Persad Govind, Joffe Steven
Sturm College of Law, University of Denver, Denver, Colorado, USA
Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
J Med Ethics. 2021 Mar 22. doi: 10.1136/medethics-2020-106792.
The COVID-19 pandemic has forced clinicians, policy-makers and the public to wrestle with stark choices about who should receive potentially life-saving interventions such as ventilators, ICU beds and dialysis machines if demand overwhelms capacity. Many allocation schemes face the question of whether to consider age. We offer two underdiscussed arguments for prioritising younger patients in allocation policies, which are grounded in prudence and fairness rather than purely in maximising benefits: prioritising one's younger self for lifesaving treatments is prudent from an individual perspective, and prioritising younger patients works to narrow health disparities by giving priority to patients at risk of dying earlier in life, who are more likely to be subject to systemic disadvantage. We then identify some confusions in recent arguments against considering age.
新冠疫情迫使临床医生、政策制定者和公众去应对一些严峻的抉择，即在需求超过供应能力时，哪些人应该接受诸如呼吸机、重症监护病房床位和透析机等可能挽救生命的干预措施。许多分配方案都面临着是否考虑年龄的问题。我们提出了两条在分配政策中优先考虑年轻患者但较少被讨论的论据，这些论据基于审慎和公平，而非纯粹为了使利益最大化：从个人角度来看，优先让自己年轻时接受挽救生命的治疗是审慎的；优先考虑年轻患者有助于缩小健康差距，因为优先照顾那些有早逝风险的患者，而这些患者更有可能遭受系统性不利因素的影响。然后，我们指出了近期反对考虑年龄的一些论点中存在的混淆之处。
