Good morning. Given the emerging public health crisis as evidence becomes undeniable that the coronavirus is ‘the problem of us all’, I thought it would be timely/appropriate to send you as ‘Surgical Ethics Education Resources #29’ a first set of reflections on wrestling with the tough decisions faced when resources are severely limited.
It is simple enough to say -- “I am for fair distribution of and access to limited resources”. I have yet to come across someone who says -- “I am for unfair distribution of and access to limited resources”. However, we all know firsthand that it is very complicated to reach agreement/consensus and very challenging to act together in/as community when resources are severely limited. One reason -- the penetrating sacrifices and the sobering risks that are inseparable from following through on the resolve to prioritize justice and to act in a consistently fair manner. A second reason – the reality (as visualized in the slide inserted below) that several ways to imag(in)e what being ‘fair/just’ looks like conflict/collide in tense deliberations when need/demand overwhelms available resources. No single definition or outcome for what it means to be ‘fair/just’ is equally compelling and effective for all situations.
I am sure you all will be steady participants in the deliberations in your hospitals, medical schools, and communities about ethically grounded distribution of and access to severely limited resources. I hope the above reflections refresh your expertise for this responsibility. The focus of this communication is on your skills for detecting/identifying the often competing theoretical paradigms embedded within the concerns and proposals expressed by participants in these deliberations.
Doug