Allocation of scarce resources in a pandemic

Cas Lek Cesk. 2021 Spring;160(2-3):47-51.

Abstract

The allocation of scarce medical resources during a pandemic is one of the most challenging medical doctors' decisions. Although these decisions are based on the best medical knowledge and lege artis practice, they are inextricably intertwined with ethical and prudential (related to the patients' well-being) values. This article stresses the importance of ethical decision making during the whole process of allocation. First, it sets out to lay down a set of moral principles governing the allocation of scarce resources (mechanical ventilation, ECMO, etc.). This way it paves the way for more concrete ethical recommendations. Second, it analyses and describes in elaborate detail the criteria for admission to the ICU and two triage phases. The first reflects egalitarian concerns, and the second considers age as a proxy for the badness of death and other age-related considerations. Lastly, the paper offers a legal analysis of the process of allocation in the context of the Czech legal system.

Keywords: allocation; ethics; guidelines; law; recommendations; scarce resources; triage.

MeSH terms

  • COVID-19*
  • Health Care Rationing
  • Humans
  • Pandemics*
  • Triage