By Hans Flaatten, Michael Beil, and Susannah Leaver. The present COVID-19 pandemic has fuelled discussions regarding the prospects and limitations of treatment in critically ill patients. This commentary describes a framework for understanding pandemic triage ranging from “business as usual” (“good”) to the extreme depletion of all resources (“ugly”). This is illustrated with different stages […]
Latest articles
COVID, Systemic Racism Protests, Anti-Lockdown Protests: Making Sense Of It All
By Austin Lam. A recent article highlighted an uncomfortable yet unassailable issue: “the way the public health narrative around coronavirus has reversed itself overnight seems an awful lot like … politicizing science.” Alternatively, another article frames this political element as itself the impetus to justify protests against systemic racism in the context of racism as […]
Seizing a Pap smear to catch a criminal? Ethical issues of forensic use of medical biobanks
By Nina de Groot. A couple of years ago, during my studies, I assisted with a surgical removal of a benign uterine tumor at a small local hospital. As not much else was happening that day, I decided to follow the tumor out of the operation room all the way down to the pathologist in […]
Herd immunity and lifting lockdowns: a new trolley problem?
By Ezio Di Nucci How does pursuing herd immunity compare with lifting lockdowns, from an ethical point of view? The (moral) problem with the pursuit of herd immunity under a pandemic such as COVID-19 is that getting more than half of the population infected (the herd immunity threshold is at least 60%), given a CFR […]
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 […]
Why praising healthcare workers as ‘heroic’ is not the best way to support them
By Caitríona Cox. “Show me a hero and I’ll write you a tragedy” – F. Scott Fitzgerald In recent weeks praise for ‘Healthcare Heroes’ has been plentiful in the media, with The Mirror even launching a campaign for all healthcare workers to receive a medal for their work. The weekly ‘Clap for Carers’ in the […]
Is it wrong to prioritise patients who have the highest chance of survival during Covid-19?
Alaa Daoud and Ezio Di Nucci. Wilkinson proposed that health systems should aim to prioritise patients who have the highest chance of survival, based on Taurek’s ‘lifeboat’ experiment, where the general public chose to save five patients instead of one patient. This is no more or less true of saying that the current approaches are […]
Accepting trust for pandemic response: we need leaders to think twice
By Samia Hurst. Many pandemic response measures, from physical distancing to confinement, rely on cooperation by members of the public for their implementation and effectiveness. In requiring such cooperation, these measures all rely on the public investing sufficient trust in scientific and/or political authorities to follow instructions and recommendations. Trust in medical and political authorities […]
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 […]