How Should Scarce Healthcare Resources be Rationed during the COVID-19 Pandemic?

Abstract

Experts have been warning of a second wave of COVID-19 infections that is expected to occur within the next two months. If this prediction comes true, the demand for ventilators, intensive care units, and other healthcare resources may be greater than the supply, raising questions of distributive justice and the rationing of scarce healthcare resources. This article summarizes some of the theoretical issues associated with distributive justice, examines the ethical basis of the rationing principles that have been adopted by certain hospitals in the United States, and attempts to identify common ground that might facilitate broad agreement concerning the principles that should guide resource-allocation decisions during this pandemic. The article aims to show, firstly, that from the perspective of a non-utilitarian, rights-based theory, it is fair or just to allocate lifesaving resources in ways that save the greatest number of lives. Nevertheless, it is also argued that there are several other factors need to be considered in the rationing of healthcare resources, including a patient’s age, disability status, health condition, occupation, time of admission to a health care facility, and whether the patient’s disease is COVID-19.