Promoting racial equity in COVID-19 resource allocation

Lori Bruce1,2,3, Ruth Tallman3,4

  • 1Interdisciplinary Center for Bioethics, Yale University, New Haven, Connecticut, USA Lori.Bruce@yale.edu.

Journal of Medical Ethics
|January 30, 2021
PubMed

Insights

COVID-19 triage protocols often worsen racial disparities. This paper critiques current methods and proposes a new paradigm to ensure equitable resource allocation for all patients, addressing systemic inequities.

Area of Science:

  • Public Health
  • Health Equity
  • Medical Ethics

Background:

  • COVID-19 has strained global health systems, necessitating triage protocols for scarce resource allocation.
  • Existing triage methods, relying on numerical morbidity scores, perpetuate racial disparities and health inequities.
  • Policy responses have been insufficient to address the complexity of racial bias in triage.

Purpose of the Study:

  • To dismantle arguments against addressing racial inequity in COVID-19 triage.
  • To highlight concerns with current and proposed triage protocols.
  • To propose a new framework for equitable allocation of COVID-19 resources.

Main Methods:

  • Critical analysis of existing COVID-19 triage protocols and their ethical implications.
  • Examination of policy statements and their translation into practice.
  • Review of arguments for and against race-based considerations in triage.
  • Development of a novel paradigm for equitable resource allocation.

Main Results:

  • Standard triage protocols exacerbate racial disparities in healthcare.
  • Race-based exceptions in triage are complex but not insurmountable.
  • Existing policies often make exceptions, demonstrating flexibility that can be applied to address racial inequity.

Conclusions:

  • A new paradigm is needed to ensure COVID-19 resource allocation is equitable.
  • Addressing racial bias in triage is crucial for achieving health justice.
  • Flexibility in policy-making should be extended to prioritize patients of color.

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