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RSE AMETS Seminar | Prof Tayfun Sönmez

RSE AMETS Seminar | Prof Tayfun Sönmez

Triage protocol design for ventilator rationing in a pandemic: Integrating multiple ethical values through reserves

Presenter: Tayfun Sönmez (Boston College) (joint work with Parag Pathak, Utku Unver, and Bumin Yenmez)

In the wake of the Covid-19 pandemic, the rationing of medical resources has become a critical issue. Nearly all existing triage protocols are based on a priority point system, in which an explicit formula specifies the order in which the total supply of a particular resource, such as a ventilator, is to be rationed for eligible patients. A priority point system generates the same priority ranking to ration all the units. Triage protocols in some states (e.g. Michigan) prioritize frontline health workers giving heavier weight to the ethical principle of instrumental value. Others (e.g. New York) do not, reasoning that if medical workers obtain high enough priority, there is a risk that they obtain all units and none remain for the general community. This debate is particularly pressing given substantial Covid-19 related health risks for frontline medical workers. In this paper, we analyze the consequences of rationing medical resources through a reserve system. In a reserve system, ventilators are placed into multiple categories. Priorities guiding allocation of units can reflect different ethical values between these categories. For example, a reserve category for essential personnel can emphasize the reciprocity and instrumental value, and another reserve category for general community can give higher weight to the values of utility and distributive justice. A reserve system provides additional flexibility over a priority point system because it does not dictate a single priority order for the allocation of all units. It offers a middle-ground approach that balances competing objectives. However, this flexibility requires careful attention to implementation, most notably the processing order of reserve categories, given that transparency is essential for triage protocol design. In this paper, we describe our mathematical model of a reserve system, characterize its potential outcomes, and examine distributional implications of particular reserve systems. We also discuss several practical considerations with triage protocol design.

Note: AUSTRALASIAN Microeconomic Theory Seminars (AMETS) the result of a collaborative effort that include representatives from the following Universities: Australian National University, Deakin University, Singapore Management University, University of Adelaide, Queensland University of Technology, University of Melbourne, University of New South Wales, University of Queensland, University of Sydney, University of Technology Sydney, and University of Western Australia.

Updated:   1 May 2020 / Responsible Officer:  CBE Communications and Outreach / Page Contact:  College Web Team