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. 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.
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.
  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.
 Tremain S. (2020). COVID-19 and The Naturalization of Vulnerability. Available at: https://biopoliticalphilosophy.com/2020/04/01covid-19-and-the-naturalization-of-vulnerabilties/
Jacobs, MPH, PhD, RN, HEC-C, Barbara Bennett, "Ethical Foundations for Fair Allocation of Scarce Critical Care Resources During the COVID-19 Pandemic" (2020). COVID-19: Spread the Science, not the Virus Seminar Series. Paper 9.