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Contractualist age rationing under outbreak circumstances.

Lasse Nielsen1

  • 1Philosophy, Department for the Study of Culture, University of Southern Denmark, Odense, Denmark.

Bioethics
|October 17, 2020
PubMed
Summary

During health crises like COVID-19, age rationing in healthcare requires different ethical approaches. Contractualism offers a better framework for prioritizing patients during outbreaks than consequentialist theories.

Keywords:
Covid-19age rationingconsequentialismcontractualismoutbreakprudential life-span account

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Area of Science:

  • Bioethics
  • Health Policy
  • Medical Ethics

Background:

  • Age rationing is a critical topic in healthcare priority-setting.
  • The COVID-19 pandemic heightened the relevance of age-based prioritization, with some authorities favoring younger patients.
  • Existing ethical frameworks face challenges in addressing age rationing during public health emergencies.

Purpose of the Study:

  • To analyze the differences in age rationing between normal and outbreak circumstances.
  • To evaluate the implications of these differences for ethical theories.
  • To propose a novel ethical framework for age rationing during health crises.

Main Methods:

  • Comparative ethical analysis of different prioritization theories.
  • Examination of consequentialist (utilitarianism, age-weighted consequentialism) and contractualist approaches.
  • Development of a contractualist prudential account for outbreak scenarios.

Main Results:

  • Outbreak circumstances introduce unique factors that alter the ethical considerations of age rationing.
  • Consequentialist theories struggle to adequately address the complexities of age rationing during pandemics.
  • Contractualism demonstrates greater adaptability in handling age-based prioritization during health crises.

Conclusions:

  • The ethical justification for age rationing shifts significantly during public health outbreaks.
  • Contractualism provides a more robust ethical foundation for age rationing in outbreak settings.
  • A contractualist prudential account offers a viable approach to navigating age-based healthcare prioritization during pandemics.