The ethics of creating a resource allocation strategy during the COVID-19 Pandemic

Naomi Laventhal, Ratna Basak, Mary Lynn Dell, Douglas Diekema, Nanette Elster, Gina Geis, Mark Mercurio, Douglas Opel, David Shalowitz, Mindy Statter, Robert MacAuley

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

The coronavirus disease 2019 pandemic has affected nearly every aspect of medicine and raises numerous moral dilemmas for clinicians. Foremost of these quandaries is how to delineate and implement crisis standards of care and, specifically, how to consider how health care resources should be distributed in times of shortage. We review basic principles of disaster planning and resource stewardship with ethical relevance for this and future public health crises, explore the role of illness severity scoring systems and their limitations and potential contribution to health disparities, and consider the role for exceptionally resource-intensive interventions. We also review the philosophical and practical underpinnings of crisis standards of care and describe historical approaches to scarce resource allocation to offer analysis and guidance for pediatric clinicians. Particular attention is given to the impact on children of this endeavor. Although few children have required hospitalization for symptomatic infection, children nonetheless have the potential to be profoundly affected by the strain on the health care system imposed by the pandemic and should be considered prospectively in resource allocation frameworks.

Original languageEnglish (US)
Article numbere20201243
JournalPediatrics
Volume146
Issue number1
DOIs
StatePublished - Jul 2020

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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