Am J Law Med. 2021 Jul;47(2-3):264-290. doi: 10.1017/amj.2021.17.
As the coronavirus pandemic intensified, many communities in the United States experienced shortages of ventilators, intensive care beds, and other medical supplies and treatments. Currently, there is no single national response to provide guidance on allocation of scarce health care resources. Accordingly, states have formulated various "triage protocols" to prioritize those who will receive care and those who may not have the same access to health care services when the population demand exceeds the supply. Triage protocols address general concepts of "fairness" under accepted medical ethics rules and the consensus is that limited medical resources "should be allocated to do the greatest good for the greatest number of people."1 The actual utility of this utilitarian ethics approach is questionable, however, leaving many questions about what is "fair" unanswered. Saving as many people as possible during a health care crisis is a laudable goal but not at the expense of ignoring patients's legal rights, which are not suspended during the crisis. This Article examines the triage protocols from six states to determine whose rights are being recognized and whose rights are being denied, answering the pivotal question: If there is potential for disparate impact of facially neutral state triage protocols against Black Americans and other ethnic groups, is this legally actionable discrimination? This may be a case of first impression for the courts to resolve."[B]lack Americans are 3.5 times more likely to die of COVID-19 than [W]hite Americans … . Latinx people are almost twice as likely to die of the disease, compared with [W]hite people." 2 "Our civil rights laws protect the equal dignity of every human life from ruthless utilitarianism … . HHS is committed to leaving no one behind during an emergency, and this guidance is designed to help health care providers meet that goal." - Roger Severino, Office of Civil Rights Director, U.S. Department of Health and Human Services. 3.
随着冠状病毒大流行的加剧，美国许多社区都面临着呼吸机、重症监护床位和其他医疗用品和治疗方法的短缺。目前，美国没有单一的国家应对措施来指导稀缺医疗资源的分配。因此，各州制定了各种“分诊协议”，优先考虑那些将获得护理的人，以及当人口需求超过供应时，那些可能无法获得相同医疗服务的人。分诊协议解决了公认的医疗伦理规则下的“公平”一般概念，共识是有限的医疗资源“应该分配给为最多的人做最大的好事”。1 然而，这种功利主义伦理方法的实际效用值得怀疑，这使得许多关于什么是“公平”的问题没有答案。在医疗危机期间拯救尽可能多的人是一个值得称赞的目标，但不能以忽视患者的合法权利为代价，这些权利在危机期间并未暂停。本文考察了六个州的分诊协议，以确定哪些人的权利得到承认，哪些人的权利被剥夺，回答了关键问题：如果表面中立的州分诊协议对非裔美国人和其他族裔群体产生不同的影响，这是否属于法律上可采取行动的歧视？这可能是法院需要解决的首例案件。“[非裔美国人]死于 COVID-19 的可能性是[白人]的 3.5 倍……拉丁裔人死于这种疾病的可能性几乎是白人的两倍。” 2 “我们的民权法律保护每个人的生命平等尊严，免受无情的功利主义的侵害……HHS 致力于在紧急情况下不落下任何人，本指南旨在帮助医疗保健提供者实现这一目标。” - 罗杰·塞维里诺，美国卫生与公众服务部民权办公室主任。 3.
