem to agree that a patient’s ability to benefit from treatment and to survive are first-order considerations. However, there is debate about what clinical measures should be used to make that determination and about other factors that might be ethically appropriate to consider. In this paper, we discuss resource allocation and several related ethical challenges to the healthcare system and society, including how to define benefit, how to handle informed consent, the special needs of pediatric patients, how to engage communities in these difficult decisions, and how to mitigate concerns of discrimination and the effects of structural inequities.
Bibliographical noteFunding Information:
We thank the Association of Bioethics Program Directors for organizing this task force and facilitating this work. We thank Amanda M. Gutierrez and Jocelyn M. Lapointe for providing research and administrative assistance in preparing the manuscript for publication, and Bharath M. Ram, Anveet S. Janwadkar, Jeremiah M. Lee for their research assistance. Eric Racine would like to thank Mariana Correro and Marianne Rochette for timely support in finding literature and reviewing a draft version of this paper. Eric Racine would like to acknowledge the support of a career award from the Fonds de recherche du Quebec-Sante (FRQ-S).
© 2020 Taylor & Francis Group, LLC.
- Decision making
- end-of-life issues
- health care delivery
- health policy
- public health
- rationing/resource allocation