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Incorporating Stakeholder Perspectives on Scarce Resource Allocation: Lessons Learned from Policymaking in a Time of Crisis

Published online by Cambridge University Press:  25 March 2021

BETHANY BRUNO ,
HEATHER MCKEE HURWITZ ,
MARYBETH MERCER ,
HILARY MABEL ,
LAUREN SANKARY ,
GEORGINA MORLEY ,
PAUL J. FORD ,
CRISTIE COLE HORSBURGH  and
SUSANNAH L. ROSE
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Abstract

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 the community more, not less, during a crisis required balancing the need to act quickly to garner stakeholder perspectives, uncertainty about the extent and duration of the pandemic, and disagreement among ethicists about the most ethically supportable way to allocate scarce resources. This article explains the process undertaken to garner stakeholder input as it relates to organizational ethics, recounts the stakeholder perspectives shared and how they informed the triage policy developed, and offers suggestions for how other organizations may integrate stakeholder involvement in ethical decision-making as well as directions for future research and public health work.

Keywords

organizational ethicsstakeholder inputscarce resource allocationpandemic planning
Type
Departments and Columns
Information
Cambridge Quarterly of Healthcare Ethics , Volume 30 , Issue 2 , April 2021 , pp. 390 - 402
Copyright
© The Author(s), 2021. Published by Cambridge University Press

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Footnotes

This CQ section will address ethical challenges arising in the actions and decisions made by health care institutions or a health care system. Organizational ethics articles shift the focus from individual patients to the broader context of the organization, including its mission, values, financial management and health care delivery practices. Readers are invited to contact Bill Nelson to propose a submission at: william.a.nelson@dartmouth.edu.

*

Bethany Bruno, Heather Mckee Hurwitz are co-first authors.

Acknowledgments: We thank the following for their contributions: G. Deadwyler, R.C. Langley, M. Michalski, M. Nall, V. Nall, C. Reeves, J. Szabo, D. Easton, R. Field, K. Flowers, J. Gorecki, R. Hosler, C. Leigh, K. Lichman, A. Markert, Y. Mauer, B. O’Neill, J. Ramsey, J. Toski Welsh, C. Turner, J. Jankowski, S. Feldman, A. Boissy, and D. Klein.

References

Notes

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