A consequentialist argument for considering age in triage decisions during the coronavirus pandemic.

Most ethics guidelines for distributing scarce medical resources during the coronavirus pandemic seek to save the most lives and the most life‐years. A patient's prognosis is determined using a SOFA or MSOFA score to measure likelihood of survival to discharge, as well as a consideration of relevant...

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Publicado en:Bioethics Vol. 35; no. 4; pp. 356 - 366
Autor principal: Altman, Matthew C.
Formato: Artículo
Publicado: Wiley-Blackwell May2021
Materias:
Acceso en línea:Ver este registro en EBSCOhost
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      dt: May2021
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      pub: Wiley-Blackwell
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        149926622
        10.1111/bioe.12864
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        atl: A consequentialist argument for considering age in triage decisions during the coronavirus pandemic.
      aug:
        au: Altman, Matthew C.
        affil: Department of Philosophy & Religious Studies, Central Washington University, Ellensburg Washington,
      su:
        Age distribution
        Medical care
        Bioethics
        Health care rationing
        COVID-19 pandemic
        Medical triage
        Medical protocols
        Comorbidity
        Algorithms
      sug:
        subj:
          Age distribution
          Medical care
          Bioethics
          Health care rationing
          COVID-19 pandemic
          Research and Development in the Physical, Engineering, and Life Sciences (except Biotechnology)
          Medical triage
          Medical protocols
          Comorbidity
          Algorithms
      keyword:
        allocation of scarce medical resources
        consequentialism
        coronavirus
        COVID‐19
        life‐cycle principle
        triage
        utilitarianism
        allocation of scarce medical resources
        consequentialism
        coronavirus
        COVID‐19
        life‐cycle principle
        triage
        utilitarianism
      ab: Most ethics guidelines for distributing scarce medical resources during the coronavirus pandemic seek to save the most lives and the most life‐years. A patient's prognosis is determined using a SOFA or MSOFA score to measure likelihood of survival to discharge, as well as a consideration of relevant comorbidities and their effects on likelihood of survival up to one or five years. Although some guidelines use age as a tiebreaker when two patients' prognoses are identical, others refuse to consider age for fear of discriminating against the elderly. In this paper, I argue that age is directly relevant for maximizing health benefits, so current ethics guidelines are wrongly excluding or deemphasizing life‐stage in their triage algorithms. Research on COVID‐19 has shown that age is a risk factor in adverse outcomes, independent of comorbidities. And limiting a consideration of life‐years to only one or five years past discharge does not maximize health benefits. Therefore, based on their own stated values, triage algorithms for coronavirus patients ought to include life‐stage as a primary consideration, along with the SOFA score and comorbidities, rather than excluding it or using it merely as a tiebreaker. This is not discriminatory because patients ought to have equal opportunity to experience life‐stages. The equitable enforcement of that right justifies unequal treatment based on age in cases when there is a scarcity of life‐saving resources. A consideration of life‐stage would thus allow healthcare workers to responsibly steward public resources in order to maximize lives and life‐years saved.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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