By Emily E. Barsky and Sadath Sayeed Amidst the COVID-19 pandemic, many nations are coping with what resource limited settings are all too familiar with—ventilator scarcity. In low-income countries, people— and particularly children— frequently die of reversible, acute respiratory failure due to across-the-board resource scarcity. Some such settings have responded to this by allowing parents […]
Category: Distributive justice
Triaging ethical issues during a pandemic: a rough guide
By David Shaw Covid-19 raises dozens of fascinating ethical issues, but you might not know it from looking at the narrow focus of many ethics papers published since the pandemic began. Most of these papers have focused on the issue of allocating scarce resources in intensive care units, because of the anticipated pressure on these […]
Death during COVID-19: Redefining terminal illness
By Samantha W. Stein and Justin T. Clapp IDENTIFYING A GAP IN TRIAGE MODELS As floodwaters rose and resources dwindled inside Memorial Medical Center in the days following Hurricane Katrina, patient Emmett Everett pleaded with nurses: “Don’t let them leave me behind.” Everett sought to be evacuated to the safety of another hospital alongside nearly […]
Supra-institutional transparency: a first step towards recovering from the COVID-19 wound
By Benjamin Herreros, Pablo Gella, Diego Real de Asúa In the wake of the first COVID-19 wave, the latest news media cycles in Spain have been filled with alarming headlines on the need to investigate the triage criteria used during the epidemic. The State’s Attorney’s Office is undertaking preliminary investigations into several hospitals in the […]
Don’t blame the science
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 […]
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 […]