TOOLKIT: Bioethics Resources for COVID-19

Bioethics.net and the American Journal of Bioethics have assembled a bioethics toolkit for people dealing with COVID-19.

We have a collection of important blogs from around the internet that you can find here. We also highly recommending our growing catalog of our original blog posts by leading scholars writing on bioethics in pandemics.

Other compendium resources

• The Hastings Center has assembled a number of reports and resources.
• Thomas Cunningham at Kaiser-Permanent has put together a comprehensive resource of academic articles, government plans, and allocation frameworks.
• AMA COVID-19 Ethics Resource Center

For the best scientific information:

• Centers for Disease Control & Prevention
• World Health Organization
• Johns Hopkins University Global Case Counter
• Epidemiology on COVID
  • Compared to flu

For policies, protocols, and practices:

• Centers for Disease Control
• Stanford Medicine
• Bringham and Women’s Hospital
• Mass General Hospital
• Penn Medicine

For ethical guidelines on vaccines & allocation:

• Advisory Committee on Immunization Practices (ACIP) Guidelines
• National Academy of Medicine Framework
• World Health Organization
• Fairly Prioritizing Groups for Access to COVID-19 Vaccines JAMA article by Govind Persad, Monica Peek, & Ezekiel Emanuel
• Four Recommendations To Efficiently And Equitably Accelerate The COVID-19 Vaccine Rollout by William Parker, Govind Persad, & Monica Peek
• AJOB Webinar on COVID-19 Vaccines & Allocation, with panelists Kathy Kinlaw, Govind Persad, Monica Peek, and Grace Lee

For ethical guidelines for responding to crisis:

• Nuffield Council on Ethics Policy Papers
• Ireland’s Ethical Framwork for Decision-Making in a Pandemic
• UNESCO: Ethical Considerations from a Global Perspective
• Colorado CSC Standards
• Illinois Ethics Framework Crisis Standards of Care White Paper
• Maryland Framework for Public Health Emergency 2017
• AMA Code of Medical Ethics: Guidance in a Pandemic
• Ethical Guidance for Leaders and Health Care Professionals in the VA

For plans on triage:

• Hastings Center Allocation White Paper for Therapeutic & Palliative Drugs
• Ethical Challenges in the Middle Tier of Covid-19 Vaccine Allocation: Guidance for Organizational Decision-Making
• Italian Guidelines for Distributing Resource Scarcity
• Swiss Academy of Medical Sciences Pandemic Triage Under Scarcity Guidelines
• From NEJM: Fair Allocation of Scarce Medical Resources in the Time of COVID-19
• State of Minnesota guidance for triaging scared resources
• State of Texas Pandemic Resource Allocation Plan
• Papdimos, Hardart, Stawicki. Ethics of Outbreaks Position Statement. Therapies, Treatment Limitations, and Duty to Treat. Society of Critical Care Medicine.
  SCCM outbreaks ethics pt1, SCCM outbreaks ethics pt2
• Cohen, Crespo, & White, Potential Legal Liability for Withdrawing or Withholding Ventilators During COVID-19. JAMA
• Truog, Mitchell, & Daley, The Toughest Triage – Allocating Ventilators in a Pandemic. NEJM
• White & Lo, A Framework for Rationing Ventilators and Critical Care Beds DUring the COVID-19 Pandemic. JAMA
• UVA’s Ethical Framework for Covid 19 Resources Allocation

For clinical algorithms for making allocation decisions

• SOFA Mortality Charts for Various Patient Populations
• APACHE II Scores
• Decision aid for Advance Directives during the COVID-19 Pandemic

For CPR/DNR with COVID protocols

• CCH CoVid19 CPR_guidance_3-22-2020[2]

For communicating with patients and others

• VitalTalk: Communication skills and sample scripts
• Communicating in a crisis

Special journal issues/articles

• The American Journal of Bioethics Special Issue on COVID-19
• Journal of Clinical Ethics (preprint of
  • Meeting the Challenge of COVID-19: The Response of Two Ethics Consultation Services in New York City Kenneth M. Prager and Joseph J. Fins
  • Clinical Ethics Consultations during the COVID-19 Pandemic Surge at a New York City Medical Center Katherine Fischkoff, Gerald Neuberg, Joyeeta Dastidar, Erin P. Williams, Kenneth Prager, and Lydia Dugdale
  • Phases of a Pandemic Surge: The Experience of an Ethics Service in New York City during COVID-19 Barrie J. Huberman and Debjani Mukherjee, Ezra Gabbay, Samantha F. Knowlton, Douglas S.T. Green, Nekee Pandya, Nicole Meredyth, Joan M. Walker, Zachary E. Shapiro, Jennifer E. Hersh, Mary F. Chisholm, Seth A. Waldman, C. Ronald MacKenzie, Inmaculada de Melo-Martín, and Joseph J. Fins
  • The COVID-19 Crisis and Clinical Ethics in New York City Joseph J. Fins and Kenneth M. Prager
• SARS-CoV-2 Seroprevalence and Symptom Onset in Culturally Linked Orthodox Jewish Communities Across Multiple Regions in the United States