The Pandemic and the Ethical Dilemma of Limited Resources: Who to Treat?
Published online by Cambridge University Press: 22 February 2022
Summary
ABSTRACT
This contribution discusses different ethical perspectives on the issue of distribution of scarce resources in health care. While in an ideal situation with sufficient availability of resources for everyone, the problem of their distribution does not exist, in fact in the context of a pandemic the distribution of scarce resources reveals itself in a dramatic and urgent way. Concerning this issue, there is agreement on the fact that distribution should be ‘fair’, according to the shared meaning of justice as ‘not to harm others’ and to ‘give each his own’. However, within the pluralist discussion there are different ways of conceiving justice on a theoretical level and applying it on a concrete level. This contribution examines classical bioethical theories that are reappearing in the discussion today – in different levels of intensity, or in different formulations – and this in the light of the international and national ethical guidelines of scientific societies of intensivists and recommendations of Committees for Bioethics, on national, European and international levels, on the distribution of resources during the COVID-19 pandemic.
INTRODUCTION
An element that immediately emerged and is still emerging in the second wave of the pandemic, in all the countries of the world affected by the pandemic (as a national, European, global problem), is the scarcity of the available health care resources (drugs, technologies, personnel, beds in intensive care and now vaccines). The issue of the distribution of health resources is certainly not a new topic in bioethics. For some time, medical ethics has raised the problem at different levels and in different areas. The problem lies in the ‘macro-distribution’ of resources, that is, the decisions taken in the context of health policies in the broad sense (how much to invest in health and in which sectors as a priority, compared to other investments). These decisions are shaped differently in the various countries of the world, in different political, economic and social contexts. It is also a problem of ‘micro-distribution’, that is, of decisions that health care facilities and doctors have to make when resources are limited in relation to the amount of patients’ requests so that a selection of patients by priority of access is required.
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- European Yearbook on Human Rights 2021 , pp. 9 - 26Publisher: IntersentiaPrint publication year: 2021