As Covid spreads and leaves intensive care units at or near full capacity in several states, some regions have approved crisis care standards, which involve rationing of healthcare. The latest report from the Hastings Center presents a collection of articles on debates over standards of care in crisis – guidelines for allocating health care resources if those resources are too scarce to meet everyone’s needs the patients.
Years of life and rationing in the Covid-19 pandemic: a critical analysis
MaryKatherine Gaurke, Bernard Prusak, Kyeong Yun Jeong, Emily Scire, Daniel P. Sulmasy
Eminent bioethicists have promoted the preservation of years of life as a rationing strategy in response to the Covid-19 pandemic. This article offers a critical investigation into the use of years of life, arguing that the evidence for public support for this approach is scant. The authors propose an alternative which adheres to the standard duties of beneficence, respect for people and justice.
University of California Crisis Care Standards: Public Rationale for Socially Responsible Medicine
Alex Rajczi, Judith Daar, Aaron Kheriaty, Cyrus Dastur
This article highlights crucial elements of the University of California Crisis Care Standards triage procedures, developed by a bioethics working group in response to the Covid-19 pandemic. The recommendations are distinguished by their emphasis on making decisions based on public preference for triage protocols. The article contrasts UC procedures with the triage procedures known as the “Pittsburgh framework”. Specific topics covered include age discrimination, disability discrimination, prioritization of essential workers for scarce resources, and triage priority for pregnant patients.
Other Voices: Five comments offer further arguments and ideas about standards of crisis care:
“Structural inequalities, fair opportunity and allocation of scarce ICR resources», By Douglas B. White, Bernard Lo
“Against exclusive survival: preventing loss of life and protecting disadvantaged people in the allocation of resources, by Govind Persad
“Center social justice for resources and research on Covid-19”, by Virginia A. Brown
“Standards of Care in Crisis: More Than Just a Thought-Through Experiment?” “ by Anuj B. Mehta and Matthew K. Wynia
“Ventilator allocation protocols: sophisticated bioethics for an unworkable strategy”, by Robert D. Truog
Table of contents of the Hastings Center report for September-October 2021: https://onlinelibrary.wiley.com/toc/1552146x/2021/51/5
