Evaluating the ethical appeal of ventilator allocation protocols


Background and objectives

Over the last two decades, numerous public health departments have proposed protocols for the allocation of ventilators during a pandemic. The need for evaluating whether the general public finds the recommended protocols ethically reasonable has been repeatedly stressed, but systematic studies are lacking. With some qualifications, ventilator allocation protocols contain three core elements: who to categorically exclude, who to prioritize among those included, and when to withdraw the ventilator from someone on a ventilator. The protocols recommend strategies that hospitals should follow when faced with ethically difficult choices: Should a patient with other medical conditions that will most likely lead to death in the near future be categorically excluded even if they will survive the current pandemic upon receiving the ventilator? Should healthcare workers be prioritized? Should the ventilator be withdrawn from a child who shows insufficient improvement and is given to an elderly person who will recover upon receiving the ventilator?

While such questions have been debated in academic journals for a long time, COVID-19 has brought them into the public domain. The objectives of this project are to examine,

  1. The considerations that people perceive to be central in the allocation of ventilators during a pandemic;
  2. The opinion of people regarding the ethical attractiveness of different protocols for the allocation of ventilators during a pandemic; and
  3. The factors that explain the potential heterogeneity in responses across people.

Research design

This project will employ online survey questionnaires and administrative data related to COVID-19 to answer these questions.

Potential policy implications

The findings may help improve existing protocols by highlighting aspects of existing protocols that people do not find normatively reasonable.