Amy L. McGuireMark 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 pandemic raised a number of ethical challenges, but a key one was the possibility that health systems may need to ration scarce critical care resources. The principles of pandemic rationing vary by institution, health system and applicable law. Most agree that the issue of treatment benefit and patient survival is a first-order concern. However, there is an ongoing debate about what clinical measures should be used to determine this, and about other factors that can be considered from an ethical point of view. In this article, we discuss resource allocation and some related ethical challenges for the healthcare system and society, including how to define benefit, how to deal with informed consent, the special needs of paediatric patients, how to involve communities in these difficult decisions and more.