Article Text

Download PDFPDF
Unweighted lotteries and compounding injustice: reply to Schmidt et al
  1. Alex James Miller Tate1,2
  1. 1Centre for Medical Law & Ethics, King's College London, London, Greater London, UK
  2. 2Philosophy, King's College London, London, UK
  1. Correspondence to Dr Alex James Miller Tate, Centre for Medical Law and Ethics, King's College London, London WC2R 2LS, UK; alexander.miller_tate{at}kcl.ac.uk

Abstract

I argue that Schmidt et al, while correctly diagnosing the serious racial inequity in current ventilator rationing procedures, misidentify a corresponding racial inequity issue in alternative ‘unweighted lottery’ procedures. Unweighted lottery procedures do not ‘compound’ (in the relevant sense) prior structural injustices. However, Schmidt et al do gesture towards a real problem with unweighted lotteries that previous advocates of lottery-based allocation procedures, myself included, have previously overlooked. On the basis that there are independent reasons to prefer lottery-based allocation of scarce lifesaving healthcare resources, I develop this idea, arguing that unweighted lottery procedures fail to satisfy healthcare providers’ duty to prevent unjust population-level health outcomes, and thus that lotteries weighted in favour of Black individuals (and others who experience serious health injustice) are to be preferred.

  • allocation of health care resources
  • COVID-19
  • distributive justice
  • minorities
  • Public Health Ethics

Statistics from Altmetric.com

Footnotes

  • Contributors AJMT is the sole author.

  • 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 None declared.

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

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Other content recommended for you