Journal article
Beyond individual triage: regional allocation of life-saving resources such as ventilators in public health emergencies
- Abstract:
- 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.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, 774.3KB, Terms of use)
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- Publisher copy:
- 10.1007/s10728-020-00427-5
Authors
- Publisher:
- Springer
- Journal:
- Health Care Analysis More from this journal
- Volume:
- 29
- Issue:
- 2021
- Pages:
- 263–282
- Publication date:
- 2021-02-06
- Acceptance date:
- 2020-12-10
- DOI:
- EISSN:
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1465-3915
- ISSN:
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1065-3058
- Language:
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English
- Keywords:
- Pubs id:
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1148525
- Local pid:
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pubs:1148525
- Deposit date:
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2020-12-10
Terms of use
- Copyright holder:
- Pugh et al.
- Copyright date:
- 2021
- Rights statement:
- © The Author(s) 2021. Open Access: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.
- Licence:
- CC Attribution (CC BY)
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