“Ethical Challenges in Ventilator Allocation During COVID-19 Crisis Level Care in a Low-Resource Setting, Subtitle: Who Gets the Last ventilator?” |Biomedgrid

The need to fairly allocate mechanical ventilator use during crisis care. The COVID-19 pandemic has put an extraordinary strain on public health systems so that medical resources had to be rationed. The most problematic resource to be rationed is the mechanical ventilator because of the limited time for a patient's life to be saved by ventilator use. The problem is heightened in low-resource countries, such as the Philippines, where there were only 1572 ventilators before the COVID-19 pandemic and, at the projected crisis level, 3,144 more were needed [1]. One of the system responses to such scarce resources needed to save lives is to have a triage system to fairly allocate ventilators. Trigging or fair allocation of scarce critical and life-saving resources by the health care system is a widely accepted public health measure during critical or disaster conditions [2,3]. It is based on the duty of stewardship of the health system and the principle of justice with the ethical utilitarian aim of providing the greatest good to the greatest number of people. Most societies consider it ethically valid for the public good to gain precedence over the traditional non-pandemic priority of providing the fiduciary optimal standard of care to each individual patient [2,4]. Thus, the never-ending moral conflict between how to balance the fair allocation of such an important life-saving equipment, the mechanical ventilator, among the excessive number of patients needing it versus the fiduciary duty of rendering medical care to each individual to save his or her life is faced primarily by the frontline physician and the whole health care system and society as well.