Is the Use of DALYs and QALYs Ethically Permissible in Triage Decisions? COVID-19 and Equity Considerations from a Queer-Crip Perspective

This paper explores the symbolic and material implications of the use of DALYs and QALYs as priority or tie-breaker criteria in triage decisions. It aims to answer the question of their ethical permissibility based on the particular case of the COVID-19 pandemic. For this purpose, theories framed in...

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Detalles Bibliográficos
Autores: Leani, Lautaro, Mastroleo, Ignacio
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:Brasil
Institución:Universidade Federal de Santa Catarina (UFSC)
Repositorio:Ethic@ - Revista Internacional de Filosofia da Moral
Idioma:inglés
OAI Identifier:oai:periodicos.ufsc.br:article/91703
Acceso en línea:https://periodicos.ufsc.br/index.php/ethic/article/view/91703
Access Level:acceso abierto
Palabra clave:Disability Adjusted Life Years
Quality Adjusted Life Years
Triage
Equity
Queer-Crip Perspective
Descripción
Sumario:This paper explores the symbolic and material implications of the use of DALYs and QALYs as priority or tie-breaker criteria in triage decisions. It aims to answer the question of their ethical permissibility based on the particular case of the COVID-19 pandemic. For this purpose, theories framed in a queer-crip perspective and ethical frameworks of equity will be used. From a queer-crip perspective, the use of DALYs and QALYs in triage decisions discriminates against and excludes people with disabilities, as it allocates scarce resources based on ableist value judgments about people's quality of life, rather than on evidence. From the point of view of equity, it may imply and reinforce structural injustices involving inequities, that is, avoidable or remediable inequalities. This analysis will argue that the use of DALYs and QALYs categories in triage decisions allocates potentially life-saving resources based on ableist value judgments that lead to an unfair distribution of risks, burdens, and costs. Finally, two objections related to the relevance or necessity of using these or similar categories as criteria will be addressed: the independent cases of structural inequities and the inevitability of setting priorities in the face of a crisis.