Hortal-Carmona, JoaquínPadilla-Bernáldez, JavierMelguizo-Jiménez, MiguelAusín, TxetxuCruz-Piqueras, MaiteLópez de la Vieja, María TeresaPuyol, ÀngelRodríguez-Arias, DavidTamayo-Velázquez, María-IsabelTriviño, Rosana2025-01-072025-01-072021-01-25https://hdl.handle.net/10668/24853To 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.esAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/Eficiencia en saludEquidad en saludHealth efficiencyHealth equityPandemiaPandemicsPublic health ethicsRacionamientoRationingÉtica de la salud públicaCOVID-19Ethical AnalysisHealth Care RationingHumansPandemicsResource AllocationSARS-CoV-2research article33509638open access10.1016/j.gaceta.2020.07.0061578-1283PMC7830264https://doi.org/10.1016/j.gaceta.2020.07.006https://pmc.ncbi.nlm.nih.gov/articles/PMC7830264/pdf