Annette Dufner

Whose Life Should We Save? - Ethical Approaches to Medical Rescue Conflicts

(German title: Welche Leben soll man retten?)
ca. 250 pages
Annette Dufner

Annette Dufner

Annette Dufner is Professor of Ethics and Medical Ethics at the University of Bonn.

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How should resources such as donor organs be distributed among patients on the waiting list? Who should receive a ventilator during the pandemic, if there are more patients than intensive care unit beds? This book addresses recent approaches to distributive justice under conditions of scarcity. In scenarios in which not everybody in need can receive help there is often a tension between efficiency and fairness.

For example, aiming at an efficient use of scarce donor organs can imply having to exclude patients who are particularly sick and therefore have lower chances of long-term benefit. Annette Dufner shows how these contradicting criteria can be reconciled in concrete cases, and what such a position would imply for the distribution of donor organs through the Eurotransplant algorithm as well as for the distribution of scarce ventilators during a pandemic.

A contribution to the difficult ethical problem of how one should act when one is faced with numerous persons requiring urgent care but is only able to help some of them due to a scarcity of resources.

Table of Contents:

I. Moral aggregation
1. Should the numbers count?
2. Utility comparisons in conflict cases
3. Welfare levels in conflict cases
4. Decision-theoretic challenges for moral forms of aggregation

II. The Eurotransplant algorithm
5. Organ distribution in the Eurotransplant area
6. Multiple and repeated organ transplantations
7. Urgent liver transplantations with low prospects of success
8. Being worse off in the sense of being more urgent

III. Triage scenarios in intensive care units during a pandemic