Discriminação por deficiência em emergências: O retorno de Taurek?
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https://doi.org/10.5007/1677-2954.2023.e97052Palavras-chave:
Ética da Assistência à Saúde, Priorização, RespeitoResumo
John Taurek defende, de forma notória, uma visão impopular na ética: ao decidir quem resgatar, os números não contam. Ao invés disso, devemos dar a todos a mesma chance de sobreviver escolhendo de forma aleatória. De forma surpreendente, tem havido pouco debate entre a literatura rica e detalhada sobre se os números contam em casos de resgate e a questão prática de saber se certos fatos sobre os pacientes são elegíveis para consideração na priorização do mundo real, por exemplo, na triagem de emergência durante uma pandemia. Sugiro que uma posição próxima da de Taurek mapeia os argumentos do mundo real por parte de grupos que representam indivíduos com deficiência. Enquanto Taurek se concentra na equalização das chances de sobrevivência, alguns ativistas e acadêmicos dos direitos das pessoas com deficiência parecem argumentar a favor da equalização das chances de seleção. Construo um argumento a favor desta posição apelando à ideia de “respeito opaco”. Considero, então, as implicações desta abordagem para princípios mais amplos de ação afirmativa nos cuidados de saúde.
Referências
ADAMS, Rachel. 2022. Urgent care: disability, pandemic, and the value of a life. The Lancet 399. 430-1.
AQUINO, Yves Saint James; ROGERS, Wendy A.; SCULLY, Jackie Leach; MAGRABI, Farah; CARTER, Stacy M. 2021. Ethical guidance for hard decisions: a critical review of early international COVID-19 ICU triage guidelines. Health Care Analysis.
de ARAUJO, Marcelo; AZEVEDO, Marco Antonio; BONELLA, Alcino E.; DALL’AGNOL, Darlei. 2023. Ethical guidelines for the allocation of scarce intensive care units during the COVID‐19 pandemic: Discussing a Brazilian proposal. Journal of Evaluation in Clinical Practice: 1-10. DOI: 10.1111/jep.13924.
BOGNAR, Greg. 2020. Cost-effectiveness analysis and disability discrimination. In Cureton and Wasserman (eds.) The Oxford Handbook of Philosophy and Disability (OUP).
CARTER, Ian. 2011. Respect and the basis of equality. Ethics 121. 538-71.
CHEN, Bo; MCNAMARA, Donna Marie. 2020. Disability discrimination, medical rationing and COVID-19. Asian Bioethics Review 12. 511-8.
DAVIES, Ben. 2022. Healthcare priorities: The “young” and the “old”. Cambridge Quarterly of Healthcare Ethics 32(2): 174-185.
FELT, Ashley Brooke; MITCHAM, Dionne; HATHCOCK, Morgan; SWIENTON, Raymond; HARRIS, Curtis. 2021. Discrimination and bias in state triage protocols toward populations with intellectual disabilities during the COVID-19 pandemic. Disaster Medicine and Public Health Preparedness.
HELLMAN, Deborah; NICHOLSON, Kate M. Rationing and Disability: The Civil Rights and Wrongs of State Triage Protocols, 78 Wash. & Lee L. Rev. 1207 (2021).
KAMM, Frances. 1993. Morality, Mortality Volume 1: Death and Whom to Save from It. OUP.
LANG, Gerald; LAWLOR, Rob. 2016. Numbers scepticism, equal chances and pluralism: Taurek revisited. Politics, Philosophy & Economics 15. 298-315.
LIDDIARD, Kirsty. No date. Surviving ableism in Covid times. University of Sheffield: iHuman https://www.sheffield.ac.uk/ihuman/surviving-ableism-covid-times.
MCQUILLEN, Meghan; TERRY, Sharon F. 2020. Genetic and Disability Discrimination during Covid-19. Genetic Testing and Molecular Biomarkers 24. 759-60.
MELLO, Michelle M.; PERSAD, Govind; WHITE, Douglas B. 2020. Respecting disability rights—toward improved crisis standards of care. New England Journal of Medicine 383. e26.
MEYER, Kirsten. 2006. How to be consistent without saving the greater number. Philosophy & Public Affairs 34(2): 136-146.
OTSUKA, Mike. 2000. Scanlon and the claims of the many versus the one. Analysis 60. 288-93.
PANOCCHIA, Nicola; D’AMBROSIO, Viola; CORTI, Serafino; Lo PRESTI, Eluisa; BERTELLI, MarcO; SCATTONI, Maria Luisa; GHELMA, Filippo. 2021. COVID-19 pandemic, the scarcity of medical resources, community-centred medicine and discrimination against persons with disabilities. Journal of Medical Ethics 47. 362-6.
PETERSON, Martin. 2008. The moral importance of selecting people randomly. Bioethics 22. 321-7.
RASMUSSEN, Katharina Berndt. 2012. Should the probabilities count? Philosophical Studies 159. 205-18.
REID, Lynette. 2020. Triage of critical care resources in COVID-19: a stronger role for justice. Journal of Medical Ethics 46. 526-530.
SAVULESCU, Julian; PERSSON, Ingmar; WILKINSON, Dominic. 2020. Utilitarianism and the pandemic. Bioethics 34. 620-32.
SCANLON, TM. 1998. What We Owe to Each Other. Harvard University Press.
SCULLY, Jackie Leach. 2020. Disability, disablism, and COVID-19 pandemic triage. Journal of Bioethical Inquiry 17. 601-5
STRAMONDO, Joseph. 2020. Disability, likelihood of survival, and inefficiency amidst a pandemic. Bioethics Today bioethicstoday.org/blog/disability-likelihood-of-survival-and-inefficiency-amidst-pandemic.
TATE, Alex Miller. Forthcoming. Rethinking the ethics of pandemic rationing. Egalitarianism and avoiding wrongs. Cambridge Quarterly of Healthcare Ethics.
TAUREK, John. 1977. Should the numbers count? Philosophy & Public Affairs 6. 293-316.
TOWN, Maria. (2020) AAPD letter, Covid-19 Response Package. Previously available at https://www.aapd.com/wp-content/uploads/2020/03/COVID-19-Response-Package.pdf.
UN Convention on the Rights of Persons with Disabilities. www.un.org/development/desa/disabilities/convention-on-the-rights-of-persons-with-disabilities.html.
WARREN et al. (2020). Letter to Honorable Alex Azar, Seema Verma, and Roger Severino from Senator Elizabeth Warren et al., April 10 2020 Available to download at www.warren.senate.gov.
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