Abstract
The COVID-19 pandemic has occasioned a great deal of ethical reflection both in general and on the issue of reverse triage; a practice that effectively reallocates resources from one patient to another on the basis of the latter having a more favourable clinical prognosis. This paper addresses a specific concern that has arisen in relation to such proposals: the potential reallocation of ventilators relied upon by disabled or chronically ill patients. This issue is examined via three morally parallel scenarios. First, the standard reallocation of a ventilator in accordance with reverse triage protocols; second, the reallocation of a personal ventilator from a chronically ill patient ordinarily reliant on it; and, third, the reallocation of a personal ventilator owned by a financially privileged individual but who is not ordinarily reliant on it. This paper suggests that whilst property rights cannot resolve these scenarios in a satisfactory manner, it may be possible to do so if we draw on the resources of phenomenology. However, in contradistinction to a recent paper on this topic (Reynolds et al. 2021), we argue that ethical claims to ventilators are not well grounded by the overly demanding notion that they are embodied objects. We suggest that the alternative phenomenological notion of homelikeness provides for a more plausible resolution of the issue. The personal ventilators of individuals who commonly rely upon them become part of their ordinary, everyday or homelike being. They are a necessary part of the continuation or maintenance of their basic state of health or wellbeing and the reallocation of such objects is unethical. Keywords: Phenomenology, COVID-19, Pandemic, Triage, Reverse triage, Ventilation, Chronic illness, Allocation of resources
Highlights
As many researchers have discussed, protocols for reverse triage are likely to be implemented if and when a pandemic overwhelms healthcare institutions and resources (Emmerich 2011; Truog et al 2020; Wilkinson 2020; Sprung et al 2020)
Their essay draws on the prominent phenomenological notion of embodiment and the idea that objects can be literally incorporated into an individual’s body and thereby into their corporeal sense of self. They argue that additional moral significance can be attached to the personal ventilators of chronic users, meaning that it is not permissible to reallocate them for the purposes of reverse triage
In parallel to the notion that items of property are public or private goods, ventilators belonging to chronically ill patients can be constitutive of their conditions of healthy or homelike being. This can be taken to mean that chronically ill patients who rely on ventilators have a moral claim that outweighs the clinical needs of others and, the imperatives generated by reverse triage protocols
Summary
As many researchers have discussed, protocols for reverse triage are likely to be implemented if and when a pandemic overwhelms healthcare institutions and resources (Emmerich 2011; Truog et al 2020; Wilkinson 2020; Sprung et al 2020). We are concerned with the kind of reverse triage that might be practiced during a disaster, such as when a pandemic has overwhelmed tertiary healthcare services in a particular location.1 In this context resources— care in an ICU and/or use of a ventilator—might be withdrawn from patients who are highly unlikely to recover without continued access to such resources. Their essay draws on the prominent phenomenological notion of embodiment and the idea that objects can be literally incorporated into an individual’s body and thereby into their corporeal sense of self As a result, they argue that additional moral significance can be attached to the personal ventilators of chronic users, meaning that it is not permissible to reallocate them for the purposes of reverse triage. If scenario B should be considered different to A, it is not obvious why scenario C cannot be considered in similar terms
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Etikk i praksis - Nordic Journal of Applied Ethics
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
