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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Detalhes bibliográficos
Autores: Leani, Lautaro, Mastroleo, Ignacio
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:Brasil
Recursos:Universidade Federal de Santa Catarina (UFSC)
Repositorio:Ethic@ - Revista Internacional de Filosofia da Moral
Idioma:inglés
OAI Identifier:oai:periodicos.ufsc.br:article/91703
Acesso em linha:https://periodicos.ufsc.br/index.php/ethic/article/view/91703
Access Level:acceso abierto
Palavra-chave:Disability Adjusted Life Years
Quality Adjusted Life Years
Triage
Equity
Queer-Crip Perspective
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spelling Is the Use of DALYs and QALYs Ethically Permissible in Triage Decisions? COVID-19 and Equity Considerations from a Queer-Crip PerspectiveDisability Adjusted Life YearsQuality Adjusted Life YearsTriageEquityQueer-Crip PerspectiveThis 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.Universidade Federal de Santa Catarina2023-11-29info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://periodicos.ufsc.br/index.php/ethic/article/view/9170310.5007/1677-2954.2023.e91703ethic@ - An international Journal for Moral Philosophy; Vol. 22 No. 1 (2023): Global Pandemic Justice; 126-154ethic@ - An international Journal for Moral Philosophy; v. 22 n. 1 (2023): Justiça Pandêmica Global; 126-1541677-295410.5007/1677-2954.2023.1reponame:Ethic@ - Revista Internacional de Filosofia da Moralinstname:Universidade Federal de Santa Catarina (UFSC)instacron:UFSCenghttps://periodicos.ufsc.br/index.php/ethic/article/view/91703/54695Copyright (c) 2023 ethic@ - An international Journal for Moral Philosophyinfo:eu-repo/semantics/openAccessLeani, LautaroMastroleo, Ignacio2023-12-01T10:42:50Zoai:periodicos.ufsc.br:article/91703Revistahttps://periodicos.ufsc.br/index.php/ethic/indexPUBhttps://periodicos.ufsc.br/index.php/ethic/oaiethic@contato.ufsc.br1677-29541677-2954opendoar:2023-12-01T10:42:50Ethic@ - Revista Internacional de Filosofia da Moral - Universidade Federal de Santa Catarina (UFSC)false
dc.title.none.fl_str_mv Is the Use of DALYs and QALYs Ethically Permissible in Triage Decisions? COVID-19 and Equity Considerations from a Queer-Crip Perspective
title Is the Use of DALYs and QALYs Ethically Permissible in Triage Decisions? COVID-19 and Equity Considerations from a Queer-Crip Perspective
spellingShingle Is the Use of DALYs and QALYs Ethically Permissible in Triage Decisions? COVID-19 and Equity Considerations from a Queer-Crip Perspective
Leani, Lautaro
Disability Adjusted Life Years
Quality Adjusted Life Years
Triage
Equity
Queer-Crip Perspective
title_short Is the Use of DALYs and QALYs Ethically Permissible in Triage Decisions? COVID-19 and Equity Considerations from a Queer-Crip Perspective
title_full Is the Use of DALYs and QALYs Ethically Permissible in Triage Decisions? COVID-19 and Equity Considerations from a Queer-Crip Perspective
title_fullStr Is the Use of DALYs and QALYs Ethically Permissible in Triage Decisions? COVID-19 and Equity Considerations from a Queer-Crip Perspective
title_full_unstemmed Is the Use of DALYs and QALYs Ethically Permissible in Triage Decisions? COVID-19 and Equity Considerations from a Queer-Crip Perspective
title_sort Is the Use of DALYs and QALYs Ethically Permissible in Triage Decisions? COVID-19 and Equity Considerations from a Queer-Crip Perspective
dc.creator.none.fl_str_mv Leani, Lautaro
Mastroleo, Ignacio
author Leani, Lautaro
author_facet Leani, Lautaro
Mastroleo, Ignacio
author_role author
author2 Mastroleo, Ignacio
author2_role author
dc.subject.por.fl_str_mv Disability Adjusted Life Years
Quality Adjusted Life Years
Triage
Equity
Queer-Crip Perspective
topic Disability Adjusted Life Years
Quality Adjusted Life Years
Triage
Equity
Queer-Crip Perspective
description 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.
publishDate 2023
dc.date.none.fl_str_mv 2023-11-29
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://periodicos.ufsc.br/index.php/ethic/article/view/91703
10.5007/1677-2954.2023.e91703
url https://periodicos.ufsc.br/index.php/ethic/article/view/91703
identifier_str_mv 10.5007/1677-2954.2023.e91703
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://periodicos.ufsc.br/index.php/ethic/article/view/91703/54695
dc.rights.driver.fl_str_mv Copyright (c) 2023 ethic@ - An international Journal for Moral Philosophy
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2023 ethic@ - An international Journal for Moral Philosophy
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Universidade Federal de Santa Catarina
publisher.none.fl_str_mv Universidade Federal de Santa Catarina
dc.source.none.fl_str_mv ethic@ - An international Journal for Moral Philosophy; Vol. 22 No. 1 (2023): Global Pandemic Justice; 126-154
ethic@ - An international Journal for Moral Philosophy; v. 22 n. 1 (2023): Justiça Pandêmica Global; 126-154
1677-2954
10.5007/1677-2954.2023.1
reponame:Ethic@ - Revista Internacional de Filosofia da Moral
instname:Universidade Federal de Santa Catarina (UFSC)
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instname_str Universidade Federal de Santa Catarina (UFSC)
instacron_str UFSC
institution UFSC
reponame_str Ethic@ - Revista Internacional de Filosofia da Moral
collection Ethic@ - Revista Internacional de Filosofia da Moral
repository.name.fl_str_mv Ethic@ - Revista Internacional de Filosofia da Moral - Universidade Federal de Santa Catarina (UFSC)
repository.mail.fl_str_mv ethic@contato.ufsc.br
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