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Abstract
This paper explores resource allocation complexities during health emergencies, focusing on pervasive racial disparities, notably affecting black communities. It aims to investigate alternatives to the Most Lives Saved approach, particularly its potential to exacerbate disparities. To analyse resource allocation strategies, the essay reviews the Dual-Principled System proposed by Bruce and Tallman (B+T) in 2021. B+T’s proposal critiques previous methods like the Area Deprivation Index and First Come First Serve while seeking to balance equity and utility by adjusting triage scores based on diseases displaying racial disparities. However, the study identifies inherent challenges in subjectivity, complexity and fairness, necessitating a careful examination and potential innovative solutions. The examination of the Dual-Principled System uncovers challenges, leading to the identification of three main issues and potential solutions. Furthermore, to address subjectivity concerns, it is necessary to adopt objective disease selection criteria through data analysis. Moreover, proposed solutions for complexity include real-time data updates, adaptability and regional considerations. Fairness concerns can be mitigated through educational campaigns and a lottery system integrated with triage score adjustments. The study emphasises nuanced resource allocation with objective disease selection, adaptable strategies and educational initiatives, including a lottery system, aligning with fairness, equity and practicality. As healthcare evolves, resource allocation must align with justice, fostering inclusivity and responsiveness for all.
- COVID-19
- Ethics- Medical
- Health Care Economics and Organizations
- Resource Allocation
- Right to Health
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Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information.
Footnotes
Contributors I, CZ, developed the concept for this paper and carried out all of the research, analysis and writing that appears here. Through a thorough assessment and a critical synthesis of existing research, the analysis of racial inequities in resource allocation—particularly in emergency scenarios like the COVID-19 pandemic—was produced. I agree with the conclusions of this manuscript and accept full responsibility for its content.
As the guarantor of this paper, I, CZ, take full responsibility for the work and/or the conduct of the study, had access to the data, and controlled the decision to publish.
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.
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