By Jonathan Michaels When I wrote about the potential for injustices to arise in evidence-based healthcare policy, the COVID-19 pandemic had not begun. Since then, numerous government agencies and academic bodies have rapidly produced policy, claiming legitimacy because it is “evidence-based” or “follows the science”. However, science cannot determine policy, and the failure to distinguish […]
Category: Distributive justice
Maximizing outcomes in triage of critical care resources—is there a consensus?
By Lynette Reid My university told us to work from home in mid-March; public health asked us to limit shopping and travel—but to get outdoors for exercise—soon after. I can’t complain. I have secure employment; my partner and I live outside the city in a fishing village with protected wilderness all around. It was like […]
Lives vs equity – analysing the dilemma in the COVID-19 response
By Neil Pickering An ethical tension that COVID-19 highlights is between saving lives and acting equitably. Bluntly, in the current circumstances, it may be that any weight given to equity will potentially cost lives. This need not always be the case, of course. The two can both be realised at one and the same time […]
COVID-19: Should we allocate health care resources based on citizens’ individual contribution to society?
By Rebecca Limb There has not been a time in recent memory where the NHS’s resources have been under so much pressure that questions around resource allocation have become pressing and persistent ethical concerns. With COVID-19 lockdown measures due to be eased in the coming weeks there is a significant threat of a second […]
Lack of leadership to limit “futile” end-of-life care leaves Canada hamstrung in COVID-19 pandemic
By Lucas Vivas and Travis Carpenter The COVID-19 pandemic has shed a light on many of the strengths and weaknesses of the world’s public health systems. In Canada, where the national health care system was stretched even before the expected COVID-19 surge, a conversation has begun about the need to direct health care resources to […]
Should culpability or negligence of the patient affect triage decisions? A question the state needs to answer for healthcare professionals
By Nikunj Agarwal Triage decision and value judgments Value judgments about justice or fairness are neither easy nor conclusive. However, this does not prevent value judgments from being made on a daily basis. When a judge attempts to determine the culpability of an accused, the procedural and evidentiary rules assist her in making those value […]
Prioritizing justice in ventilator allocation
By L. Syd M Johnson As the Covid-19 pandemic intensified worldwide, grim reports out of Italy’s embattled and overwhelmed hospitals foretold the need to plan for rationing ventilators in the event that the number of patients requiring them exceeded the number available. Hospitals, ethics committees, and government agencies around the US began planning for the […]
Not only benefit: equity and fairness in states’ responses to COVID-19
By Nic Aagaard, Lynley Anderson, Neil Pickering A range of important ethical considerations that have arisen due to the emergence of the novel coronavirus COVID-19. A potentially important part of the international response is the role of National Ethics Committees (NECs). NECs are generally advisory committees, offering ethical comment to governments and other institutions, and […]
Rewarding through prioritization: The limits of reciprocal obligation in allocating scarce medical resources in the COVID-19 crisis
By Thibaud Haaser In the face of the COVID-19 pandemic, health systems are under severe strain. Some countries are currently experiencing, or may experience within a few weeks, shortages of medical resources (in particular intensive care beds and mechanical ventilation). In this context, the health community may have to make impossible choices regarding the allocation […]
ICU triage: How many lives or whose lives?
By Angela Ballantyne Bioethicists around the world have been asked to advise on the goals and methods of triage protocols. Estimates suggest 5% of COVID19 cases will require ICU care. The key ethical tension is between utility and equity. There are other relevant principles of fair allocation such as reciprocity for frontline workers who have […]