176560 Ethics in the worst of times: A critical review of ethical guidance for rationing resources in a severe influenza pandemic

Monday, October 27, 2008: 10:55 AM

Angela Witt Prehn, PhD , School of Health Sciences, College of Health Sciences, Walden University, Minneapolis, MN
Dorothy E. Vawter, PhD , Minnesota Center for Health Care Ethics, Minneapolis, MN
Planning for a severe influenza pandemic involves tough decisions about the rationing of health-related resources. Is there general agreement about who should receive pandemic vaccine first when there's not enough to go around? Should social criteria such as age and quality-of-life play a role in prioritizing the use of scarce health-related resources? Should we give scarce resources first to those who expose themselves to risk in the service of others?

As part of the Minnesota Pandemic Ethics Project, we reviewed national and state pandemic influenza plans, guidance documents and scholarly publications in order to answer the following questions: 1) What ethical guidance is there available globally about how to ration scarce health-related resources in a severe pandemic? and; 2) Which ethical issues remain unresolved?

Ethical guidance is limited or absent in the majority of pandemic influenza plans reviewed, but is increasing. Rationing on the basis of risk of mortality, effectiveness, and social function is commonly recommended and the agreement about these priorities crosses geopolitical and cultural borders. There is less consensus on rationing on the basis of age, quality of life and duration of benefit. Ethical arguments regarding these unresolved issues in rationing during a pandemic will be presented.

Learning Objectives:
1) Identify key ethical issues in the rationing of scarce health-related resources during a severe influenza pandemic 2) Describe similarities and differences in the ethical guidance available for rationing scarce resources 3) Articulate ethical arguments for unresolved issues in pandemic influenza rationing, e.g., age-based rationing

Keywords: Ethics, Rationing

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I participated in the design and conduct of the literature review and I am an active and participating member of the Minnesota Pandemic Ethics Project Team.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.