By Gabriela Arguedas Ramírez Pandemics are threshold situations that put our individual and collective convictions, priorities and capacities to the test. They test state institutions, the ethical principles that have guided the formation of public policy and the strengths and weaknesses of our social fabric. Pandemics are ethical-political issues and not simply medical or biological […]
Category: Journal of Medical Ethics
Deciding who gets the ventilator: Will some lives be lost unlawfully?
By Kathleen Liddell, Jeffrey M. Skopek, Stephanie Palmer, Stevie Martin, Jennifer Anderson and Andrew Sagar. When Covid-19 patients reach the point of critical illness where ventilation is necessary, they tend to deteriorate quickly. They will die if they do not receive ventilation very soon. But ventilation is not a cure – it gives the patient’s […]
‘Your country needs you’: The ethics of allocating staff to high-risk clinical roles in the management of patients with COVID-19
By Michael Dunn, Mark Sheehan, Joshua Horden, Helen Turnham and Dominic Wilkinson. As the COVID-19 pandemic impacts on health service delivery, health providers are modifying care pathways and staffing models in ways that require health professionals to be reallocated to work in critical care settings. Many of the roles to which staff are being allocated […]
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 […]
COVID-19 and vaccine ethics: pre-empting conscientious objection
By Helen Watt The race is on to produce a COVID-19 vaccine: teams are working hard and fast across the world. We all long to see a vaccine in record time – but must, of course, have an eye to ethics too. Debates on vaccine ethics tend to focus on risks, whether to participants in […]
The COVID19 pandemic and ethics through the eyes of women
By Pauline Capdevielle, Amaranta Manrique de Lara, María de Jesús Medina Arellano This year’s International Women’s Day was a historic occurrence in Mexico. Tens of thousands of women took to the streets on the eighth and then chose to vanish on the ninth. Each day in its own way, the so-called 8M and 9M were […]
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 […]
COVID-19: In focussing on intensive care we must not lose sight of the wider professional duty to care for all patients.
By Anne Slowther and Sara Mitchell As the number of cases and number of deaths from COVID-19 continues to rise exponentially much of the health care response, and subsequent bioethics commentary, has focussed on provision of intensive care for critically ill patients who require ventilation. This is understandable given the mismatch between the number of people […]
Ethical rationing: Hydroxychloroquine, COVID-19 and the inequality of diseases
By Yves Saint James Aquino and Nicolo Cabrera The controversy surrounding the off-label use of hydroxychloroquine (HCQ) for COVID-19 highlights the inherent inequality of disease conditions. In this brief ethics explainer, we argue that we need to make explicit the clinical and non-clinical factors that determine the inequality of diseases. The varying appraisals of disease […]
The vital contexts of coronavirus
By David Shaw The coronavirus pandemic has taken over all our lives, confining most people to their homes and killing tens of thousands around the world. Every day we are updated on the latest infection rates and mortality figures, and speculate about how long the lockdown will last. Yet what is missing from much of […]