Coronavirus disease 2019: Utilizing an ethical framework for rationing absolutely scarce health-care resources in transplant allocation decisions

Anji E. Wall, Timothy Pruett, Peter Stock, Giuliano Testa

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

The novel coronavirus disease 2019 (COVID-19) is impacting transplant programs around the world, and, as the center of the pandemic shifts to the United States, we have to prepare to make decisions about which patients to transplant during times of constrained resources. In this paper, we discuss how to transition from the traditional justice versus utility consideration in organ allocation to a more nuanced allocation scheme based on ethical values that drive decisions in times of absolute scarcity. We recognize that many decisions are made based on the practical limitations that transplant programs face, especially at the extremes. As programs make the transition from a standard approach to a resource-constrained approach to transplantation, we utilize a framework for ethical decisions in settings of absolutely scarce resources to help guide programs in deciding which patients to transplant, which donors to accept, how to minimize risk, and how to ensure the best utilization of transplant team members.

Original languageEnglish (US)
Pages (from-to)2332-2336
Number of pages5
JournalAmerican Journal of Transplantation
Volume20
Issue number9
DOIs
StatePublished - Sep 1 2020

Bibliographical note

Publisher Copyright:
© 2020 The American Society of Transplantation and the American Society of Transplant Surgeons

Keywords

  • editorial/personal viewpoint
  • ethics
  • ethics and public policy
  • infection and infectious agents – viral
  • infectious disease
  • organ acceptance
  • organ allocation
  • organ procurement and allocation
  • organ transplantation in general
  • patient safety

PubMed: MeSH publication types

  • Journal Article
  • Review

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