Collective Reflective Equilibrium, Algorithmic Bioethics and Complex Ethics.

Area of Science:

• Bioethics
• Distributive Justice
• Health Economics

Background:

• John Harris's significant contributions to bioethics, particularly in resource allocation ethics.
• Introduction of the "fair innings argument" as an early sufficientarian approach to distributive justice.
• Critique of utilitarian allocation methods, such as maximizing Quality Adjusted Life Years (QALYs).

Purpose of the Study:

• To compare sufficientarian and egalitarian approaches with utilitarian and contractualist ethical frameworks.
• To introduce and apply a methodology (Collective Reflective Equilibrium) for ethical decision-making in resource allocation.
• To develop an ethical algorithm for ventilator allocation during pandemics, illustrating algorithmic bioethics.

Main Methods:

• Comparative analysis of ethical theories: sufficientarianism, egalitarianism, utilitarianism, and contractualism.
• Development and application of the Collective Reflective Equilibrium methodology.
• Case study: ethical algorithm for ventilator allocation during a pandemic.

Main Results:

• Harris's "fair innings argument" suggests resources should ensure a minimum lifespan (e.g., 70-80 years).
• Egalitarianism, as advanced by Harris, prioritizes equal chances for the longest, best quality life.
• The Collective Reflective Equilibrium methodology provides a framework for resolving ethical pluralism in resource allocation, leading to an ethical algorithm for ventilator deployment.

Conclusions:

• Algorithmic bioethics offers a novel approach to managing value pluralism and context-specific moral judgments in complex ethical dilemmas.
• The proposed methodology and algorithm provide practical tools for ethical resource allocation, particularly in public health emergencies.
• Reconciling different ethical perspectives is crucial for fair and just distribution of scarce resources.