Ethical Issues and the Allocation of Scarce Resources During a Public Health Emergency

Infectious disease pandemics raise significant and novel ethical challenges to the organization and practice of public health. This chapter provides an overview of the salient ethical issues involved in preparing for and responding to pandemic disease, including those arising from deploying restrictive public health measures to contain and curb the spread of disease (e.g., isolation and quarantine), setting priorities for the allocation of scarce resources, health care workers’ duty to care in the face of heightened risk of infection, conducting research during pandemics, and the global governance of preventing and responding to pandemic disease. It also outlines ethical guidance from prominent ethical frameworks that have been developed to address these ethical issues and concludes by discussing some pressing challenges that must be addressed if ethical reflection is to make a meaningful difference in pandemic preparedness and response.

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Ethical Issues in Scarce Resource Allocation in a Global Pandemic: Relevance to Craniofacial Surgery

FACE ◽

10.1177/2732501620949192 ◽

2020 ◽

Vol 1 (1) ◽

pp. 41-43

Author(s):

Christian J. Vercler

Keyword(s):

Public Health ◽

Ethical Issues ◽

Biomedical Ethics ◽

Ethical Responsibility ◽

Individual Member ◽

Protective Equipment ◽

Ethical Guidelines ◽

Life And Death ◽

Scarce Resources ◽

Global Pandemic

The response to the COVID-19 pandemic has necessitated a shift in how we apply the principles of biomedical ethics. The historical foundation of the ethical responsibility of the physician to the patient rests on the of that individual relationship. The patient comes first. However, in a pandemic, a public health ethics takes over, and the focus changes to what each individual member of society’s responsibility is to the collective. The greatest good for the greatest number trumps a given individual’s needs. Ethicists have focused primarily on creating guidelines that apply to allocating scarce life-and-death-determining resources. Very little attention has been paid to scarce resources that are more mundane, such as personal protective equipment (PPE) or operating room (OR) time. I present here a summary of the most recent ethical guidelines for allocation of scarce resources, note some concerns with these approaches, and discuss some of the shortcomings of applying these frameworks to the practice of craniofacial surgeons.

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Fallacy of the last bed dilemma

Journal of Medical Ethics ◽

10.1136/medethics-2021-107333 ◽

2021 ◽

pp. medethics-2021-107333

Author(s):

Luca Valera ◽

María A. Carrasco ◽

Ricardo Castro

Keyword(s):

Public Health ◽

Decision Making ◽

Critical Care ◽

Medical Care ◽

Ethical Issues ◽

Moral Dilemma ◽

Scarce Resources ◽

Ethical View

The COVID-19 pandemic highlights the relevance of adequate decision making at both public health and healthcare levels. A bioethical response to the demand for medical care, supplies and access to critical care is needed. Ethically sound strategies are required for the allocation of increasingly scarce resources, such as rationing critical care beds. In this regard, it is worth mentioning the so-called ‘last bed dilemma’. In this paper, we examine this dilemma, pointing out the main criteria used to solve it and argue that we cannot face these ethical issues as though they are only a dilemma. A more complex ethical view regarding the care of COVID-19 patients that is focused on proportional and ordinary treatments is required. Furthermore, discussions and forward planning are essential because deliberation becomes extremely complex during an emergency and the physicians’ sense of responsibility may be increased if it is faced only as a moral dilemma.

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The legal and medical necessity of abortion care amid the COVID-19 pandemic

Journal of Law and the Biosciences ◽

10.1093/jlb/lsaa013 ◽

2020 ◽

Vol 7 (1) ◽

Cited By ~ 3

Author(s):

Greer Donley ◽

Beatrice A Chen ◽

Sonya Borrero

Keyword(s):

Public Health ◽

Prenatal Care ◽

Healthcare Professionals ◽

Public Health Emergency ◽

Short Paper ◽

Scarce Resources ◽

Abortion Care ◽

Delivery Assistance ◽

Constitutional Right ◽

Health Purpose

Abstract In response to the COVID-19 pandemic, states have ordered the cessation of non-essential healthcare. Unfortunately, many conservative states have sought to capitalize on those orders to halt abortion care. In this short paper, we argue that abortion should not fall under any state’s non-essential healthcare order. Major medical organizations recognize that abortion is essential healthcare that must be provided even in a pandemic, and the law recognizes abortion as a time-sensitive constitutional right. Finally, we examine the constitutional arguments as to why enforcing these orders against abortion providers should not stand constitutional scrutiny. We conclude that no public health purpose can be served by this application because abortion uses less scarce resources and involves fewer contacts with healthcare professionals than prenatal care and delivery assistance, which is continuing to be provided in this public health emergency.

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Ethics in times of COVID-19

Mexican Bioethics Review ICSA ◽

10.29057/mbr.v2i4.6301 ◽

2021 ◽

Vol 2 (4) ◽

pp. 15-21

Author(s):

Claudia Hazzel De la Fuente Piñeiro ◽

Arianna Omaña-Covarrubias ◽

Adrián Moya-Escalera ◽

Carlos Cuevas-Suárez

Keyword(s):

Public Health ◽

Health Care ◽

Distributive Justice ◽

Health Care System ◽

Ethical Issues ◽

Public Health Care ◽

Scarce Resources ◽

Care System

The main ethical issues in the management and safety of public health care are: distributive justice and non-abandonment. The COVID-19 pandemic raises difficult ethical questions for our health care system. Perhaps the most difficult is how to equally distribute scarce resources, and determine who lives and who dies.

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