Covid-19 and age discrimination: Benefit maximization, fairness, and justified age-based rationing

TY - JOUR

T1 - Covid-19 and age discrimination

T2 - Benefit maximization, fairness, and justified age-based rationing

AU - Albertsen, Andreas

PY - 2023/3

Y1 - 2023/3

N2 - Age-based rationing remains highly controversial. This question has been paramount during the Covid-19 pandemic. Analyzing the practices, proposals, and guidelines applied or put forward during the current pandemic, three kinds of age-based rationing are identified: an age-based cut-off, age as a tiebreaker, and indirect age rationing, where age matters to the extent that it affects prognosis. Where age is allowed to play a role in terms of who gets treated, it is justified either because this is believed to maximize benefits from scarce resources or because it is believed to be in accordance with the value of fairness understood as (a) fair innings, where less priority is given to those who have lived a full life or (b) an egalitarian concern for the worse off. By critically assessing prominent frameworks and practices for pandemic rationing, this article considers the balance the three kinds of age-based rationing strike between maximizing benefits and fairness. It evaluates whether elements in the proposals are, in fact, contrary to the justifications of these measures. Such shortcomings are highlighted, and it is proposed to adjust prominent proposals to care for the worse off more appropriately and better consider whether the acquired benefits befalls the young or the old.

AB - Age-based rationing remains highly controversial. This question has been paramount during the Covid-19 pandemic. Analyzing the practices, proposals, and guidelines applied or put forward during the current pandemic, three kinds of age-based rationing are identified: an age-based cut-off, age as a tiebreaker, and indirect age rationing, where age matters to the extent that it affects prognosis. Where age is allowed to play a role in terms of who gets treated, it is justified either because this is believed to maximize benefits from scarce resources or because it is believed to be in accordance with the value of fairness understood as (a) fair innings, where less priority is given to those who have lived a full life or (b) an egalitarian concern for the worse off. By critically assessing prominent frameworks and practices for pandemic rationing, this article considers the balance the three kinds of age-based rationing strike between maximizing benefits and fairness. It evaluates whether elements in the proposals are, in fact, contrary to the justifications of these measures. Such shortcomings are highlighted, and it is proposed to adjust prominent proposals to care for the worse off more appropriately and better consider whether the acquired benefits befalls the young or the old.

KW - Age rationing

KW - Covid-19

KW - Distributive justice

KW - Fair Innings

KW - Health care rationing

UR - http://www.scopus.com/inward/record.url?scp=85139859055&partnerID=8YFLogxK

U2 - 10.1007/s11019-022-10118-8

DO - 10.1007/s11019-022-10118-8

M3 - Journal article

C2 - 36242727

SN - 1386-7423

VL - 26

SP - 3

EP - 11

JO - Medicine, Health Care and Philosophy

JF - Medicine, Health Care and Philosophy

IS - 1

ER -