Health Care Analysis:1-20 (forthcoming)

Authors
Jonathan Pugh
Oxford University
Dominic Wilkinson
Oxford University
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 some precedence in the regional triage question, but also note important limitations to the extent of the influence that it should have in regional allocation decisions.
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DOI 10.1007/s10728-020-00427-5
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References found in this work BETA

Equality and Priority.Derek Parfit - 1997 - Ratio 10 (3):202–221.
First Come, First Served?Tyler M. John & Joseph Millum - 2019 - Ethics 130 (2):179-207.
Innumerate Ethics.Derek Parfit - 1978 - Philosophy and Public Affairs 7 (4):285-301.

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