Most ethics guidelines for distributing scarce medical resources during the coronavirus pandemic seek to save the most lives and the most life-years. A patient's prognosis is determined using a SOFA or MSOFA score to measure likelihood of survival to discharge, as well as a consideration of relevant comorbidities and their effects on likelihood of survival up to one or five years. Although some guidelines use age as a tiebreaker when two patients' prognoses are identical, others refuse to consider age for fear of discriminating against the elderly. In this paper, I argue that age is directly relevant for maximizing health benefits, so current ethics guidelines are wrongly excluding or deemphasizing life-stage in their triage algorithms. Research on COVID-19 has shown that age is a risk factor in adverse outcomes, independent of comorbidities. And limiting a consideration of life-years to only one or five years past discharge does not maximize health benefits. Therefore, based on their own stated values, triage algorithms for coronavirus patients ought to include life-stage as a primary consideration, along with the SOFA score and comorbidities, rather than excluding it or using it merely as a tiebreaker. This is not discriminatory because patients ought to have equal opportunity to experience life-stages. The equitable enforcement of that right justifies unequal treatment based on age in cases when there is a scarcity of life-saving resources. A consideration of life-stage would thus allow healthcare workers to responsibly steward public resources in order to maximize lives and life-years saved.
Keywords: COVID-19; allocation of scarce medical resources; consequentialism; coronavirus; life-cycle principle; triage; utilitarianism.
© 2021 John Wiley & Sons Ltd.