4 principles to help health care professionals decide who gets scarce resources during a pandemic
about pandemics based primarily on age and prognosis for short-term and long-term survival that is less explicit about values.
The Italian group recognizes that age is not the only factor to be taken into account in deciding who gets a ventilator. A younger patient with underlying health problems such as high blood pressure and diabetes may be a worse risk for survival than an older patient with fewer problems.
I think that the policy for giving ventilators to younger patients is justifiable even if it causes harm to older ones. Alternative strategies such as lotteries and first-come-first-served bring less overall benefits. Not having a strategy leaves decision making to individual doctors whose intuitions may be biased by race or other unfair factors.
Similarly, government decisions to restrict freedom by imposing quarantines and lockdowns are ethically justifiable because of the terrible harms suffered by large numbers of people who are sick or dying from COVID-19. Eventually, the waning of the pandemic will eliminate the need for these excruciating decisions, but future pandemics will bring them back.
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