#2 Govind Persad: How (not) to allocate resources during a pandemic

Bio(un)ethical

In this episode, we interview Dr. Govind Persad, an expert on resource allocation whose work influenced COVID-19 allocation policies, about how we should allocate scarce medical resources, what stood in the way of optimal allocation during the covid pandemic, and how we can improve resource allocation within the US healthcare system.

(00:00) Our Introduction
(04:05) Interview begins
(12:06) What is a “framework” for allocating health resources?
(14:20) What normative assumptions are baked into allocation frameworks?
(19:36) What principles are included in allocation frameworks?
(20:24) Overview of first two principles: Maximizing benefits and favoring the worst off
(26:11) Overview of second two principles: Equal treatment and rewarding social usefulness
(39:37) Which benefits matter when allocating health resources?
(43:33) Should we account for quality of life?
(49:22) Should we prioritize the youngest first?
(53:29) When does reciprocity matter?
(57:32) Putting principles into practice
(1:02:22) Legal considerations
(1:07:25) Improving resource allocation in the US healthcare system
(1:13:16) How living through the pandemic influenced Govind’s research
Mentioned:

• “Principles for Allocation of Scarce Medical Interventions” by Govind Persad, Alan Wertheimer, and Ezekiel Emanuel (2009)
• “Fair Allocation of Scarce Medical Resources in the Time of COVID-19” by Ezekiel Emanuel et al. (2020)
• “The Rebugnant Conclusion” by Jeff Sebo (Draft)
• “Equality and Priority” by Derek Parfit (1997)
• “Should the Numbers Count?” by John Taurek (1977)
• “In the Line For Scarce Covid Treatments, Immunocompromised Americans Should Go Before the Unvaccinated” by Govind Persad and Emily Largent (Opinion in The Washington Post, 2022)
• “How COVID-19 Hollowed Out a Generation of Young Black Men” by Akilah Johnson and Nina Martin (ProPublica, 2020)

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Bio(un)ethical is a bioethics podcast written by Leah Pierson and Sophie Gibert, with editing and production by Ambedo Media (previous production support by Audiolift.co). Our music is written by Nina Khoury and performed by Social Skills. We are supported by a grant from Amplify Creative Grants.