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Structural Inequities, Fair Opportunity, and the Allocation of Scarce ICU Resources
Author(s) -
White Douglas B.,
Lo Bernard
Publication year - 2021
Publication title -
hastings center report
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.515
H-Index - 63
eISSN - 1552-146X
pISSN - 0093-0334
DOI - 10.1002/hast.1285
Subject(s) - rationing , triage , equity (law) , health care rationing , scarcity , resource allocation , pandemic , covid-19 , economics , sociology , political science , actuarial science , public relations , medicine , health care , economic growth , law , microeconomics , medical emergency , infectious disease (medical specialty) , management , disease , pathology
The September‐October 2021 issue of the Hastings Center Report highlights the important topic of allocating scarce critical care resources during the Covid‐19 pandemic. The article by Alex Rajczi and colleagues urges that policy‐makers use public reasoning, not private reasoning, when developing triage policies. We completely agree. We show how the allocation framework we developed as private scholars, the “Pittsburgh framework,” has been supported by public reasoning . The article by MaryKatherine Gaurke and colleagues criticizes rationing based on maximizing life‐years saved and mistakenly claims that our framework recommended this approach. We explain that our framework never contained such a criterion but instead included a more limited consideration of near‐term prognosis. In December 2020, in response to emerging data and important criticisms, we modified our framework to further strengthen equity. We are committed to improving allocation guidelines during crisis standards of care through reflective discussions and debates .