The Poverty of Bioethics: Disability, Medical Austerity, and Traumatic Care

Abstract

Amidst crisis-level shortages of medical resources across the board, frontline hospital workers (doctors and nurses) are being forced to make routine decisions over who lives and who dies. Hospitals normally employ professional bioethics standards to help alleviate the burden of such impossible moral decisions from healthcare staff. This essay looks at how three mainstream bioethics theories (utilitarianism, deontology, Rawlsianism) systematically fail frontline hospital workers who are responsible for rationing medical triage during the COVID-19 pandemic. Taking the pandemic response in New York City hospitals as an example, it then argues that the failures of these theories compounds the sense of “unavoidable moral failure” that additionally burdens these workers with psychological trauma. I conclude that the bioethics protocols employed in most major hospitals function alongside neoliberal governmentality, as an extension of what feminist bioethicist Shelley Tremain calls the “apparatus of disability.” Importantly, for Tremain, the apparatus of disability both produces disability (as a social category) and naturalizes impairment (by equating difference with disadvantage). Both sides of this coin can be observed in the crisis at New York City hospitals.