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Original research
Pandemic justice: fairness, social inequality and COVID-19 healthcare priority-setting
  1. Lasse Nielsen1,2,
  2. Andreas Albertsen2,3
  1. 1 Philosophy, Department for the Study of Culture, University of Southern Denmark, Odense, Denmark
  2. 2 Centre for the Experimental-Philosophical Study of Discrimination, Aarhus University, Aarhus, Denmark
  3. 3 Department of Political Science, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
  1. Correspondence to Dr Andreas Albertsen, School of Business and Social Sciences: Department of Political Science, Aarhus Universitet, Aarhus 8000, Denmark; aba{at}ps.au.dk

Abstract

A comprehensive understanding of the ethics of the COVID-19 pandemic priorities must be sensitive to the influence of social inequality. We distinguish between ex-ante and ex-post relevance of social inequality for COVID-19 disadvantage. Ex-ante relevance refers to the distribution of risks of exposure. Ex-post relevance refers to the effect of inequality on how patients respond to infection. In the case of COVID-19, both ex-ante and ex-post effects suggest a distribution which is sensitive to the prevalence social inequality. On this basis, we provide a generic fairness argument for the claim that welfare states ought to favour a healthcare priority scheme that gives particular weight to protecting the socially disadvantaged.

  • COVID-19
  • ethics
  • philosophy
  • health care economics and organizations

Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study.

This article is made freely available for personal use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/jme-2022-108384

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    Data availability statement

    Data sharing not applicable as no datasets generated and/or analysed for this study.

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    Footnotes

    • Contributors The authors have contributed equally to the article. AA is the guarantor.

    • Funding This study was funded by Danmarks Frie Forskningsfond (grant number: 9037-00007B); Danmarks Grundforskningsfond (Grant number: DNRF114).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

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