Using lifesaving drugs as a means of redistribution
When lifesaving drugs run low, hospitals have to choose which patients get a scarce drug, while others go without. Some even die. Historically, medical ethicists have recommended giving the drug to the patient most likely to benefit or using a lottery to give every patient an equal chance.
Not any more. Pennsylvania hospitals are tilting the scale in favor of patients from "disadvantaged areas." If you're middle class, you're toast.
To "redress social injustices," Pennsylvania is applying a "weighted lottery" statewide, to hike the odds that the scarce drug remdesivir for COVID-19 will be given to patients from poor neighborhoods in preference to other patients.
Remdesivir is a medicine that speeds recovery and, according to its maker, Gilead Sciences, increases survival by 62%.
If you can get it. Your ZIP code could literally mean the difference between life and death.
"This is all very new," explains Douglas White, an ethicist at the University of Pittsburgh, who helped devise the weighted lottery.
Some medical ethicists are urging that other states follow suit. South Carolina reports that if remdesivir runs short there, the state will apply preferences like UPMC's lottery, according to Dee Ford, professor at the Medical University of South Carolina who helped design the South Carolina approach.
The public needs to speak out before this deadly scheme comes to their state.
In the past, if many patients needed a scarce drug, deciding who got it involved only their medical conditions. That's consistent with the American Medical Association guidelines -- that the patient most likely to benefit medically from the drug should get it.
It's a far cry from favoring patients from low-income ZIP codes.