Ethical Challenges Arising in the COVID-19 Pandemic: An Overview from the Association of Bioethics Program Directors (ABPD) Task Force

Abstract

The COVID-19 pandemic has raised a host of ethical challenges, but key among these has been the possibility that health care systems might need to ration scarce critical care resources. Rationing policies for pandemics differ by institution, health system, and applicable law. Most seem to agree that a patient’s ability to benefit from treatment and to survive are first-order considerations. However, there is debate about what clinical measures should be used to make that determination and about other factors that might be ethically appropriate to consider. In this paper, we discuss resource allocation and several related ethical challenges to the healthcare system and society, including how to define benefit, how to handle informed consent, the special needs of pediatric patients, how to engage communities in these difficult decisions, and how to mitigate concerns of discrimination and the effects of structural inequities.     

Critical elements of the crisis intervention team model of jail diversion: An expert survey

The Crisis Intervention Team (CIT) model of jail diversion is a promising approach to addressing the over-involvement of people with mental illness with the criminal justice system. Despite its popularity and promising empirical support, the literature has yet to clarify CIT's critical elements. The aim of this study was to assess the degree to which experts agreement on the importance and perceived implementation of the critical elements of CIT. Study 1 used a literature review to cull potential elements. Three experts familiar with the CIT model reviewed these elements. Study 2 utilized an online survey of 55 CIT co-ordinators/officers and published experts to assess agreement regarding importance and degree the element is implemented. A preliminary list of 36 elements was identified with a high level of expert agreement on their importance regarding importance and implementation. This study developed a preliminary list of elements of the CIT's program. Further research should develop consensus, explore elements' association with outcomes, and differentiate elements from those common to all jail diversion programs. Copyright © 2010 John Wiley & Sons, Ltd.