Is the Use of DALYs and QALYs Ethically Permissible in Triage Decisions? COVID-19 and Equity Considerations from a Queer-Crip Perspective
This paper explores the symbolic and material implications of the use of DALYs and QALYs as priority or tie-breaker criteria in triage decisions. It aims to answer the question of their ethical permissibility based on the particular case of the COVID-19 pandemic. For this purpose, theories framed i...
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| Format: | Article |
| Language: | English |
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Universidade Federal de Santa Catarina
2023-11-01
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| Series: | Ethic@: an International Journal for Moral Philosophy |
| Subjects: | |
| Online Access: | https://periodicos.ufsc.br/index.php/ethic/article/view/91703 |
| _version_ | 1797402167758290944 |
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| author | Lautaro Leani Ignacio Mastroleo |
| author_facet | Lautaro Leani Ignacio Mastroleo |
| author_sort | Lautaro Leani |
| collection | DOAJ |
| description |
This paper explores the symbolic and material implications of the use of DALYs and QALYs as priority or tie-breaker criteria in triage decisions. It aims to answer the question of their ethical permissibility based on the particular case of the COVID-19 pandemic. For this purpose, theories framed in a queer-crip perspective and ethical frameworks of equity will be used. From a queer-crip perspective, the use of DALYs and QALYs in triage decisions discriminates against and excludes people with disabilities, as it allocates scarce resources based on ableist value judgments about people's quality of life, rather than on evidence. From the point of view of equity, it may imply and reinforce structural injustices involving inequities, that is, avoidable or remediable inequalities. This analysis will argue that the use of DALYs and QALYs categories in triage decisions allocates potentially life-saving resources based on ableist value judgments that lead to an unfair distribution of risks, burdens, and costs. Finally, two objections related to the relevance or necessity of using these or similar categories as criteria will be addressed: the independent cases of structural inequities and the inevitability of setting priorities in the face of a crisis.
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| first_indexed | 2024-03-09T02:20:30Z |
| format | Article |
| id | doaj.art-13541d06270d4c8fb487a9f322da95f9 |
| institution | Directory Open Access Journal |
| issn | 1677-2954 |
| language | English |
| last_indexed | 2024-03-09T02:20:30Z |
| publishDate | 2023-11-01 |
| publisher | Universidade Federal de Santa Catarina |
| record_format | Article |
| series | Ethic@: an International Journal for Moral Philosophy |
| spelling | doaj.art-13541d06270d4c8fb487a9f322da95f92023-12-06T16:56:48ZengUniversidade Federal de Santa CatarinaEthic@: an International Journal for Moral Philosophy1677-29542023-11-0122110.5007/1677-2954.2023.e91703Is the Use of DALYs and QALYs Ethically Permissible in Triage Decisions? COVID-19 and Equity Considerations from a Queer-Crip PerspectiveLautaro LeaniIgnacio Mastroleo0University of Buenos Aires (UBA) / National Scientific and Technical Research Council (CONICET) This paper explores the symbolic and material implications of the use of DALYs and QALYs as priority or tie-breaker criteria in triage decisions. It aims to answer the question of their ethical permissibility based on the particular case of the COVID-19 pandemic. For this purpose, theories framed in a queer-crip perspective and ethical frameworks of equity will be used. From a queer-crip perspective, the use of DALYs and QALYs in triage decisions discriminates against and excludes people with disabilities, as it allocates scarce resources based on ableist value judgments about people's quality of life, rather than on evidence. From the point of view of equity, it may imply and reinforce structural injustices involving inequities, that is, avoidable or remediable inequalities. This analysis will argue that the use of DALYs and QALYs categories in triage decisions allocates potentially life-saving resources based on ableist value judgments that lead to an unfair distribution of risks, burdens, and costs. Finally, two objections related to the relevance or necessity of using these or similar categories as criteria will be addressed: the independent cases of structural inequities and the inevitability of setting priorities in the face of a crisis. https://periodicos.ufsc.br/index.php/ethic/article/view/91703Disability Adjusted Life YearsQuality Adjusted Life YearsTriageEquityQueer-Crip Perspective |
| spellingShingle | Lautaro Leani Ignacio Mastroleo Is the Use of DALYs and QALYs Ethically Permissible in Triage Decisions? COVID-19 and Equity Considerations from a Queer-Crip Perspective Ethic@: an International Journal for Moral Philosophy Disability Adjusted Life Years Quality Adjusted Life Years Triage Equity Queer-Crip Perspective |
| title | Is the Use of DALYs and QALYs Ethically Permissible in Triage Decisions? COVID-19 and Equity Considerations from a Queer-Crip Perspective |
| title_full | Is the Use of DALYs and QALYs Ethically Permissible in Triage Decisions? COVID-19 and Equity Considerations from a Queer-Crip Perspective |
| title_fullStr | Is the Use of DALYs and QALYs Ethically Permissible in Triage Decisions? COVID-19 and Equity Considerations from a Queer-Crip Perspective |
| title_full_unstemmed | Is the Use of DALYs and QALYs Ethically Permissible in Triage Decisions? COVID-19 and Equity Considerations from a Queer-Crip Perspective |
| title_short | Is the Use of DALYs and QALYs Ethically Permissible in Triage Decisions? COVID-19 and Equity Considerations from a Queer-Crip Perspective |
| title_sort | is the use of dalys and qalys ethically permissible in triage decisions covid 19 and equity considerations from a queer crip perspective |
| topic | Disability Adjusted Life Years Quality Adjusted Life Years Triage Equity Queer-Crip Perspective |
| url | https://periodicos.ufsc.br/index.php/ethic/article/view/91703 |
| work_keys_str_mv | AT lautaroleani istheuseofdalysandqalysethicallypermissibleintriagedecisionscovid19andequityconsiderationsfromaqueercripperspective AT ignaciomastroleo istheuseofdalysandqalysethicallypermissibleintriagedecisionscovid19andequityconsiderationsfromaqueercripperspective |