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What goes into making tough COVID-19 calls, from vaccine distribution to lockdowns

Every element of pandemic responses has an ethical dimension, bioethicist Maxwell Smith says.
COVID-19 infected blood sample in sample tube.

It’s been a consistent task of making tough calls throughout the COVID-19 pandemic for physicians and provincial officials — calls that have taken their toll not only on patients, but on the people who had to make them.

From lockdowns and paid sick days to deciding who gets a COVID-19 vaccine first, no decision has been easy, but they're decisions that have to be balanced, Maxwell Smith, bioethicist member of Ontario’s COVID-19 vaccine distribution task force, says.

“Every element of the pandemic response has an ethical dimension,” he says. “We need to look at the evidence, but the evidence can’t tell us precisely what to do, we need to look to the ethics as well. We always need to be thinking about what’s equitable and what’s the right thing to do.”

The biggest ethical challenges they’ve faced so far, Smith adds, were the trade-offs whenever resources were limited, like vaccines or ICU beds.

The hardest decision has not yet been made, but as the third wave persists, Smith says officials are looking into how healthcare would be prioritized if hospital and ICU beds were to run out.

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