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Tragic choices in intensive care during the COVID-19 pandemic: on fairness, consistency and community
- Source :
- Journal of Medical Ethics
- Publication Year :
- 2020
- Publisher :
- BMJ Publishing Group, 2020.
-
Abstract
- Tragic choices arise during the COVID-19 pandemic when the limited resources made available in acute medical settings cannot be accessed by all patients who need them. In these circumstances, healthcare rationing is unavoidable. It is important in any healthcare rationing process that the interests of the community are recognised, and that decision-making upholds these interests through a fair and consistent process of decision-making. Responding to recent calls (1) to safeguard individuals’ legal rights in decision-making in intensive care, and (2) for new authoritative national guidance for decision-making, this paper seeks to clarify what consistency and fairness demand in healthcare rationing during the COVID-19 pandemic, from both a legal and ethical standpoint. The paper begins with a brief review of UK law concerning healthcare resource allocation, considering how community interests and individual rights have been marshalled in judicial deliberation about the use of limited health resources within the National Health Service (NHS). It is then argued that an important distinction needs to be drawn between procedural and outcome consistency, and that a procedurally consistent decision-making process ought to be favoured. Congruent with the position that UK courts have adopted for resource allocation decision-making in the NHS more generally, specific requirements for a procedural framework and substantive triage criteria to be applied within that framework during the COVID-19 pandemic are considered in detail.
- Subjects :
- Health (social science)
Critical Care
media_common.quotation_subject
Decision Making
Pneumonia, Viral
0603 philosophy, ethics and religion
State Medicine
Health(social science)
03 medical and health sciences
Betacoronavirus
0302 clinical medicine
Consistency (negotiation)
Arts and Humanities (miscellaneous)
Intensive care
Political science
Pandemic
Health care
Humans
030212 general & internal medicine
Current Controversy
law
Pandemics
media_common
Health Care Rationing
business.industry
SARS-CoV-2
Health Policy
Rationing
clinical ethics
COVID-19
06 humanities and the arts
decision-making
Public relations
16. Peace & justice
Deliberation
allocation of health care resources
Triage
United Kingdom
3. Good health
Issues, ethics and legal aspects
Resource allocation
060301 applied ethics
business
Coronavirus Infections
Subjects
Details
- Language :
- English
- ISSN :
- 14734257
- Database :
- OpenAIRE
- Journal :
- Journal of Medical Ethics
- Accession number :
- edsair.doi.dedup.....69ab497570050e2ac62adda267b07eee