School of Nursing, Department of Philosophy, Duquesne University, Pennsylvania, Pittsburgh, USA.
College of Law, University of Oklahoma, Norman, Oklahoma, USA.
Bioethics. 2023 Mar;37(3):226-238. doi: 10.1111/bioe.13132. Epub 2023 Jan 7.
Since the onset of the COVID-19 pandemic, a controversial criterion for allocating scarce medical treatment has been defended and incorporated into policy: the criterion of equity. Equity-included allocation schemes prioritize, to some degree, patients from marginalized or historically disadvantaged racial/ethnic groups, or patients with low socioeconomic status, for scarce treatment. The use of such criteria has been most prominently defended in two ways: (1) as reflecting a risk factor for severe COVID-19, and thus as a way of tracking medical need, and (2) as a form of remedial justice, viz. a way of redressing disparities in COVID outcomes that are caused by underlying unjust social conditions. Here, we delineate and critique those arguments. We argue that not only are such arguments unconvincing but also that there are compelling moral reasons to reject the sort of equity-included allocation schemes at issue.
自 COVID-19 大流行以来,一种有争议的分配稀缺医疗资源的标准被辩护并纳入政策:公平标准。包括公平在内的分配方案优先考虑来自边缘化或历史上处于不利地位的种族/族裔群体的患者,或社会经济地位较低的患者,以获得稀缺的治疗。这种标准的使用主要通过两种方式得到辩护:(1)作为严重 COVID-19 的风险因素,因此是跟踪医疗需求的一种方式,以及(2)作为一种补救性正义,即纠正由潜在不公正社会条件造成的 COVID 结果差异的一种方式。在这里,我们阐述和批判这些论点。我们认为,这些论点不仅没有说服力,而且有令人信服的道德理由拒绝所涉及的这种公平纳入分配方案。