Abstract

Since the start of the Covid-19 pandemic, many countries have anticipated a strain on healthcare infrastructure, which may lead to rationing access to scarce medical resources. Faced with a shortage of ventilators, clinicians and their institutions need to make difficult triage decisions about when to withhold or withdraw ventilation. Such decisions impose a heavy moral and psychological burden on clinicians, and may expose them to liability risks. To alleviate that burden and those risks, it is necessary to provide clinicians with clear, official ethical guidelines. There is a substantial heterogeneity between (and sometimes within) countries in the metrics that are officially deemed acceptable for triage, and the priority between these metrics. This heterogeneity is perhaps unavoidable, given the difficulty of triage decisions, and the ethical controversies raised by any single metric. With these controversies comes a risk of social turmoil: The mere existence of a triage protocol is enough to provoke people’s discomfort with active decisions being made about life and death, triggering discussions of ‘death panels’; if the metrics used in the protocol are perceived as biased or unfair, trust and morale are likely to suffer even more. To prevent this turmoil, it is important for experts (doctors, ethicists, legal scholars, policymakers) to understand which triage metrics citizens believe to be fair, and which metrics they believe to be unacceptable. Here we provide them with such data, collected in 20 countries across the world.

Reference

Jean-François Bonnefon, “Citizen preferences across 20 countries for the ethical allocation of ventilators during the Covid-19 pandemic: Always polarized but perhaps reconcilable”, IAST Lunch Seminar, Toulouse: IAST, November 17, 2020, 14:00–15:00, room Zoom Meeting.