Efficiency is not enough. Ethical analysis and recommendations for the allocation of scarce resources in a pandemic situation

• Published in: Gaceta sanitaria Vol. 35; no. 6; p. 525
• Main Authors: Hortal-Carmona, Joaquín, Padilla-Bernáldez, Javier, Melguizo-Jiménez, Miguel, Ausín, Txetxu, Cruz-Piqueras, Maite, López de la Vieja, María Teresa, Puyol, Àngel, Rodríguez-Arias, David, Tamayo-Velázquez, María-Isabel, Triviño, Rosana
• Format: Journal Article
• Language: English; Spanish
• Published: Spain 01-11-2021
• Subjects: COVID-19; Ethical Analysis; Health Care Rationing; Humans; Pandemics; Resource Allocation; SARS-CoV-2; Eficiencia en salud; Rationing; Pandemics; Racionamiento; Ética de la salud pública; Pandemia; Health equity; Public health ethics; Equidad en salud; Health efficiency
• ISSN: 1578-1283
• DOI: 10.1016/j.gaceta.2020.07.006

To develop a support tool to decision-making in the framework of the COVID-19 pandemic.
Different ethical recommendations that emerged in Spain on prioritizing scarce health resources in the COVID-19 pandemic first wave were searched; it was conducted a narrative review of theoretical models on distribution in pandemics to define an ethical foundation. Finally, recommendations are drawn to be applied in different healthcare settings.
Three principles are identified; strict equality, equity and efficiency, which are substantiated in specific distribution criteria.
A model for the distribution of scarce health resources in a pandemic situation is proposed, starting with a decision-making procedure and adapting the distribution criteria to different healthcare scenarios: primary care settings, nursing homes and hospitals.