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1.
Gac Sanit ; 36 Suppl 1: S51-S55, 2022.
Article in Spanish | MEDLINE | ID: covidwho-1913330

ABSTRACT

The COVID-19 pandemic has been a clinical challenge, but also a legal and bioethical one. These three fundamental pillars are developed in the approach to prioritizing health resources in pandemic, clinical criteria, corresponding legal framework and applicable ethical principles. Initially, clinical criteria were applied to identify patients with the best survival prognosis, combining a clinical evaluation and the use of short-term and long-term prognostic variables. But the decision to prioritize the care of one patient over another has a legal-political burden, which poses a risk of falling into discrimination since fundamental rights are at stake. The prioritization criteria must be based on principles that reflect as a vehicle philosophy that which we have constitutionally assumed as a social and democratic State of Law, which did not respond to utilitarianism but to personalism. Any philosophy of resource distribution must bear in mind the scientific and constitutional perspective and, with them, those of fundamental rights and bioethical principles. In the prioritization of resources, ethical principles must be consolidated such as respect for the human dignity, the principle of necessity (equal need, equal access to the resource), the principle of equity (which advises prioritizing the most vulnerable population groups), transparency (fundamental in society's trust) and the principle of reciprocity (which requires protecting the sectors of the population that take more risks), among others.


Subject(s)
COVID-19 , Health Resources , COVID-19/epidemiology , Humans , Pandemics , Vulnerable Populations
2.
Front Public Health ; 9: 737755, 2021.
Article in English | MEDLINE | ID: covidwho-1497179

ABSTRACT

Objectives: Each new wave of the COVID-19 pandemic invites the possible obligation to prioritize individuals' access to vital resources, and thereby leads to unresolved and important bioethical concerns. Governments have to make decisions to protect access to the health system with equity. The prioritization criteria during a pandemic are both a clinical and legal-administrative decision with ethical repercussion. We aim to analyse the prioritization protocols used in Spain during the pandemic which, in many cases, have not been updated. Method: We carried out a narrative review of 27 protocols of prioritization proposed by healthcare ethics committees, scientific societies and institutions in Spain for this study. The review evaluated shared aspects and unique differences and proffered a bioethical reflection. Results: The research questions explored patient prioritization, the criteria applied and the relative weight assigned to each criterion. There was a need to use several indicators, being morbidity and mortality scales the most commonly used, followed by facets pertaining to disease severity and functional status. Although age was initially considered in some protocols, it cannot be the sole criterion used when assigning care resources. Conclusions: In COVID-19 pandemic there is a need for a unified set of criteria that guarantees equity and transparency in decision-making processes. Establishing treatment indications is not the aim of such criteria, but instead prioritizing access to care resources. In protocols of prioritization, the principle of efficiency must vary according to the principle of equity and the criteria used to guarantee such equity.


Subject(s)
COVID-19 , Pandemics , Delivery of Health Care , Ethics Committees , Humans , Pandemics/prevention & control , SARS-CoV-2 , Spain/epidemiology
3.
Cuad Bioet ; 31(102): 183-202, 2020.
Article in Spanish | MEDLINE | ID: covidwho-761284

ABSTRACT

The article deals with the analysis of the criteria for the allocation of scarce health resources during the pandemic produced by the COVID 19 virus in Spain. It critically analyses the absence of a legal-constitutional perspective in the elaboration of such criteria and suggests the incorporation of the criterion of equity as a guarantee of the effective exercise of the constitutional right to health protection by vulnerable persons.


Subject(s)
Betacoronavirus , Health Resources/ethics , Pandemics/ethics , Resource Allocation/ethics , COVID-19 , Constitution and Bylaws , Coronavirus Infections/prevention & control , Ethical Theory , Government Agencies , Health Priorities , Health Resources/legislation & jurisprudence , Health Resources/supply & distribution , Health Services Accessibility/ethics , Health Services Accessibility/legislation & jurisprudence , Human Rights/legislation & jurisprudence , Humans , Minority Groups , Pandemics/legislation & jurisprudence , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Publications , Resource Allocation/legislation & jurisprudence , Role , SARS-CoV-2 , Social Justice , Societies, Medical , Spain/epidemiology , Triage/ethics , Vulnerable Populations
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