Affirmative action in healthcare resource allocation: Vaccines, ventilators and race


Zohny, H., Davies, B. and Wilkinson, D., (2022), 'Affirmative action in healthcare resource allocation: Vaccines, ventilators and race', Bioethics, Vol: 36(9): 970-977 [PMC9539241]


This article is about the potential justification for deploying some form of affirmative action (AA) in the context of healthcare, and in particular in relation to the pandemic. We call this Affirmative Action in healthcare Resource Allocation (AARA). Specifically, we aim to investigate whether the rationale and justifications for using prioritization policies based on race in education and employment apply in a healthcare setting, and in particular to the COVID-19 pandemic. We concentrate in this article on vaccines and ventilators because these are both highly scarce resources in the pandemic, and there has been a need to develop policies for allocating them. However, as will become clear, the ethical considerations relating to them may diverge. We first set out two rationales for AAs and what they might entail in a healthcare setting. We then consider some disanalogies between AA and AARA, as well as the different implications of AARA for allocating ventilators as opposed to vaccines. Finally, we consider some of the practical ways in which AARA could be implemented, and conclude by responding to some key objections.


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Wellcome Trust WT203132 [Wellcome Centre for Ethics and Humanities]

UKRI AH/V013947/1 [UK Ethics Accelerator: Coordinating and Mobilising Ethics Research Excellence to Inform Key Challenges in a Pandemic Crisis]

World Health Organization  2020/1077166-0 [Racing to respond: Race and resource allocation in the COVID-19 pandemic]