Bioethical considerations for medical decision making in a situation of an pandemic and sanitary emergency. Learning from the SARS-COV-2 pandemic.

Abstract

The health crisis suffered during the 2020 SARS-CoV-2 pandemic caused healthcare professionals to face an unprecedented ethical conflict. The massive and short-term consumption of life support means meant that in many cases, these treatments could not be offered, at least in due course, when under normal conditions they would have been. This situation makes the importance of uniform, consensual and fair prioritization protocols in situations of epidemic and health emergency clear. The objective of this document is to address the bioethic criteria that should guide the elaboration of the prioritization protocols, which bodies should assume the maximum responsibility in such elaboration and how they should be applied. The resource allocation model must be a mixed model in which the possibility of survival is the fundamental pillar and the first criterion and equity and the protection of vulnerability are also guaranteed. Both prejudices against older people or people with disabilities and criteria of social utility and utilitarian approaches, which subordinate individual rights to the common good or the total number of lives saved, must be avoided. The main responsibility for the preparation, organization and protection of the prioritization protocols must be assumed by the highest legal and political authorities since this inevitable prioritization could implies the denial of a fundamental right included in the Spanish Constitution as is the protection of the health of each individual.