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Preparing for an influenza pandemic: are some people more equal than others?

Publication ,  Journal Article
Rosoff, PM; DeCamp, M
Published in: J Health Care Poor Underserved
August 2011

CONTEXT: Planning for a severe influenza pandemic entails facing many substantive public health challenges, especially in the area of the distribution of insufficient supplies of materials and personnel. It is anticipated that rationing of health care resources will be required, thus demanding that choices be made about which individuals should receive potentially life-saving care when not all who can be saved can be served. EVIDENCE ACQUISITION: Most proposed triage and allocation plans have used medical inclusion and exclusion criteria to reduce this gap, but there will still be many more patients than resources. Thus, the potential to arbitrarily exclude groups of people on non-medical grounds in order to reduce relative scarcity could offer an attractive option. Can societies make reasoned anticipatory decisions to keep certain people from receiving influenza treatment in order to maximize the availability of care for other, more favored groups? RESULTS: In this paper, we argue that taking the fundamental moral equality of people seriously requires the inclusion of vulnerable, socially marginalized groups (such as illegal immigrants and incarcerated prisoners) in planning for a pandemic. While there may be a majoritarian justification for a priori discrimination against some groups of people on non-medical grounds, there are no morally defensible reasons to do so and many reasons not to engage in such behavior. CONCLUSIONS: Pandemic planners should resist attempts to institute either unsanctioned or authorized discrimination in resource allocation. Because of their unique position in society, their ethical code and their essential role in confronting a pandemic, physicians can (and should) defend egalitarianism in the allocation of health care resources in such a public health crisis and advocate and act against such exclusion were it to occur.

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Published In

J Health Care Poor Underserved

DOI

EISSN

1548-6869

Publication Date

August 2011

Volume

22

Issue

3 Suppl

Start / End Page

19 / 35

Location

United States

Related Subject Headings

  • Vulnerable Populations
  • United States
  • Social Justice
  • Public Health
  • Pandemics
  • Morals
  • Influenza, Human
  • Humans
  • Health Resources
  • Health Care Rationing
 

Citation

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Rosoff, P. M., & DeCamp, M. (2011). Preparing for an influenza pandemic: are some people more equal than others? J Health Care Poor Underserved, 22(3 Suppl), 19–35. https://doi.org/10.1353/hpu.2011.0098
Rosoff, Philip M., and Matthew DeCamp. “Preparing for an influenza pandemic: are some people more equal than others?J Health Care Poor Underserved 22, no. 3 Suppl (August 2011): 19–35. https://doi.org/10.1353/hpu.2011.0098.
Rosoff PM, DeCamp M. Preparing for an influenza pandemic: are some people more equal than others? J Health Care Poor Underserved. 2011 Aug;22(3 Suppl):19–35.
Rosoff, Philip M., and Matthew DeCamp. “Preparing for an influenza pandemic: are some people more equal than others?J Health Care Poor Underserved, vol. 22, no. 3 Suppl, Aug. 2011, pp. 19–35. Pubmed, doi:10.1353/hpu.2011.0098.
Rosoff PM, DeCamp M. Preparing for an influenza pandemic: are some people more equal than others? J Health Care Poor Underserved. 2011 Aug;22(3 Suppl):19–35.
Journal cover image

Published In

J Health Care Poor Underserved

DOI

EISSN

1548-6869

Publication Date

August 2011

Volume

22

Issue

3 Suppl

Start / End Page

19 / 35

Location

United States

Related Subject Headings

  • Vulnerable Populations
  • United States
  • Social Justice
  • Public Health
  • Pandemics
  • Morals
  • Influenza, Human
  • Humans
  • Health Resources
  • Health Care Rationing