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Rationing Limited Healthcare Resources in the COVID‐19 Era and Beyond: Ethical Considerations Regarding Older Adults
Author(s) -
Farrell Timothy W.,
Francis Leslie,
Brown Teneille,
Ferrante Lauren E.,
Widera Eric,
Rhodes Ramona,
Rosen Tony,
Hwang Ula,
Witt Leah J.,
Thothala Niranjan,
Liu Shan W.,
Vitale Caroline A.,
Braun Ursula K.,
Stephens Caroline,
Saliba Debra
Publication year - 2020
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.16539
Subject(s) - medicine , health care rationing , pandemic , health care , rationing , geriatrics , gerontology , resource allocation , position statement , ethnic group , disease , covid-19 , family medicine , economic growth , psychiatry , law , political science , pathology , infectious disease (medical specialty) , economics , computer network , computer science
Coronavirus disease 2019 (COVID‐19) continues to impact older adults disproportionately with respect to serious consequences ranging from severe illness and hospitalization to increased mortality risk. Concurrently, concerns about potential shortages of healthcare professionals and health supplies to address these issues have focused attention on how these resources are ultimately allocated and used. Some strategies, for example, misguidedly use age as an arbitrary criterion that disfavors older adults in resource allocation decisions. This is a companion article to the American Geriatrics Society (AGS) position statement, “Resource Allocation Strategies and Age‐Related Considerations in the COVID‐19 Era and Beyond.” It is intended to inform stakeholders including hospitals, health systems, and policymakers about ethical considerations that should be considered when developing strategies for allocation of scarce resources during an emergency involving older adults. This review presents the legal and ethical background for the position statement and discusses these issues that informed the development of the AGS positions: (1) age as a determining factor, (2) age as a tiebreaker, (3) criteria with a differential impact on older adults, (4) individual choices and advance directives, (5) racial/ethnic disparities and resource allocation, and (6) scoring systems and their impact on older adults. It also considers the role of advance directives as expressions of individual preferences in pandemics. J Am Geriatr Soc 68:1143–1149, 2020.