The Role of Racial Bias When Medical Experts Are Making Decision on the Allocation of Scarce Resources
This makes it challenging to meet the medical needs of all. Ethicists provide normative guidance for how to fairly allocate scarce medical resources, but legitimate decisions require additionally information regarding what the general public considers to be fair.
The Implementation Team recommends collaboration between LHDs and social service agencies, home care providers, free clinics, community organizations such as the Salvation Army, faith-based communities that serve low income people, etc. These groups work directly with populations that are most likely to face barriers to access during a pandemic.
In this regard, they are more like some foreign medical systems than the more fragmented and mixed public-private medical system of the United States. In the context of budget cuts domestically and in many countries responding to an economic downturn, how to invest (and allocate) public health resources is a pressing issue (Christian, M.D.).
Avoidance of high-risk exposure may be appropriate for clinicians who are older, have dependents, are pregnant, are immunocompromised, or have chronic cardiopulmonary disease. The supply of PPE may also play a role in these decisions. However, those who are making duty schedules may experience significant difficulties in balancing competing interests among clinicians. For example, it is difficult to weigh mitigating exposure risk for a single caregiver of children versus a single caregiver for an elderly parent versus a 2 clinician family with no extended support network. These questions do not have easy answers but require careful consideration.
Christian, M.D., L. Hawryluck, R.S. Wax, et al. 2006. Development of a triage protocol for critical care during an influenza pandemic. Canadian Medical Association Journal 175(11): 1377–1381.
Hick, J., L. Rubinson, D. O’Laughlin, and J. Farmer. 2007. Allocating ventilators during largescale disasters—Problem, planning, and process. Critical Care 11(3): 217–226.
Hoffman, S. 2009. Preparing for disaster: Protecting the most vulnerable in emergencies. UC Davis Law Review 42: 1491–1547.