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 […]

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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 […]

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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 […]

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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 […]

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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 […]

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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 […]

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Allocating scarce biospecimens

By Leah Pierson, Sophia Gibert, and Joseph Millum Clinical researchers frequently collect samples of blood, skin, and other bodily tissues from their patient-participants and have samples left over when their research is complete. These biospecimens are often in high demand from other scientists who want them for their own research. How should such collections of […]

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Why care about severity?

By Mathias Barra, Mari Broqvist, Erik Gustavsson, Martin Henriksson, Niklas Juth, Lars Sandman, and Carl Tollef Solberg In an ideal world, everyone one of us would receive medical treatments in a timely manner, in the best possible way. There would be an unlimited number of organs available for transplantation. There would be enough health workers […]

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Should the state permit us to be younger and treat us accordingly in health care?

By Kasper Lippert-Rasmussen and Thomas Søbirk Petersen. In some states, citizens can change their officially recognized gender. Why not other identities as well? Why not age, for instance? In December 2018, 69-year-old Dutchman and former politician Emile Ratelband lost his court battle to have his legal age reduced by 20 years. In presenting his case […]

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Transwomen in elite women’s sport – clarifying the nuances of our approach

By Taryn Knox, Lynley Anderson, and Alison Heather Our paper in the Journal of Medical Ethics entitled Transwomen in elite sport: scientific and ethical considerations, along with the related posts on the Journal of Medical Ethics and British Journal of Sports Medicine blogs, have generated widespread debate around New Zealand and the rest of the […]

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