[Efficiency is not enough. Ethical analysis and recommendations for the allocation of scarce resources in a pandemic situation].

Abstract

To develop a support tool to decision-making in the framework of the COVID-19 pandemic. Different ethical recommendations that emerged in Spain on prioritizing scarce health resources in the COVID-19 pandemic first wave were searched; it was conducted a narrative review of theoretical models on distribution in pandemics to define an ethical foundation. Finally, recommendations are drawn to be applied in different healthcare settings. Three principles are identified; strict equality, equity and efficiency, which are substantiated in specific distribution criteria. A model for the distribution of scarce health resources in a pandemic situation is proposed, starting with a decision-making procedure and adapting the distribution criteria to different healthcare scenarios: primary care settings, nursing homes and hospitals.