Problems of Triage Revealed by COVID-19 at the Intersection of Biopolitics and Bioethics

Abstract

    Due to the COVID-19 pandemic in 2020, medical resources (especially ICU beds with advanced life support, such as respirators) have become scarce around the world, and the necessity of their allocation/rationing is discussed as an ICU triage. This paper reviews the bioethical discussions on ICU triage during the pandemic and addresses three issues: (1) treatment of the elderly, (2) priorities for medical resource allocation, and (3) medical resource re-allocation. Our analysis showed (1) that using age as exclusion criteria for ICU can be discrimination against the elderly, (2) that there were mainly three policies guiding the allocation; no triage, triage by medical needs, and triage by medical utility, while lacking the evidence-based medical assessments on the utility of the triage, and (3) that the reallocation of scarce medical resources in a utilitarian ICU triage scheme might not be legally secure. Finally, we discussed the social implications of utilitarian triage during the state of exception such as the COVID-19 pandemic in the framework of biopolitics theory.