About this topic
Summary The allocation of medical resources is a subfield within more general concerns about distributive justice. As such, much discussion of healthcare allocation uses familiar terms and theories from this broader area. However, it is also a subject that has been seen by many to have particular importance, due to the central importance that health plays in human lives. Resource allocations are typically driven by two competing factors: 'efficiency' (on the grounds that we should want resources in a social institution like medicine to bring about more benefit rather than less) and 'equality' (on the grounds people can suffer to differing degrees from ill health, and we should have some preference to help those who are worse off). Broadly speaking, many discussions of health care allocation are discussions of how to understand, and how to make commensurable, these two competing considerations. More recently, there has also been a turn towards the idea that since there may be no single, uniquely acceptable way of allocating medical resources, a theory of fair medical allocation must include some discussion of procedural principles, i.e. principles that relate to the process by which actual allocation decisions are made. 
Key works Bognar & Hirose 2014 Daniels 2007
Introductions Cookson & Dolan 2000 Buchanan 1984
Related categories

521 found
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1 — 50 / 521
  1. (Draft) The Prospects for Prospect Utilitarianism.Benjamin Davies - manuscript
    Sufficientarianism is a view of distributive justice that places importance on one or more ‘thresholds’, whereby those who are above the threshold have much weaker claims to additional benefits than those below, and may even have no claims at all. Hun Chung has recently argued for a new theory of distributive justice that overcomes two central problems faced by sufficientarianism. Sufficientarianism cannot give intuitively compelling answers to ‘lifeboat cases’, where we can save the lives of some but not all of (...)
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  2. Public Perception of Organ Donation and Transplantation Policies in Southern Spain.Gonzalo Díaz-Cobacho, Maite Cruz-Piqueras, Janet Delgado, Joaquín Hortal-Carmona, María Victoria Martínez-López, Alberto Molina-Pérez, Álvaro Padilla-Pozo, Julia Ranchal-Romero & David Rodríguez-Arias - forthcoming - Transplantation Proceedings.
    Background: This research explores how public awareness and attitudes toward donation and transplantation policies may contribute to Spain's success in cadaveric organ donation. Materials and Methods: A representative sample of 813 people residing in Andalusia (Southern Spain) were surveyed by telephone or via Internet between October and December 2018. Results: Most participants trust Spain's donation and transplantation system (93%) and wish to donate their organs after death (76%). Among donors, a majority have expressed their consent (59%), and few nondonors have (...)
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  3. We Should Not Use Randomization Procedures to Allocate Scarce Life-Saving Resources.Roberto Fumagalli - forthcoming - Public Health Ethics.
    In the recent literature across philosophy, medicine and public health policy, many influential arguments have been put forward to support the use of randomization procedures to allocate scarce life-saving resources. In this paper, I provide a systematic categorization and a critical evaluation of these arguments. I shall argue that those arguments justify using randomization procedures to allocate scarce life-saving resources in fewer cases than their proponents maintain and that the relevant decision makers should typically allocate scarce life-saving resources directly to (...)
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  4. Special Supplement: What Do We Owe the Elderly? Allocating Social and Health Care Resources.Ruud ter Meulen, Eva Topinková & Daniel Callahan - forthcoming - Hastings Center Report.
  5. Value Assessment Frameworks: Who is Valuing the Care in Healthcare?Jonathan Anthony Michaels - forthcoming - Journal of Medical Ethics:medethics-2020-106503.
    Many healthcare agencies are producing evidence-based guidance and policy that may determine the availability of particular healthcare products and procedures, effectively rationing aspects of healthcare. They claim legitimacy for their decisions through reference to evidence-based scientific method and the implementation of just decision-making procedures, often citing the criteria of ‘accountability for reasonableness’; publicity, relevance, challenge and revision, and regulation. Central to most decision methods are estimates of gains in quality-adjusted life-years, a measure that combines the length and quality of survival. (...)
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  6. Why We Should Stop Using Animal-Derived Products on Patients Without Their Consent.Daniel Rodger - forthcoming - Journal of Medical Ethics.
    Medicines and medical devices containing animal-derived ingredients are frequently used on patients without their informed consent, despite a significant proportion of patients wanting to know if an animal-derived product is going to be used in their care. Here, I outline three arguments for why this practice is wrong. Firstly, I argue that using animal-derived medical products on patients without their informed consent undermines respect for their autonomy. Secondly, it risks causing non-trivial psychological harm. Thirdly, it is morally inconsistent to respect (...)
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  7. Responsibility and the Recursion Problem.Ben Davies - 2022 - Ratio 35 (2):112-122.
    A considerable literature has emerged around the idea of using ‘personal responsibility’ as an allocation criterion in healthcare distribution, where a person's being suitably responsible for their health needs may justify additional conditions on receiving healthcare, and perhaps even limiting access entirely, sometimes known as ‘responsibilisation’. This discussion focuses most prominently, but not exclusively, on ‘luck egalitarianism’, the view that deviations from equality are justified only by suitably free choices. A superficially separate issue in distributive justice concerns the two–way relationship (...)
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  8. COVID-19 Vaccine Refusal and Fair Allocation of Scarce Medical Resources.Govind Persad & Emily A. Largent - 2022 - JAMA Health Forum 3 (4):e220356.
    When hospitals face surges of patients with COVID-19, fair allocation of scarce medical resources remains a challenge. Scarcity has at times encompassed not only hospital and intensive care unit beds—often reflecting staffing shortages—but also therapies and intensive treatments. Safe, highly effective COVID-19 vaccines have been free and widely available since mid-2021, yet many Americans remain unvaccinated by choice. Should their decision to forgo vaccination be considered when allocating scarce resources? Some have suggested it should, while others disagree. We offer a (...)
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  9. Fair Access to Scarce Medical Capacity for Non-Covid-19 Patients: A Role for Reserves.Govind Persad, Parag A. Pathak, Tayfun Sonmez & M. Utku Unver - 2022 - Bmj:10.1136/bmj.o276.
    As hospitals in the US and elsewhere fill again with patients with covid-19, discussions about how to fairly allocate scarce medical resources have come to the fore once again. One frequently voiced concern is that non-covid-19 patients with urgent health needs are facing indefinitely postponed surgeries, long-distance hospital transfers, or even are unable to access medical treatment. In our view, a reserve or categorised priority system could help. It could be used to fairly distribute scarce medical capacity—such as staffing, physical (...)
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  10. Rare and Common Diseases Should Be Treated Equally and Why the Article by de Magalhaes Somewhat Misses its’ Mark.Lars Sandman - 2022 - Journal of Medical Ethics 48 (2):97-98.
    In the article Should rare diseases get special treatment? by Monica Q F de Magalhaes,1 it is argued that rarity is not a morally relevant feature to consider in prioritising treatment in healthcare, but severity is. A central conclusion in the article is that severity rather than prevalence should guide different cost-effectiveness thresholds. Hence, I take it, she answers no to the question in her own heading. I agree with all of this—and with most of her other arguments and conclusions (...)
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  11. COVID-19 Vaccine Boosters for All Adults: An Optimal U.S. Approach?Ameet Sarpatwari, Ankur Pandya, Emily P. Hyle & Govind Persad - 2022 - Annals of Internal Medicine 175 (2):280–282.
    By 20 October 2021, the U.S. Food and Drug Administration (FDA) had amended its Emergency Use Authorizations for immunocompetent adults who previously received the Pfizer-BioNTech, Moderna, or Johnson & Johnson COVID-19 vaccines. For the 2-dose Pfizer-BioNTech and Moderna vaccines, the FDA permitted a single booster dose for adults aged 65 years or older and adults aged 18 to 64 years at high-risk for severe COVID-19 or at high risk for occupational or institutional COVID-19 exposure. For the single-dose Johnson & Johnson (...)
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  12. How the Past Matters for the Future: A Luck Egalitarian Sustainability Principle for Healthcare Resource Allocation.Andreas Albertsen - 2021 - Journal of Medical Ethics 47 (2):102-103.
    Christian Munthe, David Fumagalli and Erik Malmqvist argue that well-known healthcare resource allocation principles, such as need, prognosis, equal treatment and cost-effectiveness, should be supplemented with a principle of sustainability.1 Employing such a principle would entail that the allocation of healthcare resources should take into account whether a specific allocation causes negative dynamics, which would limit the amount of resources available in the future. As examples of allocation decisions, which may have such negative dynamics, they mention those who cause a (...)
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  13. What’s the Appropriate Target of Allocative Justification?Zara Anwarzai & Ricky Mouser - 2021 - American Journal of Bioethics Neuroscience 12 (2-3):167-168.
    Building on work by Peterman, Aas, and Wasserman (2021), we modify their prospective benefit analysis to include only medically-relevant information about patients as persons without reference to their broader lives. Because patients (not their lives) must be treated equally, we argue that patients are the appropriate targets of allocative justification. We go on to challenge some of our current data-collection practices on this basis.
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  14. Approaches to Critical Care Resource Allocation and Triage During the COVID-19 Pandemic: An Examination From a Developing World Perspective.Saurav Basu - 2021 - Journal of Medical Ethics and History of Medicine 14.
    The distribution of scarce critical care resources during public health emergencies in an ethically justified manner has been widely acknowledged as a major bioethics concern. The Center for Disease Control (CDC) recommends that critical care allocation during a pandemic emergency should uphold basic biomedical principles through maintenance of procedural justice which requires decision-making that is consistent, impartial, neutral, and nondiscriminatory. During the current COVID-19 pandemic, health systems, even in developed countries with robust existing health infrastructure, have experienced sustained demands that (...)
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  15. Precautionary Personhood: We Should Treat Patients with Disorders of Consciousness as Persons.Matthew Braddock - 2021 - American Journal of Bioethics Neuroscience 12 (2-3):162-164.
    Should we allocate costly health care to patients diagnosed with disorders of consciousness (DoC), such as patients diagnosed as being in a vegetative state or minimally conscious state? Peterson, Aas, and Wasserman (2021) argue that we should in their paper “What justifies the allocation of health care resources to patient with disorders of consciousness?” Their key insight is that the expected benefits to this patient population helps to justify such allocations. However, their insight is attached to a consequentialist framework aimed (...)
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  16. Mistrust and Inconsistency During COVID-19: Considerations for Resource Allocation Guidelines That Prioritise Healthcare Workers.Alexander T. M. Cheung & Brendan Parent - 2021 - Journal of Medical Ethics 47 (2):73-77.
    As the USA contends with another surge in COVID-19 cases, hospitals may soon need to answer the unresolved question of who lives and dies when ventilator demand exceeds supply. Although most triage policies in the USA have seemingly converged on the use of clinical need and benefit as primary criteria for prioritisation, significant differences exist between institutions in how to assign priority to patients with identical medical prognoses: the so-called ‘tie-breaker’ situations. In particular, one’s status as a frontline healthcare worker (...)
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  17. ‘Personal Health Surveillance’: The Use of mHealth in Healthcare Responsibilisation.Ben Davies - 2021 - Public Health Ethics 14 (3):268-280.
    There is an ongoing increase in the use of mobile health technologies that patients can use to monitor health-related outcomes and behaviours. While the dominant narrative around mHealth focuses on patient empowerment, there is potential for mHealth to fit into a growing push for patients to take personal responsibility for their health. I call the first of these uses ‘medical monitoring’, and the second ‘personal health surveillance’. After outlining two problems which the use of mHealth might seem to enable us (...)
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  18. Grow the Pie, or the Resource Shuffle? Commentary on Munthe, Fumagalli and Malmqvist.Ben Davies - 2021 - Journal of Medical Ethics 47 (2):98-99.
    John Rawls’s ‘just savings’ principle is among the better-known attempts to outline how we should balance the claims of the present with the claims of the future generations on resources. A central element of Rawls’s approach involves endorsing a sufficientarian approach, where our central obligation is to ensure ‘the conditions needed to establish and to preserve a just basic structure’.1 This engaging paper by Christian Munthe, Davide Fumagalli and Erik Malmqvist does not explicitly mention Rawls’s work on this issue.2 Still, (...)
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  19. Healthcare, Responsibility and Golden Opportunities.Gabriel De Marco, Thomas Douglas & Julian Savulescu - 2021 - Ethical Theory and Moral Practice 1 (3).
    When it comes to determining how healthcare resources should be allocated, there are many factors that could—and perhaps should—be taken into account. One such factor is a patient’s responsibility for his or her illness, or for the behavior that caused it. Policies that take responsibility for the unhealthy lifestyle or its outcomes into account—responsibility-sensitive policies—have faced a series of criticisms. One holds that agents often fail to meet either the control or epistemic conditions on responsibility with regard to their unhealthy (...)
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  20. Priority, Ethical Principle, and Allocation of Scarce Medical Resources. Di Wu - 2021 - Studies in Dialectics of Nature 11 (37):62-68.
    Aiming at the allocation of scarce medical resources, Immanuel and other scholars have put forward a set of influential ethical values and guiding principles. It assigns the priority of resource allocation to those whose lives can be saved and maximized, those who can bring the greatest instrumental value, and those who are the worse off. For other members of society, random selection under the same conditions is adopted. Following the Rawlsian "lexical order, lexicographical" rule, this priority arrangement requires that the (...)
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  21. What Are the Obligations of Pharmaceutical Companies in a Global Health Emergency?Ezekiel Emanuel, Allen Buchanan, Shuk Ying Chan, Fabre Cecile, Daniel Halliday, Joseph Heath, Lisa Maria Herzog, R. J. Leland, Matthew McCoy, Ole F. Norheim, Carla Saenz, G. Owen Schaefer, Kok-Chor Tan, Christopher Heath Wellman, Jonathan Wolff & Govind Persad - 2021 - Lancet 398 (10304):1015–1020.
    All parties involved in researching, developing, manufacturing, and distributing COVID-19 vaccines need guidance on their ethical obligations. We focus on pharmaceutical companies' obligations because their capacities to research, develop, manufacture, and distribute vaccines make them uniquely placed for stemming the pandemic. We argue that an ethical approach to COVID-19 vaccine production and distribution should satisfy four uncontroversial principles: optimising vaccine production, including development, testing, and manufacturing; fair distribution; sustainability; and accountability. All parties' obligations should be coordinated and mutually consistent. For (...)
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  22. Obligations in a Global Health Emergency - Authors’ Reply.Ezekiel Emanuel, Cecile Fabre, Lisa M. Herzog, Ole F. Norheim, Govind Persad, G. Owen Schaefer & Kok-Chor Tan - 2021 - Lancet 398 (10316):2072.
  23. Understanding Government Decisions to De-Fund Medical Services Analyzing the Impact of Problem Frames on Resource Allocation Policies.Mark Embrett & Glen E. Randall - 2021 - Health Care Analysis 29 (1):78-98.
    Many medical services lack robust evidence of effectiveness and may therefore be considered “unnecessary” care. Proactively withdrawing resources from, or de-funding, such services and redirecting the savings to services that have proven effectiveness would enhance overall health system performance. Despite this, governments have been reluctant to discontinue funding of services once funding is in place. The focus of this study is to understand how the framing of an issue or problem influences government decision-making related to de-funding of medical services. To (...)
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  24. Love Thy Neighbour? Allocating Vaccines in a World of Competing Obligations.Kyle Ferguson & Arthur Caplan - 2021 - Journal of Medical Ethics 47 (12):20-20.
    Although a safe, effective, and licensed coronavirus vaccine does not yet exist, there is already controversy over how it ought to be allocated. Justice is clearly at stake, but it is unclear what justice requires in the international distribution of a scarce vaccine during a pandemic. Many are condemning ‘vaccine nationalism’ as an obstacle to equitable global distribution. We argue that limited national partiality in allocating vaccines will be a component of justice rather than an obstacle to it. For there (...)
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  25. Phantom Premise and a Shape-Shifting Ism: Reply to Hassoun.Kyle Ferguson & Arthur Caplan - 2021 - Journal of Medical Ethics 47 (11).
    In ‘Against vaccine nationalism’, Nicole Hassoun misrepresents our argument, distorts our position and ignores crucial distinctions we present in our article, ‘Love thy neighbor? Allocating vaccines in a world of competing obligations’. She has created a strawman that does not resemble our position. In this reply, we address two features of ‘Against vaccine nationalism’. First, we address a phantom premise. Hassoun misattributes to us a thesis, according to which citizen-directed duties are stronger than noncitizen-directed duties. This thesis is a figment (...)
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  26. Solidarity, Sustainability and Medical Ethics.Zoë Fritz - 2021 - Journal of Medical Ethics 47 (2):63-64.
    In this issue of the Journal of Medical Ethics arguments are cogently made that sustainability and solidarity should be considered as core medical ethical principles, and that more explicit attention should be given to the complex context in which a decision is made.
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  27. Ordeals, Women and Gender Justice.Anca Gheaus - 2021 - Economics and Philosophy 37 (1):8-22.
    Rationing health care by ordeals is likely to have different effects on women and men, and on distinct groups of women. I show how such putative effects of ordeals are relevant to achieving gender justice. I explain why some ordeals may disproportionately set back women’s interest in discretionary time, health and access to health care, and may undermine equality of opportunity for positions of advantage. Some ordeals protect the interests of the worse-off women yet set back the interests of better-off (...)
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  28. Rawlsian Contractualism and Healthcare Allocation: A Response to Torbjörn Tännsjö.Quinn Hiroshi Gibson - 2021 - Diametros 18 (68):9-23.
    The consideration of the problem of healthcare allocation as a special case of distributive justice is especially alluring when we only consider consequentialist theories. I articulate here an alternative Rawlsian non-consequentialist theory which prioritizes the fairness of healthcare allocation procedures rather than directly setting distributive parameters. The theory in question stems from Rawlsian commitments that, it is argued, have a better Rawlsian pedigree than those considered as such by Tännsjö. The alternative framework is worthy of consideration on its own merits, (...)
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  29. Health Justice and Rawls's Theory at Fifty: Will New Thinking About Health and Inequality Influence the Most Influential Account of Justice?Johannes Kniess - 2021 - Hastings Center Report 51 (6):44-50.
    This year marks the centenary of John Rawls's birth and the fiftieth anniversary of the publication of A Theory of Justice. The influence of Rawls's landmark book on the general fields of moral and political philosophy is undisputed and well-documented. It has also left a significant imprint on debates surrounding health policy, health care, and health inequalities. This article traces the changing ways in which Rawls's theory influenced debates about justice in health over the last five decades. Just as Rawls's (...)
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  30. Resource Allocation in the Covid-19 Health Crisis: Are Covid-19 Preventive Measures Consistent with the Rule of Rescue?Julian W. März, Søren Holm & Michael Schlander - 2021 - Medicine, Health Care and Philosophy 24 (4):487-492.
    The Covid-19 pandemic has led to a health crisis of a scale unprecedented in post-war Europe. In response, a large amount of healthcare resources have been redirected to Covid-19 preventive measures, for instance population-wide vaccination campaigns, large-scale SARS-CoV-2 testing, and the large-scale distribution of protective equipment to high-risk groups and hospitals and nursing homes. Despite the importance of these measures in epidemiological and economic terms, health economists and medical ethicists have been relatively silent about the ethical rationales underlying the large-scale (...)
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  31. Health Care in Contexts of Risk, Uncertainty, and Hybridity – Introduction to the Volume.Daniel Messelken & David T. Winkler - 2021 - In Daniel Messelken & David Winkler (eds.), Health Care in Contexts of Risk, Uncertainty, and Hybridity. Springer. pp. 1-15.
    This chapter introduces to the main topic of the volume, namely the influence of the changing nature of warfare on the provision of medical care and the ethical challenges that occur. It presents the main ideas of relevant concepts such as asymmetrical warfare, hybrid warfare, and complex emergencies before illustrating the ethical challenges that new forms of warfare create for military and humanitarian health care providers. Examples of ethical challenges include embedding medical personnel in combating forces, questions regarding the treatment (...)
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  32. Justice criteria for the allocation of scarce medical resources in pandemic situations.Alejandro Miranda - 2021 - Veritas – Revista de Filosofia da Pucrs 49:55-70.
    Resumen En este trabajo se exponen veintiuna tesis sobre la asignación de recursos escasos en tiempos de pandemia o crisis sanitaria. El autor parte de la base de que nunca se justifica tratar a una persona como un mero medio. A partir de este principio fundamental, y de otras exigencias de justicia, procura determinar cuáles son los límites a las consideraciones, por lo demás legítimas, de eficiencia o de utilidad. Esto le permite discernir qué criterios de distribución son moral mente (...)
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  33. Sustainability Principle for the Ethics of Healthcare Resource Allocation.Christian Munthe, Davide Fumagalli & Erik Malmqvist - 2021 - Journal of Medical Ethics 47 (2):90-97.
    We propose a principle of sustainability to complement established principles used for justifying healthcare resource allocation. We argue that the application of established principles of equal treatment, need, prognosis and cost-effectiveness gives rise to what we call negative dynamics: a gradual depletion of the value possible to generate through healthcare. These principles should therefore be complemented by a sustainability principle, making the prospect of negative dynamics a further factor to consider, and possibly outweigh considerations highlighted by the other principles. We (...)
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  34. Difficult Trade-Offs in Response to COVID-19: The Case for Open and Inclusive Decision-Making.Ole Frithjof Norheim, Joelle Abi-Rached, Liam Kofi Bright, Kristine Baeroe, Octavio Ferraz, Siri Gloppen & Alex Voorhoeve - 2021 - Nature Medicine 27:10-13.
    We argue that deliberative decision-making that is inclusive, transparent and accountable can contribute to more trustworthy and legitimate decisions on difficult ethical questions and political trade-offs during the pandemic and beyond.
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  35. Fair Allocation at COVID-19 Mass Vaccination Sites.William F. Parker, Govind Persad & Monica E. Peek - 2021 - JAMA Health Forum 2 (4):e210464.
    We propose 4 equity-advancing operational improvements to eligibility and sign-up processes at mass vaccination sites: (1) preregistration using existing information, (2) eligibility rules that recognize the greater burden of COVID-19 in underserved neighborhoods, (3) appointment assignment that prioritizes those with disadvantage, and (4) socioculturally informed outreach to lottery selectees.
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  36. Prioritizing the Prevention of Early Deaths During Covid‐19.Govind Persad - 2021 - Hastings Center Report 51 (2):42-43.
    In this Correspondence, I argue that given that scarcity has existed both for critical care resources and for vaccines, allocating critical care resources to prioritize the prevention of early COVID-19 deaths (i.e. COVID-19 deaths among younger patients) could valuably counterbalance the disproportionate exclusion of minority patients and those with life shortening disabilities that age-based vaccine allocation produces. -/- Covid-19 deaths early in life have overwhelmingly befallen minorities and people with life-shortening disabilities. Policies preventing early deaths prevent an outcome widely recognized (...)
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  37. Against Exclusive Survivalism: Preventing Lost Life and Protecting the Disadvantaged in Resource Allocation.Govind Persad - 2021 - Hastings Center Report 51 (5):47-51.
    When life-saving medical resources are scarce and not everyone can be saved, is the only relevant goal saving the most lives? Or can other factors be considered, at least as tiebreakers, such as how early in life the people we don't save will die or how much future life they are likely to lose? This commentary defends a multiprinciple allocation approach that considers objectives in addition to saving more lives, including preventing early death and preventing harm in the form of (...)
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  38. Allocating Medicine Fairly in an Unfair Pandemic.Govind Persad - 2021 - University of Illinois Law Review 2021 (3):1085-1134.
    America’s COVID-19 pandemic has both devastated and disparately harmed minority communities. How can the allocation of scarce treatments for COVID-19 and similar public health threats fairly and legally respond to these racial disparities? Some have proposed that members of racial groups who have been especially hard-hit by the pandemic should receive priority for scarce treatments. Others have worried that this prioritization misidentifies racial disparities as reflecting biological differences rather than structural racism, or that it will generate mistrust among groups who (...)
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  39. Public Perspectives on COVID-19 Vaccine Prioritization.Govind Persad, Ezekiel J. Emanuel, Samantha Sangenito, Aaron Glickman, Steven Phillips & Emily A. Largent - 2021 - JAMA Network Open 4 (4):e217943.
    In this survey study of 4735 US adults, respondents of all demographic and political affiliations agreed with prioritizing COVID-19 vaccine access for health care workers, adults of any age with serious comorbid conditions, frontline workers (eg, teachers and grocery workers), and Black, Hispanic, Native American, and other communities that have been disproportionately affected by COVID-19. Older adult respondents were less likely than younger respondents to list healthy people older than 65 years as 1 of their top 4 priority groups. These (...)
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  40. Fair Allocation of Scarce Therapies for COVID-19.Govind Persad, Monica E. Peek & Seema K. Shah - 2021 - Clinical Infectious Diseases 18:ciab1039.
    The U.S. FDA has issued emergency use authorizations for monoclonal antibodies for non-hospitalized patients with mild or moderate COVID-19 disease and for individuals exposed to COVID-19 as post-exposure prophylaxis. One EUA for an oral antiviral drug, molnupiravir, has also been recommended by FDA’s Antimicrobial Drugs Advisory Committee, and others appear likely in the near future. Due to increased demand because of the Delta variant, the federal government resumed control over the supply and asked states to ration doses. As future variants (...)
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  41. Allocation of Scarce Biospecimens for Use in Research.Leah Pierson, Sophia Gibert, Benjamin Berkman, Marion Danis & Joseph Millum - 2021 - Journal of Medical Ethics 47 (11):740-743.
    Hundreds of millions of rare biospecimens are stored in laboratories and biobanks around the world. Often, the researchers who possess these specimens do not plan to use them, while other researchers limit the scope of their work because they cannot acquire biospecimens that meet their needs. This situation raises an important and underexplored question: how should scientists allocate biospecimens that they do not intend to use? We argue that allocators should aim to maximise the social value of the research enterprise (...)
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  42. The Complex Relationship Between Disability Discrimination and Frailty Scoring.Joel Michael Reynolds, Charles E. Binkley & Andrew Shuman - 2021 - American Journal of Bioethics 21 (11):74-76.
    In "Frailty Triage: Is Rationing Intensive Medical Treatment on the Grounds of Frailty Ethical?," Wilkinson (2021) argues that the use of frailty scores in ICU triage does not necessarily involve discrimination on the basis of disability. In support of this argument, he claims, “it is not the disability per se that the score is measuring – rather it is the underlying physiological and physical vulnerability." While we appreciate the attention Wilkinson explicitly pays to disability in this piece, we find the (...)
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  43. How Can We Decide a Fair Allocation of Healthcare Resources During a Pandemic?Cristina Roadevin & Harry Hill - 2021 - Journal of Medical Ethics 47 (12):84-84.
    Whenever the government makes medical resource allocation choices, there will be opportunity costs associated with those choices: some patients will have treatment and live longer, while a different group of patients will die prematurely. Because of this, we have to make sure that the benefits we get from investing in treatment A are large enough to justify the benefits forgone from not investing in the next best alternative, treatment B. There has been an increase in spending and reallocation of resources (...)
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  44. COVID-19 Pandemic Healthcare Resource Allocation, Age and Frailty.David G. Smithard & James Haslam - 2021 - The New Bioethics 27 (2):127-132.
    The current coronavirus pandemic presents the greatest healthcare crisis in living memory. Hospitals across the world have faced unprecedented pressure. In the face of this tidal wave of demand for limited healthcare resources, how are clinicians to identify patients most likely to benefit? Should age or frailty be discriminators? This paper seeks to analyse the current evidence-base, seeking a nuanced approach to pandemic decision-making, such as admission to critical care.
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  45. Respect for Persons and the Allocation of Lifesaving Healthcare Resources.Xavier Symons - 2021 - Bioethics 35 (5):392-399.
    Many ethicists argue that we should respect persons when we distribute resources. Yet it is unclear what this means in practice. For some, the idea of respect for persons is synonymous with the idea of respect for autonomy. Yet a principle of respect for autonomy provides limited guidance for how we should distribute scarce medical interventions. In this article, however, I sketch an alternative conception of respect for persons—one that is based on an ethic of mutual accountability. I draw in (...)
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  46. Triage and Justice in an Unjust Pandemic: Ethical Allocation of Scarce Medical Resources in the Setting of Racial and Socioeconomic Disparities.Benjamin Tolchin, Sarah C. Hull & Katherine Kraschel - 2021 - Journal of Medical Ethics 47 (3):200-202.
    Shortages of life-saving medical resources caused by COVID-19 have prompted hospitals, healthcare systems, and governmentsto develop crisis standards of care, including 'triage protocols' to potentially ration medical supplies during the public health emergency. At the same time, the pandemic has highlighted and exacerbated racial, ethnic, and socioeconomic health disparities that together constitute a form of structural racism. These disparities pose a critical ethical challenge in developing fair triage systems that will maximize lives saved without perpetuating systemic inequities. Here we review (...)
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  47. The Evolving Science of Disorders of Consciousness Calls for an Inclusive Framework for Healthcare Resource Allocation.Jasmine Walter - 2021 - American Journal of Bioethics Neuroscience 12 (2-3):151-153.
    Commentary on "What Justifies the Allocation of Health Care Resources to Patients with Disorders of Consciousness?", Peterson, Aas and Wasserman.
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  48. Rural Bioethics: The Alaska Context.Fritz Allhoff & Luke Golemon - 2020 - HEC Forum 32 (4):313-331.
    With by far the lowest population density in the United States, myriad challenges attach to healthcare delivery in Alaska. In the “Size, Population, and Accessibility” section, we characterize this geographic context, including how it is exacerbated by lack of infrastructure. In the “Distributing Healthcare” section, we turn to healthcare economics and staffing, showing how these bear on delivery—and are exacerbated by geography. In the “Health Care in Rural Alaska” section, we turn to rural care, exploring in more depth what healthcare (...)
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  49. Pandemic Ethics: 8 Big Questions of COVID-19.Ben Bramble - 2020 - Sydney: Bartleby Books.
    A clear and provocative introduction to the ethics of COVID-19, suitable for university-level students, academics, and policymakers, as well as the general reader. It is also an original contribution to the emerging literature on this important topic. The author has made it available Open Access, so that it can be downloaded and read for free by all those who are interested in these issues. Key features include: -/- A neat organisation of the ethical issues raised by the pandemic. An exploration (...)
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  50. Ethical Allocation of Remdesivir.Parker Crutchfield, Tyler S. Gibb, Michael J. Redinger & William Fales - 2020 - American Journal of Bioethics 20 (7):84-86.
    As the federal government distributed remdesivir to some of the states COVID-19 hit hardest, policymakers scrambled to develop criteria to allocate the drug to their hospitals. Our state, Michigan, was among those states to receive an initial quantity of the drug from the U.S. government. The disparities in burden of disease in Michigan are striking. Detroit has a death rate more than three times the state average. Our recommendation to the state was that it should prioritize the communities that bear (...)
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