The Ethics of Creating a Resource Allocation Strategy During the COVID-19 Pandemic

Laventhal, Naomi; Basak, Ratna B; Dell, Mary Lynn; Diekema, Douglas S.; Elster, Nanette; Geis, Gina; Mercurio, Mark R.; Opel, Douglas J.; Shalowitz, David I.; Statter, Mindy B.; Macauley, Robert

doi:10.1542/peds.2020-1243

Cited by 71 publications

(63 citation statements)

References 37 publications

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“…During a pandemic, standard crises care protocols should be developed by public health institutions to establish a systematic and evidence based procedure which ensures fair distribution of health care resources. Thus shifting the focus from prioritizing individual patient benefits to maximizing benefits to the community as a whole [56]. Priority decisions regarding resource allocation should not be discriminatory i.e.…”

Section: Ethical Obligations With Respect To Resource Allocationmentioning

confidence: 99%

Ethics, pandemic and environment; looking at the future of low middle income countries

Tanveer

Khalil

Ali

2020

Int J Equity Health

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COVID-19 which started in Wuhan, China and swiftly expanded geographically worldwide, including to Low to Middle Income Countries (LMICs). This in turn raised numerous ethical concerns in preparedness, knowledge sharing, intellectual property rights, environmental health together with the serious constraints regarding readiness of health care systems in LMICs to respond to this enormous public health crisis. From the restrictions on public freedom and burgeoning socio-economic impacts to the rationing of scarce medical resources, the spread of COVID-19 is an extraordinary ethical dilemma for resource constrained nations with less developed health and research systems. In the current crisis, scientific knowledge and technology has an important role to play in effective response. Emergency preparedness is a shared responsibility of all countries with a moral obligation to support each other. This review discusses the ethical concerns regarding the national capacities and response strategies in LMICs to deal with the COVID-19 pandemic as well as the deep link between the environment and the increasing risk of pandemics.

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Section: Ethical Obligations With Respect To Resource Allocationmentioning

confidence: 99%

Ethics, pandemic and environment; looking at the future of low middle income countries

Tanveer

Khalil

Ali

2020

Int J Equity Health

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“…It is noteworthy that, currently, it is unclear whether any severity score for pediatric or neonatal disease provides valid prognostic measures for COVID-19 patients [51].…”

Section: Clinical Criteriamentioning

confidence: 99%

COVID-19: instruments for the allocation of mechanical ventilators—a narrative review

et al. 2020

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After the World Health Organization declared COVID-19 to be a pandemic, the elaboration of comprehensive and preventive public policies became important in order to stop the spread of the disease. However, insufficient or ineffective measures may have placed health professionals and services in the position of having to allocate mechanical ventilators. This study aimed to identify instruments, analyze their structures, and present the main criteria used in the screening protocols, in order to help the development of guidelines and policies for the allocation of mechanical ventilators in the COVID-19 pandemic. The instruments have a low level of scientific evidence, and, in general, are structured by various clinical, non-clinical, and tiebreaker criteria that contain ethical aspects. Few instruments included public participation in their construction or validation. We believe that the elaboration of these guidelines cannot be restricted to specialists as this question involves ethical considerations which make the participation of the population necessary. Finally, we propose seventeen elements that can support the construction of screening protocols in the COVID-19 pandemic.

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“…Estimation of benefit is tightly linked to the prognosis of individuals who receive scarce resources; policies should consider both lives saved as well as morbidity prevented. The Sequential Organ Failure Assessment (SOFA) scale has been frequently utilized as a standardized assessment of prognosis in critically ill adults; alternate scales should be used for pediatric patients [7,8]. For critical care resources, survival-to-discharge may be the most appropriate metric of benefit.…”

Section: General Principles For Allocation Of Scarce Healthcare Resoumentioning

confidence: 99%

Principles of ethics and critical communication during the COVID-19 pandemic

Shalowitz

Lefkowits

Landrum

et al. 2020

Gynecologic Oncology

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h i g h l i g h t s • During the COVID-19 pandemic, the primary clinical emphasis has shifted to optimizing community health. • Scarce resources should be allocated to maximize benefit without unfairly affecting any group. • Healthcare systems should consider adopting a formal, tier-based response to COVID-19 related demand on resources. • Clinicians should use principles of high-stakes communication to guide care planning during the pandemic.

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The Ethics of Creating a Resource Allocation Strategy During the COVID-19 Pandemic

Cited by 71 publications

References 37 publications

Ethics, pandemic and environment; looking at the future of low middle income countries

Ethics, pandemic and environment; looking at the future of low middle income countries

COVID-19: instruments for the allocation of mechanical ventilators—a narrative review

Principles of ethics and critical communication during the COVID-19 pandemic

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