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  1. Systemising Triage: COVID-19 Guidelines and Their Underlying Theories of Distributive Justice.Lukas J. Meier - 2022 - Medicine, Health Care and Philosophy 25 (4):703-714.
    The COVID-19 pandemic has been overwhelming public health-care systems around the world. With demand exceeding the availability of medical resources in several regions, hospitals have been forced to invoke triage. To ensure that this difficult task proceeds in a fair and organised manner, governments scrambled experts to draft triage guidelines under enormous time pressure. Although there are similarities between the documents, they vary considerably in how much weight their respective authors place on the different criteria that they propose. Since most (...)
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  • The Ethical Duty to Reduce the Ecological Footprint of Industrialized Healthcare Services and Facilities.Corey Katz - 2022 - Journal of Medicine and Philosophy 47 (1):32-53.
    According to the widely accepted principles of beneficence and distributive justice, I argue that healthcare providers and facilities have an ethical duty to reduce the ecological footprint of the services they provide. I also address the question of whether the reductions in footprint need or should be patient-facing. I review Andrew Jameton and Jessica Pierce’s claim that achieving ecological sustainability in the healthcare sector requires rationing the treatment options offered to patients. I present a number of reasons to think that (...)
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  • Helpful Lessons and Cautionary Tales: How Should COVID-19 Drug Development and Access Inform Approaches to Non-Pandemic Diseases?Holly Fernandez Lynch, Arthur Caplan, Patricia Furlong & Alison Bateman-House - 2021 - American Journal of Bioethics 21 (12):4-19.
    After witnessing extraordinary scientific and regulatory efforts to speed development of and access to new COVID-19 interventions, patients facing other serious diseases have begun to ask “where’s...
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  • Who should be tested in a pandemic? Ethical considerations. [REVIEW]Niklas Juth, Gert Helgesson & Sven Ove Hansson - 2021 - BMC Medical Ethics 22 (1):1-11.
    BackgroundIn the initial phase of the Covid-19 pandemic, difficult decisions had to be made on the allocation of testing resources. Similar situations can arise in future pandemics. Therefore, careful consideration of who should be tested is an important part of pandemic preparedness. We focus on four ethical aspects of that problem: how to prioritize scarce testing resources, the regulation of commercial direct-to-consumer test services, testing of unauthorized immigrants, and obligatory testing.Main textThe distribution of scarce resources for testing: We emphasize the (...)
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  • Ethical Challenges Arising in the COVID-19 Pandemic: An Overview from the Association of Bioethics Program Directors (ABPD) Task Force.Amy L. McGuire, Mark P. Aulisio, F. Daniel Davis, Cheryl Erwin, Thomas D. Harter, Reshma Jagsi, Robert Klitzman, Robert Macauley, Eric Racine, Susan M. Wolf, Matthew Wynia & Paul Root Wolpe - 2020 - American Journal of Bioethics 20 (7):15-27.
    The COVID-19 pandemic has raised a host of ethical challenges, but key among these has been the possibility that health care systems might need to ration scarce critical care resources. Rationing p...
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  • The Ethics of the Reuse of Disposable Medical Supplies.Anjan Kumar Das, Taketoshi Okita, Aya Enzo & Atsushi Asai - 2020 - Asian Bioethics Review 12 (2):103-116.
    The use of single-use items is now ubiquitous in medical practice. Because of the high costs of these items, the practice of reusing them after sterilisation is also widespread especially in resource-poor economies. However, the ethics of reusing disposable items remain unclear. There are several analogous conditions, which could shed light on the ethics of reuse of disposables. These include the use of restored kidney transplantation and the use of generic drugs etc. The ethical issues include the question of patient (...)
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  • First Come, First Served?Tyler M. John & Joseph Millum - 2020 - Ethics 130 (2):179-207.
    Waiting time is widely used in health and social policy to make resource allocation decisions, yet no general account of the moral significance of waiting time exists. We provide such an account. We argue that waiting time is not intrinsically morally significant, and that the first person in a queue for a resource does not ipso facto have a right to receive that resource first. However, waiting time can and sometimes should play a role in justifying allocation decisions. First, there (...)
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  • Bursting Bubbles? QALYs and Discrimination.Ben Davies - 2019 - Utilitas 31 (2):191-202.
    The use of Quality-Adjusted Life Years (QALYs) in healthcare allocation has been criticized as discriminatory against people with disabilities. This article considers a response to this criticism from Nick Beckstead and Toby Ord. They say that even if QALYs are discriminatory, attempting to avoid discrimination – when coupled with other central principles that an allocation system should favour – sometimes leads to irrationality in the form of cyclic preferences. I suggest that while Beckstead and Ord have identified a problem, it (...)
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  • Uterus Transplantation: The Ethics of Using Deceased Versus Living Donors.Bethany Bruno & Kavita Shah Arora - 2018 - American Journal of Bioethics 18 (7):6-15.
    Research teams have made considerable progress in treating absolute uterine factor infertility through uterus transplantation, though studies have differed on the choice of either deceased or living donors. While researchers continue to analyze the medical feasibility of both approaches, little attention has been paid to the ethics of using deceased versus living donors as well as the protections that must be in place for each. Both types of uterus donation also pose unique regulatory challenges, including how to allocate donated organs; (...)
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  • Fair, just and compassionate: A pilot for making allocation decisions for patients requesting experimental drugs outside of clinical trials.Arthur L. Caplan, J. Russell Teagarden, Lisa Kearns, Alison S. Bateman-House, Edith Mitchell, Thalia Arawi, Ross Upshur, Ilina Singh, Joanna Rozynska, Valerie Cwik & Sharon L. Gardner - 2018 - Journal of Medical Ethics 44 (11):761-767.
    Patients have received experimental pharmaceuticals outside of clinical trials for decades. There are no industry-wide best practices, and many companies that have granted compassionate use, or ‘preapproval’, access to their investigational products have done so without fanfare and without divulging the process or grounds on which decisions were made. The number of compassionate use requests has increased over time. Driving the demand are new treatments for serious unmet medical needs; patient advocacy groups pressing for access to emerging treatments; internet platforms (...)
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  • Let Us Be Fair to 5-Year-Olds: Priority for the Young in the Allocation of Scarce Health Resources.Kelsey Gipe & Samuel J. Kerstein - 2018 - Public Health Ethics 11 (3):325-335.
    Life-saving health resources like organs for transplant and experimental medications are persistently scarce. How ought we, morally speaking, to ration these resources? Many hold that, in any morally acceptable allocation scheme, the young should to some extent be prioritized over the old. Govind Persad, Alan Wertheimer and Ezekiel Emanuel propose a multi-principle allocation scheme called the Complete Lives System, according to which persons roughly between 15 and 40 years old get priority over younger children and older adults, other things being (...)
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  • Fairness and Transparency in an Expanded Access Program: Allocation of the Only Treatment for SMA1.Alyssa M. Burgart, Julie Collier & Mildred K. Cho - 2017 - American Journal of Bioethics 17 (10):71-73.
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  • What Is the Relevance of Procedural Fairness to Making Determinations about Medical Evidence?Govind Persad - 2017 - AMA Journal of Ethics 19 (2):183-191.
    Approaches relying on fair procedures rather than substantive principles have been proposed for answering dilemmas in medical ethics and health policy. These dilemmas generally involve two questions: the epistemological (factual) question of which benefits an intervention will have, and the ethical (value) question of how to distribute those benefits. This article focuses on the potential of fair procedures to help address epistemological and factual questions in medicine, using the debate over antidepressant efficacy as a test case. In doing so, it (...)
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  • Medical Need: Evaluating a Conceptual Critique of Universal Health Coverage.Lynette Reid - 2017 - Health Care Analysis 25 (2):114-137.
    Some argue that the concept of medical need is inadequate to inform the design of a universal health care system—particularly an institutional rather than a residual system. They argue that the concept contradicts the idea of comprehensiveness; leads to unsustainable expenditures; is too indeterminate for policy; and supports only a prioritarian distribution. I argue that ‘comprehensive’ understood as ‘including the full continuum of care’ and ‘medically necessary’ understood as ‘prioritized by medical criteria’ are not contradictory, and that UHC is a (...)
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  • Balancing Legitimate Critical-Care Interests: Setting Defensible Care Limits Through Policy Development.Jeffrey Kirby - 2016 - American Journal of Bioethics 16 (1):38-47.
    Critical-care decision making is highly complex, given the need for health care providers and organizations to consider, and constructively respond to, the diverse interests and perspectives of a variety of legitimate stakeholders. Insights derived from an identified set of ethics-related considerations have the potential to meaningfully inform inclusive and deliberative policy development that aims to optimally balance the competing obligations that arise in this challenging, clinical decision-making domain. A potential, constructive outcome of such policy engagement is the collaborative development of (...)
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  • Against ‘Saving Lives’: Equal Concern and Differential Impact.Richard Yetter Chappell - 2016 - Bioethics 30 (3):159-164.
    Bioethicists often present ‘saving lives’ as a goal distinct from, and competing with, that of extending lives by as much as possible. I argue that this usage of the term is misleading, and provides unwarranted rhetorical support for neglecting the magnitudes of the harms and benefits at stake in medical allocation decisions, often to the detriment of the young. Equal concern for all persons requires weighting equal interests equally, but not all individuals have an equal interest in ‘life-saving’ treatment.
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  • The Seminal Contribution of Rabbi Moshe Feinstein to the Development of Modern Jewish Medical Ethics.Alan Jotkowitz - 2014 - Journal of Religious Ethics 42 (2):285-309.
    The purpose of this essay is to show how, on a wide variety of issues, Rabbi Moshe Feinstein broke new ground with the established Orthodox rabbinic consensus and blazed a new trail in Jewish medical ethics. Rabbi Feinstein took power away from the rabbis and let patients decide their treatment, he opened the door for a Jewish approach to palliative care, he supported the use of new technologies to aid in reproduction, he endorsed altruistic living organ donation and recognized brain (...)
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  • Priority Setting in the Assessment for Kidney Transplant Candidacy: A Canadian Case Study.Faisal Omar - 2012 - Journal of Clinical Research and Bioethics 3 (S1).
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  • Which newborn infants are too expensive to treat? Camosy and rationing in intensive care.Dominic Wilkinson - 2013 - Journal of Medical Ethics 39 (8):502-506.
    Are there some newborn infants whose short- and long-term care costs are so great that treatment should not be provided and they should be allowed to die? Public discourse and academic debate about the ethics of newborn intensive care has often shied away from this question. There has been enough ink spilt over whether or when for the infant's sake it might be better not to provide life-saving treatment. The further question of not saving infants because of inadequate resources has (...)
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  • Conceptions of Care: Altruism, Feminism, and Mature Care.Tove Pettersen - 2012 - Hypatia 27 (2):366-389.
    In “Conceptions of Care,” Tove Pettersen discusses and articulates select ways in which care can be comprehended. Several difficulties related to an altruistic understanding of care are examined before the author presents the case for a more favorable concept: mature care. Mature care is intended to take into account the interests of both parties to the caring relationship. This understanding of care facilitates the expression of the relational and reciprocal aspects of caring while emphasizing the equal worth of all involved. (...)
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  • End-of-life decisions as bedside rationing. An ethical analysis of life support restrictions in an Indian neonatal unit.I. Miljeteig, K. A. Johansson, S. A. Sayeed & O. F. Norheim - 2010 - Journal of Medical Ethics 36 (8):473-478.
    Introduction Hundreds of thousands of premature neonates born in low-income countries are implicitly denied treatment each year. Studies from India show that treatment is rationed even for neonates born at 32 gestational age weeks (GAW), and multiple external factors influence treatment decisions. Is withholding of life-saving treatment for children born between 28 and 32 GAW acceptable from an ethical perspective? Method A seven-step impartial ethical analysis, including outcome analysis of four accepted priority criteria: severity of disease, treatment effect, cost effectiveness (...)
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  • What’s the Appropriate Target of Allocative Justification?Zara Anwarzai & Ricky Mouser - 2021 - American Journal of Bioethics Neuroscience 12 (2-3):167-168.
    Building on work by Peterman, Aas, and Wasserman (2021), we modify their prospective benefit analysis to include only medically-relevant information about patients as persons without reference to their broader lives. Because patients (not their lives) must be treated equally, we argue that patients are the appropriate targets of allocative justification. We go on to challenge some of our current data-collection practices on this basis.
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  • Reciprocity as an Argument for Prioritizing Health Care Workers for the COVID-19 Vaccine.Borgar Jølstad & Carl Tollef Solberg - 2023 - De Ethica 7 (2):28-43.
    During the recent debates on whether to prioritize health care workers for COVID-19 vaccines, two main lines of arguments emerged: one centered on maximizing health and one centered on reciprocity. In this article, we scrutinize the argument from reciprocity. The notions of fittingness and proportionality are fundamental for the act of reciprocating. We consider the importance of these notions for various arguments from reciprocity, showing that the arguments are problematic. If there is a plausible argument for reciprocity during the pandemic, (...)
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  • A market failures approach to justice in health.L. Chad Horne & Joseph Heath - 2022 - Politics, Philosophy and Economics 21 (2):165-189.
    Politics, Philosophy & Economics, Volume 21, Issue 2, Page 165-189, May 2022. It is generally acknowledged that a certain amount of state intervention in health and health care is needed to address the significant market failures in these sectors; however, it is also thought that the primary rationale for state involvement in health must lie elsewhere, for example in an egalitarian commitment to equalizing access to health care for all citizens. This paper argues that a complete theory of justice in (...)
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  • We Should Not Use Randomization Procedures to Allocate Scarce Life-Saving Resources.Roberto Fumagalli - 2022 - Public Health Ethics 15 (1):87-103.
    In the recent literature across philosophy, medicine and public health policy, many influential arguments have been put forward to support the use of randomization procedures to allocate scarce life-saving resources. In this paper, I provide a systematic categorization and a critical evaluation of these arguments. I shall argue that those arguments justify using RAND to allocate SLSR in fewer cases than their proponents maintain and that the relevant decision-makers should typically allocate SLSR directly to the individuals with the strongest claims (...)
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  • Incorporating Stakeholder Perspectives on Scarce Resource Allocation: Lessons Learned from Policymaking in a Time of Crisis.Bethany Bruno, Heather Mckee Hurwitz, Marybeth Mercer, Hilary Mabel, Lauren Sankary, Georgina Morley, Paul J. Ford, Cristie Cole Horsburgh & Susannah L. Rose - 2021 - Cambridge Quarterly of Healthcare Ethics 30 (2):390-402.
    The coronavirus disease (COVID-19) crisis provoked an organizational ethics dilemma: how to develop ethical pandemic policy while upholding our organizational mission to deliver relationship- and patient-centered care. Tasked with producing a recommendation about whether healthcare workers and essential personnel should receive priority access to limited medical resources during the pandemic, the bioethics department and survey and interview methodologists at our institution implemented a deliberative approach that included the perspectives of healthcare professionals and patient stakeholders in the policy development process. Involving (...)
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  • Severity as a Priority Setting Criterion: Setting a Challenging Research Agenda.Mathias Barra, Mari Broqvist, Erik Gustavsson, Martin Henriksson, Niklas Juth, Lars Sandman & Carl Tollef Solberg - 2019 - Health Care Analysis 28 (1):25-44.
    Priority setting in health care is ubiquitous and health authorities are increasingly recognising the need for priority setting guidelines to ensure efficient, fair, and equitable resource allocation. While cost-effectiveness concerns seem to dominate many policies, the tension between utilitarian and deontological concerns is salient to many, and various severity criteria appear to fill this gap. Severity, then, must be subjected to rigorous ethical and philosophical analysis. Here we first give a brief history of the path to today’s severity criteria in (...)
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  • Context is Needed When Assessing Fair Subject Selection.G. Owen Schaefer - 2020 - American Journal of Bioethics 20 (2):20-22.
    Volume 20, Issue 2, February 2020, Page 20-22.
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  • Should Lack of Social Support Prevent Access to Organ Transplantation?Keren Ladin, Norman Daniels & Kelsey N. Berry - 2019 - American Journal of Bioethics 19 (11):13-24.
    Transplantation programs commonly rely on clinicians’ judgments about patients’ social support (care from friends or family) when deciding whether to list them for organ transplantation. We examine whether using social support to make listing decisions for adults seeking transplantation is morally legitimate, drawing on recent data about the evidence-base, implementation, and potential impacts of the criterion on underserved and diverse populations. We demonstrate that the rationale for the social support criterion, based in the principle of utility, is undermined by its (...)
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  • Allocating Scarce Medical Resources: Using Social Usefulness as a Criterion.D. Selvaraj, A. McClelland & A. Furnham - 2019 - Ethics and Behavior 29 (4):274-286.
    This study aimed to determine if people would use social usefulness as a criterion when allocating a kidney to potential recipients. Participants ranked hypothetical patients in order of priority to receive the kidney, using only information on the patients’ volunteering record, intelligence, emotional intelligence, and attractiveness. The results showed that volunteers were prioritized over nonvolunteers, highly intelligent patients over those with average intelligence, patients with high emotional intelligence over those with average emotional intelligence, and good-looking patients over average-looking patients. There (...)
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  • Substantial Life Extension and the Fair Distribution of Healthspans.Christopher S. Wareham - 2016 - Journal of Medicine and Philosophy 41 (5):521-539.
    One of the strongest objections to the development and use of substantially life-extending interventions is that they would exacerbate existing unjust disparities of healthy lifespans between rich and poor members of society. In both popular opinion and ethical theory, this consequence is sometimes thought to justify a ban on life-prolonging technologies. However, the practical and ethical drawbacks of banning receive little attention, and the viability of alternative policies is seldom considered. Moreover, where ethicists do propose alternatives, there is scant effort (...)
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  • The Intensive Care Lifeboat: a survey of lay attitudes to rationing dilemmas in neonatal intensive care.C. Arora, J. Savulescu, H. Maslen, M. Selgelid & D. Wilkinson - 2016 - BMC Medical Ethics 17 (1):69.
    BackgroundResuscitation and treatment of critically ill newborn infants is associated with relatively high mortality, morbidity and cost. Guidelines relating to resuscitation have traditionally focused on the best interests of infants. There are, however, limited resources available in the neonatal intensive care unit, meaning that difficult decisions sometimes need to be made. This study explores the intuitions of lay people regarding resource allocation decisions in the NICU.MethodsThe study design was a cross-sectional quantitative survey, consisting of 20 hypothetical rationing scenarios. There were (...)
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  • Challenges for Principles of Need in Health Care.Niklas Juth - 2015 - Health Care Analysis 23 (1):73-87.
    What challenges must a principle of need for prioritisations in health care meet in order to be plausible and practically useful? Some progress in answering this question has recently been made by Hope, Østerdal and Hasman. This article continue their work by suggesting that the characteristic feature of principles of needs is that they are sufficientarian, saying that we have a right to a minimally acceptable or good life or health, but nothing more. Accordingly, principles of needs must answer two (...)
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  • Iranian intensive care unit nurses' moral distress: A content analysis.F. A. Shorideh, T. Ashktorab & F. Yaghmaei - 2012 - Nursing Ethics 19 (4):464-478.
    Researchers have identified the phenomena of moral distress through many studies in Western countries. This research reports the first study of moral distress in Iran. Because of the differences in cultural values and nursing education, nurses working in intensive care units may experience moral distress differently than reported in previous studies. This research used a qualitative method involving semistructured and in-depth interviews of a purposive sample of 31 (28 clinical nurses and 3 nurse educators) individuals to identify the types of (...)
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  • Standing by our principles: Meaningful guidance, moral foundations, and multi-principle methodology in medical scarcity.Govind C. Persad, Alan Wertheimer & Ezekiel J. Emanuel - 2010 - American Journal of Bioethics 10 (4):46 – 48.
    In this short response to Kerstein and Bognar, we clarify three aspects of the complete lives system, which we propose as a system of allocating scarce medical interventions. We argue that the complete lives system provides meaningful guidance even though it does not provide an algorithm. We also defend the investment modification to the complete lives system, which prioritizes adolescents and older children over younger children; argue that sickest-first allocation remains flawed when scarcity is absolute and ongoing; and argue that (...)
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  • Beyond explainability: justifiability and contestability of algorithmic decision systems.Clément Henin & Daniel Le Métayer - 2022 - AI and Society 37 (4):1397-1410.
    In this paper, we point out that explainability is useful but not sufficient to ensure the legitimacy of algorithmic decision systems. We argue that the key requirements for high-stakes decision systems should be justifiability and contestability. We highlight the conceptual differences between explanations and justifications, provide dual definitions of justifications and contestations, and suggest different ways to operationalize justifiability and contestability.
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  • Between hoping to die and longing to live longer.Christopher S. Wareham - 2021 - History and Philosophy of the Life Sciences 43 (2):1-20.
    Drawing on Ezekiel Emanuel’s controversial piece ‘Why I hope to die at 75,’ I distinguish two types of concern in ethical debates about extending the human lifespan. The first focusses on the value of living longer from prudential and social perspectives. The second type of concern, which has received less attention, focusses on the value of aiming for longer life. This distinction, which is overlooked in the ethical literature on life extension, is significant because there are features of human psychology (...)
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  • A Conceptual Framework for Clearer Ethical Discussions About COVID-19 Response.Govind C. Persad - 2020 - American Journal of Bioethics 20 (7):98-101.
    In this Commentary, I propose an ethical framework for ethical discussions around the allocation of scarce resources in COVID-19 response. The framework incorporates four principles: beneficence (benefiting people by saving lives or years of life), equality, remedying disadvantage, and recognizing past conduct. I then discuss how the framework interacts with ethical constraints against using people as a mere means and against causing death. The commentary closes by criticizing the equation of deontological ethics with random or first-come, first-served allocation and of (...)
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  • Beneficence and Wellbeing: A Critical Appraisal.Laurence B. McCullough - 2020 - American Journal of Bioethics 20 (3):65-68.
    Volume 20, Issue 3, March 2020, Page 65-68.
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  • Døden som et onde.Carl Tollef Solberg - 2019 - Norsk Filosofisk Tidsskrift 54 (3):167-186.
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  • Public Preferences about Fairness and the Ethics of Allocating Scarce Medical Interventions.Govind Persad - 2017 - In Meng Li & David P. Tracer (eds.), Interdisciplinary Perspectives on Fairness, Equity, and Justice. Springer. pp. 51-65.
    This chapter examines how social- scientific research on public preferences bears on the ethical question of how those resources should in fact be allocated, and explain how social-scientific researchers might find an understanding of work in ethics useful as they design mechanisms for data collection and analysis. I proceed by first distinguishing the methodologies of social science and ethics. I then provide an overview of different approaches to the ethics of allocating scarce medical interventions, including an approach—the complete lives system—which (...)
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  • One and done? Equality of opportunity and repeated access to scarce, indivisible medical resources.Marco D. Huesch - 2012 - BMC Medical Ethics 13 (1):1-13.
    Background: Existing ethical guidelines recommend that, all else equal, past receipt of a medical resource (e.g. a scarce organ) should not be considered in current allocation decisions (e.g. a repeat transplantation).DiscussionOne stated reason for this ethical consensus is that formal theories of ethics and justice do not persuasively accept or reject repeated access to the same medical resources. Another is that restricting attention to past receipt of a particular medical resource seems arbitrary: why couldn't one just as well, it is (...)
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  • Social Value Judgements in Healthcare: A Philosophical Critique.Laura R. Biron, Ruth Faden & Benedict Rumbold - 2012 - Journal of Health Organization and Management 26 (3):317-30.
    PURPOSE: The purpose of this paper is to consider some of the philosophical and bioethical issues raised by the creation of the draft social values framework developed to facilitate data collection and country-specific presentations at the inaugural workshop on "Social values and health priority setting" held in February 2011. -/- DESIGN/METHODOLOGY/APPROACH: Conceptual analysis is used to analyse the term "social values", as employed in the framework, and its relationship to related ideas such as moral values. The structure of the framework (...)
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  • A Step Toward Pluralist Fairness.Samia A. Hurst - 2011 - American Journal of Bioethics 11 (12):46-47.
    The American Journal of Bioethics, Volume 11, Issue 12, Page 46-47, December 2011.
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  • Deciding the Criteria Is Not Enough: Moral Issues to Consider for a Fair Allocation of Scarce ICU Resources.Davide Battisti & Mario Picozzi - 2022 - Philosophies 7 (5):92.
    During the first wave of the COVID-19 pandemic in Italy, practitioners had to make tragic decisions regarding the allocation of scarce resources in the ICU. The Italian debate has paid a lot of attention to identifying the specific regulatory criteria for the allocation of resources in the ICU; in this paper, however, we argue that deciding such criteria is not enough for the implementation of fair and transparent allocative decisions. In this respect, we discuss three ethical issues: (a) in the (...)
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  • The Grandview Medical Center Bioethics Consultation Service Perspective on the Peril of Isolated and Vulnerable Individuals due to COVID-19.Jeffrey Kaufhold, Sharon Merryman, Leland Cancilla & Nicholas Salupo - 2021 - Asian Bioethics Review 13 (4):463-471.
    We present the perspective of a Bioethics Consultation Service operating in an urban hospital in Dayton, Ohio, USA, as it adapted to treating Sars-CoV-2 patients throughout 2020. Since the first case of COVID-19 was reported in Ohio on 9 March 2020, until 1 January 2021, the Bioethics Consultation Service was consulted 60 times, a 22.5% increase from the same period of 2019. The most common diagnoses requiring consultation included end-stage renal disease requiring dialysis, out-of-hospital cardiac arrest, and sepsis. Only 10% (...)
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  • Disability Discrimination, Medical Rationing and COVID-19.Bo Chen & Donna Marie McNamara - 2020 - Asian Bioethics Review 12 (4):511-518.
    The current public health crisis has exposed deep cracks in social equality and justice for marginalised and vulnerable communities around the world. The reported rise in the number of ‘do not resuscitate’ orders being imposed on people with disabilities has caused particular concerns from a human rights perspective. While the evidence of this is contested, this article will consider the human rights implications at stake and the dangers associated with using ‘quality of life’ measures as determinant of care in medical (...)
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  • Should Extremely Premature Babies Get Ventilators During the COVID-19 Crisis?Marlyse F. Haward, Annie Janvier, Gregory P. Moore, Naomi Laventhal, Jessica T. Fry & John Lantos - 2020 - American Journal of Bioethics 20 (7):37-43.
    In a crisis, societal needs take precedence over a patient’s best interests. Triage guidelines, however, differ on whether limited resources should focus on maximizing lives or life-years. Choosing between these two approaches has implications for neonatology. Neonatal units have ventilators, some adaptable for adults. This raises the question of whether, in crisis conditions, guidelines for treating extremely premature babies should be altered to free-up ventilators. Some adults who need ventilators will have a survival rate higher than some extremely premature babies. (...)
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  • (1 other version)Prioritization of Referrals in Outpatient Physiotherapy Departments in Québec and Implications for Equity in Access.Simon Deslauriers, Marie-Hélène Raymond, Maude Laliberté, Anne Hudon, François Desmeules, Debbie E. Feldman & Kadija Perreault - unknown
    In the context of long waiting time to access rehabilitation services, a large majority of settings use referral prioritization to help manage waiting lists. Prioritization practices vary greatly between settings and there is little consensus on how best to prioritize referrals. This paper describes the prioritization processes for physiotherapy services in Québec and its potential implications in terms of equity in access to services. This is a secondary analysis of a survey of outpatient physiotherapy departments (n=98; proportion of participation was (...)
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  • Experience adjusted life years and critical medical allocations within the British context: which patient should live?Michal Pruski - 2018 - Medicine, Health Care and Philosophy 21 (4):561-568.
    Medical resource allocation is a controversial topic, because in the end it prioritises some peoples’ medical problems over those of others. This is less controversial when there is a clear clinical reason for such a prioritisation, but when such a reason is not available people might perceive it as deeming certain individuals more important than others. This article looks at the role of social utility in medical resource allocation, in a situation where the clinical outcome would be identical if either (...)
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