Identify the morally relevant features of the case


Problem

The Regional Hospital is a major trauma center with a large emergency department and intensive care unit (ICU). During the outbreak of a pandemic coronavirus crisis, the ICU is filled to capacity with patients suffering from life-threatening medical conditions, including complications from influenza-like bacterial pneumonia. The emergency department calls the ICU seeking to admit Mr. M, who was brought to the emergency room with a severe but potentially reversible brain injury after a bicycling accident. One alternative is to move one of the current ICU patients to a medical unit in order to make room for Mr. M. However, the ICU staff reports that all of their patients need ventilator support, and there are no other ventilated beds available in the hospital. Another alternative is to send Mr. M to another unit in the hospital.

However, given Mr. M's injuries, it is clear that this would overtax the clinical capabilities of the health care staff, who are not trained in critical care and who are already struggling to care for other patients. The final alternative is to transfer Mr. M to another health care facility. However, the pandemic has overwhelmed all hospitals in the region, and there are no available ICU beds anywhere else. An ICU patient passes away. There is now a bed available in the ICU for Mr. M. However, just as his transfer is about to be made... An ICU nurse named Ms. A is admitted with severe difficulty breathing. It is determined that she has been infected with the coronavirus, which she may have contracted while caring for patients in the hospital's ICU. She needs immediate ventilation support, which is only available in the ICU bed designated for, but not yet occupied by, Mr. M. At the same time another patient, Ms. T is admitted with similar symptoms. It is also determined that she has been infected with the coronavirus. She needs immediate ventilation support, which is only available in the ICU bed designated for, but not yet occupied by, Mr. M. Ms. T and Ms A are both in their 50s. Ms. A. is white and, as an ICU nurse has medical insurance and a good income. Ms. T is a person of color and comes from a lower socioeconomic background, because of her poverty she has not had access to routine medical care and, as a consequence, has a congenital heart disease that would have been treated had her family had medical insurance when she was a child.

Task

A. Identify the morally relevant features of this case. These are details that should be taken into account when making a decision about this case.

B. Explain what general method of triage should be used at the regional hospital to guide decision making about cases like this one. Show how the method applies to this case.

C. Show how your answer is supported by one of the theories of distributive justice examined in class (i.e., egalitarian, contractarian (or Rawlsian), utilitarian, communitarian, or libertarian). Make sure to explain the theory in your answer.

D. What are the moral disadvantages of the approach that you propose for handling this and similar circumstances? Give reasons for your answer.

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