Ethical challenges in the prioritization of elective care in pandemic settings: On the significance of time-sensitive scoring

Sarah Diner, Manuel Ritter, Mariacarla Gadebusch Bondio

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

In times of ongoing resource shortages, appropriate evaluation criteria are crucial for the ethical prioritization of medical care. While the use of scoring models as tools for prioritization is widespread, they are barely discussed in the medical-ethical discourse in the context of the COVID-19 pandemic. During this time, the challenge of providing care for patients in need has promoted consequentialist reasoning. In this light, we advocate for the integration of time- and context-sensitive scoring (TCsS) models in prioritization policies that foster treatment opportunities for patients with subacute and chronic conditions. We argue, first, that TCsSs enable a more efficient use of resources, reducing avoidable harm to patients by preventing arbitrary postponement of necessary but nonurgent interventions. Second, we contend that on an interrelational level, TCsSs render decision-making pathways more transparent, which promotes the information requirement of patient autonomy and raises confidence in the resulting prioritization decision. Third, we claim that TCsS contributes to distributive justice by reallocating available resources to the benefit of elective patients. We conclude that TCsSs promote anticipatory measures that extend the timeframe for responsible action into the future. This strengthens patients' ability to exercise their right to healthcare—primarily during times of crisis, but ultimately in the longer term too.

Original languageEnglish
Pages (from-to)343-349
Number of pages7
JournalBioethics
Volume37
Issue number4
DOIs
StatePublished - May 2023
Externally publishedYes

Keywords

  • ethics
  • health resources
  • pandemics
  • patient care
  • prioritization

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