Article Text
Abstract
The COVID-19 pandemic has forced clinicians, policy-makers and the public to wrestle with stark choices about who should receive potentially life-saving interventions such as ventilators, ICU beds and dialysis machines if demand overwhelms capacity. Many allocation schemes face the question of whether to consider age. We offer two underdiscussed arguments for prioritising younger patients in allocation policies, which are grounded in prudence and fairness rather than purely in maximising benefits: prioritising one’s younger self for lifesaving treatments is prudent from an individual perspective, and prioritising younger patients works to narrow health disparities by giving priority to patients at risk of dying earlier in life, who are more likely to be subject to systemic disadvantage. We then identify some confusions in recent arguments against considering age.
- resource allocation
- political philosophy
- public health ethics
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Footnotes
Twitter @GovindPersad, @SteveJoffe
Contributors Both authors drafted and revised the manuscript in collaboration.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests GP receives research funding from the Greenwall foundation and has received personal fees from the ASCO Post and WHO. SJ is a member of the independent data and safety monitoring board responsible for oversight of SARS-CoV-2 clinical trials supported by Operation Warp Speed, for which he receives an honorarium of US$200 per meeting from the National Institute of Allergy and Infectious Diseases. He received research funding from Pfizer through the University of Pennsylvania until May 2020.
Provenance and peer review Not commissioned; externally peer reviewed.
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