Get Published | Subscribe | About | Write for Our Blog    

EDITORIAL

Ethical Dilemmas in Covid-19 Medical Care: Is a Problematic Triage Protocol Better or Worse than No Protocol at All?
Sheri Fink

The anthrax mailings following the September 11, 2001 attacks in the United States led to fears that victims of bioterrorism could overwhelm hospitals. The federal government convened experts to define how medical treatments should best be allocated across a population affected by a mass casualty disaster, a concept at first referred to as “altered standards of care,” later changed to the more...

Read More →
The COVID-19 Pandemic: Critical Care Allocated in Extremis
Susan Dorr Goold

Professor McCullough, a distinguished scholar in bioethics and the history of bioethics, wisely exhorts us to learn from past experience as we confront the COVID-19 pandemic (McCullough 2020). We should not rush to develop brand new criteria for allocating scarce resources in intensive care units (ICUs), says McCullough, but should instead rely on what we have learned over many years. […] ...

Read More →
In Response to COVID-19 Pandemic Physicians Already Know What to Do
Laurence B. McCullough

The COVID-19 pandemic has prompted multiple responses from bioethicists and bioethics organizations. One prominent response has come from The Hastings Center, “Ethical Framework for Health Care Institutions and Guidelines for Institutional Ethics Services Responding to the Novel Coronavirus Pandemic” (Hastings Center 2020). […] ...

Read More →
Medically Vulnerable Clinicians and Unnecessary Risk During the COVID-19 Pandemic
Annie Janvier & John D. Lantos

Jason is 68 years old. He is a retired family doctor who lives in Vermont. He worked in the emergency room, made home visits to complex patients and was responsible for organizing the home visit schedule for his hospital system. Mostly because of his work, he had neglected his lifestyle, became obese and started having angina at 64, which was a wake-up call. He decided to retire at 65 to take care...

Read More →

Target Article

Ethical Challenges Arising in the COVID-19 Pandemic: An Overview from the Association of Bioethics Program Directors (ABPD) Task Force
Amy L. McGuire, Mark P. Aulisio, F. Daniel Davis, Cheryl Erwin, Thomas D. Harter, Reshma Jagsi, Robert Klitzman, Robert Macauley, Eric Racine, Susan M. Wolf, Matthew Wynia, Paul Root Wolpe & The COVID-19 Task Force of the Association of Bioethics Program Directors (ABPD)

The COVID-19 pandemic has raised a host of ethical challenges, but key among these has been the possibility that health care systems might need to ration scarce critical care resources. Rationing policies for pandemics differ by institution, health system, and applicable law. Most seem to agree that a patient’s ability to benefit from treatment and to survive are first-order considerations. Howe...

Read More →
Eliminating Categorical Exclusion Criteria in Crisis Standards of Care Frameworks
Catherine L. Auriemma, Ashli M. Molinero, Amy J. Houtrow, Govind Persad, Douglas B. White & Scott D. Halpern

During public health crises including the COVID-19 pandemic, resource scarcity and contagion risks may require health systems to shift—to some degree—from a usual clinical ethic, focused on the well-being of individual patients, to a public health ethic, focused on population health. Many triage policies exist that fall under the legal protections afforded by “crisis standards of care,” bu...

Read More →
Should Extremely Premature Babies Get Ventilators During the COVID-19 Crisis?
Marlyse F. Haward, Annie Janvier, Gregory P. Moore, Naomi Laventhal, Jessica T. Fry & John Lantos

In a crisis, societal needs take precedence over a patient’s best interests. Triage guidelines, however, differ on whether limited resources should focus on maximizing lives or life-years. Choosing between these two approaches has implications for neonatology. Neonatal units have ventilators, some adaptable for adults. This raises the question of whether, in crisis conditions, guidelines for tre...

Read More →
Positive Public Health Ethics: Toward Flourishing and Resilient Communities and Individuals
Jennifer Prah Ruger

The COVID-19 pandemic is a global contagion of unprecedented proportions and health, economic, and social consequences. As with many health problems, its impact is uneven. This article argues the COVID-19 pandemic is a global health injustice due to moral failures of national governments and international organizations to prepare for, prevent and control it. Global and national health communiti...

Read More →
Vexing, Veiled, and Inequitable: Social Distancing and the “Rights” Divide in the Age of COVID-19
Amy Fairchild, Lawrence Gostin & Ronald Bayer

Although unprecedented in scope and beyond all our life experiences, sweeping social distancing measures are not without historical precedent. Historically, racism, stigma, and discrimination resulted in grossly inequitable application of disease containment measures. But history also provides examples in which broad measures enjoyed remarkable public support. When it comes to COVID-19, blame and ...

Read More →
COVID in NYC: What We Could Do Better
Tia Powell & Elizabeth Chuang

New York City hospitals expanded resources to an unprecedented extent in response to the COVID pandemic. Thousands of beds, ICU beds, staff members, and ventilators were rapidly incorporated into hospital systems. Nonetheless, this historic public health disaster still created scarcities and the need for formal crisis standards of care. These were not available to NY clinicians because of the stat...

Read More →
Ethics Lessons From Seattle’s Early Experience With COVID-19
Denise M. Dudzinski, Benjamin Y. Hoisington & Crystal E. Brown

Ethics consultants and critical care clinicians reflect on Seattle’s early experience as the United States’ first epicenter of COVID-19. We discuss ethically salient issues confronted at UW Medicine’s hospitals and provide lessons for other health care institutions that may soon face what we have faced. ...

Read More →