Abstract

The Covid-19 pandemic provides a real-world context for evaluating the fairness of disability-based rationing of scarce medical resources. I discuss three situations clinicians may face: rationing based on disability itself; rationing based on inevitable disability-related comorbidities; and rationing based on preventable disability-related comorbidities. I defend three conclusions. First, in a just distribution, extraneous factors do not influence a person’s share. This rules out rationing based on disability alone, where no comorbidities decrease a person’s capacity to benefit from treatment. Second, in a just distribution, undeserved luck does not influence a person’s share. This rules out rationing for biologically caused comorbidities that decrease capacity to benefit. Third, in a just distribution, social injustice does not influence a person’s share. This rules out rationing for socially caused comorbidities that decrease capacity to benefit.