"Just" Utility? A Bioethical Analysis of COVID-19 Resource Allocation

COVID-19 has brought into focus the bioethical challenge of resource allocation by straining healthcare delivery in limiting the availability of healthcare resources. While the bioethical principle of autonomy has typically taken precedence for medical practices, with the struggle of resource allocation, the bioethical principles emerging as front-line and conflicting have been utility and justice. Balancing these ideals has been challenging because while utility has demanded that society make decisions maximizing good and minimizing harm, justice has emphasized all people getting their due, despite if most efficient. Looking at how these principles could work without compromising each other, the question how a “just” utility, or a utility well-balanced with justice, could be attained has emerged because while utility has encouraged policies that would save the most lives in dire situations, it has inadvertently allowed for the magnification of prepandemic inequities disproportionately impacting the marginalized, marking an issue of justice. The conversation has proven complex when considering the ventilator crisis, showing the importance of resource allocation for public health emergencies. To grasp the scope of resource allocation challenges during COVID-19, the role of bioethical principles in making decisions, the concept of “just” utility, and the implications of resource allocation (including questions of accountability and use of innovative technologies) will be evaluated. Advocated for will be the consistent discussion of resource allocation strategies by diverse community members who take responsibility together, health officials being transparent during crisis situations, and using bioethical principles to predict and combat inequities that might be amplified during crises.