Published Paper Details:

The COVID-19 pandemic has raised many ethical challenges, but key among these has been the possibility that healthcare systems might need to ration scarce critical care resources. Rationing policies for pandemics differ by institution, health system, and applicable law. Most seem to agree that a patient's ability to benefit from treatment and to survive is first-order consideration. However, there is debate about what clinical measures should be used to make that determination and other factors that might be ethically appropriate to consider. The covid-19 pandemic has concentrated bioethics attention on the "lifeboat ethics" of rationing and fair allocation of scarce medical resources, such as testing, intensive care unit beds, and ventilators. This focus drives ethics resources away from persistent and systemic problems-in particular, the structural injustices that give rise to health disparities affecting disadvantaged communities of color. Bioethics, long allied with academic medicine and highly attentive to individual decision-making, has largely neglected its responsibility to address these problematic "upstream" issues. It is time to broaden our teaching, research, and practice to match the breadth of these significant societal inequalities and unmet health needs.