Title

Ethical Foundations for Fair Allocation of Scarce Critical Care Resources During the COVID-19 Pandemic

Document Type

Presentation

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Publication Date

6-10-2020

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Dr. Jacobs is a nurse (Georgetown University), holds a MPH (Yale), and PhD (University of Connecticut). She completed a 2-year post-doctoral fellowship at the Pellegrino Center of Clinical Bioethics at Georgetown University. She is currently an Associate in Ethics for Hartford HealthCare in Hartford Connecticut and serves as Co-Chairwoman of the Ethics Committee at Hartford Hospital. She is an Associate Professor-in-Residence at the University of Connecticut’s School of Nursing. She is the author of Clinical Ethics Consultation Guide: Reference Information for Responding to Ethics Consultation in Health Care (2020). Dr. Jacobs is a member of the “inaugural class” of 136 certified healthcare ethics consultants in the United States. Her philosophy of ethics consultation is grounded in existential phenomenology, narrative ethics and the telos of human flourishing. She recently lead-authored the Protocol for Fair Allocation of Scarce Critical Care Resources during COVID-19 for Hartford Healthcare’s seven acute care hospitals.

Presentation: 1:03:31

Abstract

An ethical foundation that grounds decision-making to allocate scarce resources maybe based on ethical principles defined by the National Academy of Medicine – justice (fairness), duty to care, duty to steward resources, transparency, consistency, proportionality, accountability.[1] Additional principles are individual liberty, protecting the public from harm, privacy, reciprocity, equity, and solidarity. Normative ethical theories of utilitarianism (distributive and egalitarian justice) and virtue ethics are relevant to such a framework. Controversy in allocation guidelines, protocols, standards, etc. included concerns for fair distribution, objectivity of triage scoring systems, avoidance of categorical exclusions, reciprocity for health care workers, and issues associated with the influence of health inequities of minorities and avoidance of discrimination related to elderly and disabled persons, e.g., naturalization of vulnerability.

Objectives:

1) Describe ethical principles associated with fair distribution of scarce resources.

2) Identify the normative moral theories that would justify rationing of resources.

3) Explain the nationalization theory of vulnerability.[2]

[1] [1] Institute of Medicine of the National Academy of Sciences Committee on Guidance for Establishing Standards for Use in Disaster Situations (2012). Crisis Standards of Care: A Systems Framework for Catastrophic Disaster Response. Washington, DC: National Academies Press.

[2] Tremain S. (2020). COVID-19 and The Naturalization of Vulnerability. Available at: https://biopoliticalphilosophy.com/2020/04/01covid-19-and-the-naturalization-of-vulnerabilties/

Language

English

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