Addressing inequities in pandemic policies BARUCH FISCHHOFF
The Covid-19 pandemic has produced shortages of many things, ranging from mundane necessities to vital medicines and equipment. Anticipating such dire situations, ethicists have proposed various schemes for rationing limited supplies. One common term for these schemes is “crisis standards of care,” as distinct from “usual standards of care”.1 The ethical principles guiding these standards preclude inequitable allocation of resources. Sometimes, those principles clash. For example, a scheme could either treat all lives as equal or all life-years as equal. The second principle values younger people more than the first, because more life-years are lost if they die. Reasonable people have argued both ways. Schemes that avoid creating inequities may still perpetuate them. Consider a scheme that assigns higher priority to 1. National Academies of Sciences, Engineering, and Medicine. Rapid Expert Consultation on Crisis Standards of Care for the COVID-19 Pandemic. Washington, DC: The National Academies Press, 2020. https://doi.org/10.17226/25765
