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Ethical Challenges Arising in the COVID-19 Pandemic: An Overview from the Association of Bioethics Program Directors (ABPD) Task Force

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The novel coronavirus (COVID-19) pandemic has invigorated bioethics discourse related to scarce resource allocation. In this issue, McGuire et al. (2020) thoughtfully discuss important ethical dimens... ions to consider when making difficult explicit rationing decisions. The national ethics conversation has focused specifically on rationing mechanical ventilators and ICU beds, which (fortunately) was generally unnecessary during the first months of the pandemic in the United States. But a narrow focus on a single intervention or setting fails to account for the complexity of contemporary medical care (Haward et al. 2020). There is, in fact, a broad spectrum of resources that have or could become scarce during this pandemic. For example, it does not matter if the last ventilator is allocated equitably if it is missing a filter, accompanying sedatives, a respiratory therapist, or the personal protective equipment (PPE) to protect clinicians securing the airway. Clinicians and hospital administrators have been largely left to their own devices to attempt to “flatten the rationing curve”—slowing the use rate of potentially scarce resources in hopes that they never have to be explicitly rationed. [Show More]

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