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10.1111/bioe.12864

http://scihub22266oqcxt.onion/10.1111/bioe.12864
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33683705!8251012!33683705
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suck abstract from ncbi


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pmid33683705      Bioethics 2021 ; 35 (4): 356-365
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  • A consequentialist argument for considering age in triage decisions during the coronavirus pandemic #MMPMID33683705
  • Altman MC
  • Bioethics 2021[May]; 35 (4): 356-365 PMID33683705show ga
  • Most ethics guidelines for distributing scarce medical resources during the coronavirus pandemic seek to save the most lives and the most life-years. A patient's prognosis is determined using a SOFA or MSOFA score to measure likelihood of survival to discharge, as well as a consideration of relevant comorbidities and their effects on likelihood of survival up to one or five years. Although some guidelines use age as a tiebreaker when two patients' prognoses are identical, others refuse to consider age for fear of discriminating against the elderly. In this paper, I argue that age is directly relevant for maximizing health benefits, so current ethics guidelines are wrongly excluding or deemphasizing life-stage in their triage algorithms. Research on COVID-19 has shown that age is a risk factor in adverse outcomes, independent of comorbidities. And limiting a consideration of life-years to only one or five years past discharge does not maximize health benefits. Therefore, based on their own stated values, triage algorithms for coronavirus patients ought to include life-stage as a primary consideration, along with the SOFA score and comorbidities, rather than excluding it or using it merely as a tiebreaker. This is not discriminatory because patients ought to have equal opportunity to experience life-stages. The equitable enforcement of that right justifies unequal treatment based on age in cases when there is a scarcity of life-saving resources. A consideration of life-stage would thus allow healthcare workers to responsibly steward public resources in order to maximize lives and life-years saved.
  • |*Age Factors[MESH]
  • |*COVID-19[MESH]
  • |Ethical Theory[MESH]
  • |Health Care Rationing/*ethics[MESH]
  • |Humans[MESH]
  • |Life Expectancy[MESH]
  • |Organ Dysfunction Scores[MESH]
  • |Prognosis[MESH]
  • |Risk Factors[MESH]
  • |SARS-CoV-2[MESH]


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