Decision-making, Medical Resource Allocation and the Elderly in the Context of COVID-19: An Anthropology of and for Bioethics

Abstract

In the context of the COVID-19 pandemic, decision-making practices related to the allocation of medical resources and the treatment of the elderly inform us about the ethics present in the health care setting and at the societal level. The comparison between decision-making in the daily context and the particularity of a pandemic ethics highlights the transition between a non-pandemic ethic and a “pandethic”. The public health ethics approach, particularly utilitarian, has been brought forward in a prominent way in the ethical debates and dilemmas surrounding resource allocation and prioritization. By raising the oppositions and issues associated with age rationing discourses and choices, the question of the treatment of the elderly in the context of COVID-19, and the ageism experienced in this context, emerges. At the same time, difficult ethical decisions and choices are intertwined with the caregiver’s duty to care, and therefore the possibility of moral injury. Conflict emerges between ethical decision-making practices and the caregiver’s personal or professional values, as the balance between various duties is upset. Alternative approaches and ethics are thus put forward in light of the situations experienced, particularly in the context of long-term care. The thesis developed here aims to support the added value of anthropology to decision-making processes and its more formal integration into well-known approaches in bioethics. Using an anthropological perspective, I conclude by exploring avenues of reflection associated with the ethics of discussion, vulnerability, feminism, or care as other ways of approaching decision-making in the context of a pandemic, at a time when ethical and social reflection is essential.