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Ethical Issues in Scarce Resource Allocation in a Global Pandemic: Relevance to Craniofacial Surgery

The response to the COVID-19 pandemic has necessitated a shift in how we apply the principles of biomedical ethics. The historical foundation of the ethical responsibility of the physician to the patient rests on the of that individual relationship. The patient comes first. However, in a pandemic, a public health ethics takes over, and the focus changes to what each individual member of society’s responsibility is to the collective. The greatest good for the greatest number trumps a given individual’s needs. Ethicists have focused primarily on creating guidelines that apply to allocating scarce life-and-death-determining resources. Very little attention has been paid to scarce resources that are more mundane, such as personal protective equipment (PPE) or operating room (OR) time. I present here a summary of the most recent ethical guidelines for allocation of scarce resources, note some concerns with these approaches, and discuss some of the shortcomings of applying these frameworks to the practice of craniofacial surgeons.