Abstract
Adding a Correction Factor to the Allocation of Scarce Life-saving Resources in a Pandemic
Highlights
I address the issue of structural inequities in the context of resource allocation during a period of crisis standard of care
At least one study shows that using Sequential Organ Failure Assessment (SOFA) scoring for resource allocation during COVID-19 has a discriminatory effect on non-Hispanic black patients
When an influx of critically ill patients and limited resources required implementing a crisis standard of care, many hospitals quickly established protocols addressing the allocation of scarce resources
Summary
Various theories of justice support applying the correction factor in the allocation of scarce resources. Rawls’s difference principle provides an ethical justification for the correction factor as it benefits the worse off in the event of resource allocation.[9] Applying the correction factor and subtracting one point from the triage score admittedly creates inequality among two otherwise like patients, but it is justified under Rawls’s theory since it gives the advantage to the least advantaged, addressing equity. If the unequal status results from circumstances such as a genetic condition or an accidental injury, like Daniel’s equality of opportunity, deontic egalitarianism does not support giving an advantage to the worse-off. If the unequal position results from the unjust actions of another, such as discriminatory treatment of people of color, deontic egalitarianism supports providing the advantage to address the inequity.
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