Allocating medical resources fairly: the CSG bioethics guide

On April 12, 2020, a bioethics guide for allocating scarce hospital resources during the current Covid-19 pandemic was posted on the website of the Consejo de Salubridad General (CSG) of the Government of Mexico. The guide, entitled Guía bioética para asignación de recursos limitados de medicina crítica en situación de emergencia, was intended as a preliminary document, but the website posting did not describe it as a first step in the process. The publicity resulted in a wide array of comments and criticisms. That first version posted on the CSG website contained an age-based criterion for breaking a tie between two or more medically eligible patients who needed of a ventilator: younger patients would have prefer­ence over older ones. The final version of the guide eliminated that criterion and instead, relied on the leading public health principle, “save the most lives”, without regard to personal characteristics other than the possibility of benefitting from the scarce medical resources.