Appel Jacob M
Icahn School of Medicine at Mount Sinai, NY, USA.
J Diabetes Sci Technol. 2021 Sep;15(5):1005-1009. doi: 10.1177/1932296821991112. Epub 2021 Feb 16.
The COVID-19 pandemic raised distinct challenges in the field of scarce resource allocation, a long-standing area of inquiry in the field of bioethics. Policymakers and states developed crisis guidelines for ventilator triage that incorporated such factors as immediate prognosis, long-term life expectancy, and current stage of life. Often these depend upon existing risk factors for severe illness, including diabetes. However, these algorithms generally failed to account for the underlying structural biases, including systematic racism and economic disparity, that rendered some patients more vulnerable to these conditions. This paper discusses this unique ethical challenge in resource allocation through the lens of care for patients with severe COVID-19 and diabetes.
新冠疫情在稀缺资源分配领域带来了独特挑战,这是生物伦理学领域长期以来的一个研究领域。政策制定者和各州制定了呼吸机分配的危机指南,其中纳入了即时预后、长期预期寿命和当前生活阶段等因素。这些因素通常取决于严重疾病的现有风险因素,包括糖尿病。然而,这些算法通常没有考虑到潜在的结构性偏见,包括系统性种族主义和经济差距,这些偏见使一些患者更容易患上这些疾病。本文通过对重症新冠患者和糖尿病患者的护理视角,探讨了资源分配中这一独特的伦理挑战。