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[Efficiency is not enough. Ethical analysis and recommendations for the allocation of scarce resources in a pandemic
Joaquín Hortal-Carmona1, Javier Padilla-Bernáldez2, Miguel Melguizo-Jiménez3
1Hospital de Guadix, Agencia Pública Sanitaria Hospital de Poniente, Granada, España; Red de Ética Salubrista para la Acción, Cuidados y Observación Social (ESPACyOS), España.
Objective:
To develop a support tool to decision-making in the framework of the COVID-19 pandemic.
Method:
Different ethical recommendations that emerged in Spain on prioritizing scarce health resources in the COVID-19 pandemic first wave were searched; it was conducted a narrative review of theoretical models on distribution in pandemics to define an ethical foundation. Finally, recommendations are drawn to be applied in different healthcare settings.
Results:
Three principles are identified; strict equality, equity and efficiency, which are substantiated in specific distribution criteria.
Conclusions:
A model for the distribution of scarce health resources in a pandemic situation is proposed, starting with a decision-making procedure and adapting the distribution criteria to different healthcare scenarios: primary care settings, nursing homes and hospitals.
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