Beyond individual triage: regional allocation of life-saving resources such as ventilators in public health emergencies

In the first wave of the COVID-19 pandemic, healthcare workers in some countries were forced to make distressing triaging decisions about which individual patients should receive potentially life-saving treatment. Much of the ethical discussion prompted by the pandemic has concerned which moral prin...

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Main Authors: Wilkinson, D, Pugh, J, Gonzales, CP, Savulescu, J
Format: Journal article
Language:English
Published: Springer 2021
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author Wilkinson, D
Pugh, J
Gonzales, CP
Savulescu, J
author_facet Wilkinson, D
Pugh, J
Gonzales, CP
Savulescu, J
author_sort Wilkinson, D
collection OXFORD
description In the first wave of the COVID-19 pandemic, healthcare workers in some countries were forced to make distressing triaging decisions about which individual patients should receive potentially life-saving treatment. Much of the ethical discussion prompted by the pandemic has concerned which moral principles should ground our response to these individual triage questions. In this paper we aim to broaden the scope of this discussion by considering the ethics of broader structural allocation decisions raised by the COVID-19 pandemic. More specifically, we consider how nations ought to distribute a scarce life-saving resource across healthcare regions in a public health emergency, particularly in view of regional differences in projected need and existing capacity. We call this the regional triage question. Using the case study of ventilators in the COVID-19 pandemic, we show how the moral frameworks that we might adopt in response to individual triage decisions do not translate straightforwardly to this regional-level triage question. Having outlined what we take to be a plausible egalitarian approach to the regional triage question, we go on to propose a novel way of operationalising the ‘save the most lives’ principle in this context. We claim that the latter principle ought to take precedence in the regional triage question, but also note some important limitations to the extent of the influence that it should have in regional allocation decisions.
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spelling oxford-uuid:4828bb18-df52-49bd-8f35-71594a4adeb02022-03-26T15:24:04ZBeyond individual triage: regional allocation of life-saving resources such as ventilators in public health emergenciesJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:4828bb18-df52-49bd-8f35-71594a4adeb0EnglishSymplectic ElementsSpringer2021Wilkinson, DPugh, JGonzales, CPSavulescu, JIn the first wave of the COVID-19 pandemic, healthcare workers in some countries were forced to make distressing triaging decisions about which individual patients should receive potentially life-saving treatment. Much of the ethical discussion prompted by the pandemic has concerned which moral principles should ground our response to these individual triage questions. In this paper we aim to broaden the scope of this discussion by considering the ethics of broader structural allocation decisions raised by the COVID-19 pandemic. More specifically, we consider how nations ought to distribute a scarce life-saving resource across healthcare regions in a public health emergency, particularly in view of regional differences in projected need and existing capacity. We call this the regional triage question. Using the case study of ventilators in the COVID-19 pandemic, we show how the moral frameworks that we might adopt in response to individual triage decisions do not translate straightforwardly to this regional-level triage question. Having outlined what we take to be a plausible egalitarian approach to the regional triage question, we go on to propose a novel way of operationalising the ‘save the most lives’ principle in this context. We claim that the latter principle ought to take precedence in the regional triage question, but also note some important limitations to the extent of the influence that it should have in regional allocation decisions.
spellingShingle Wilkinson, D
Pugh, J
Gonzales, CP
Savulescu, J
Beyond individual triage: regional allocation of life-saving resources such as ventilators in public health emergencies
title Beyond individual triage: regional allocation of life-saving resources such as ventilators in public health emergencies
title_full Beyond individual triage: regional allocation of life-saving resources such as ventilators in public health emergencies
title_fullStr Beyond individual triage: regional allocation of life-saving resources such as ventilators in public health emergencies
title_full_unstemmed Beyond individual triage: regional allocation of life-saving resources such as ventilators in public health emergencies
title_short Beyond individual triage: regional allocation of life-saving resources such as ventilators in public health emergencies
title_sort beyond individual triage regional allocation of life saving resources such as ventilators in public health emergencies
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