Making Sense of Race-Based Affirmative Action in Allocating Scarce Medical Resources

Abstract

The aim of this article is to consider whether, when, and why it is morally right to treat members of socially disadvantaged racial or ethnic groups favorably when allocating scarce medical resources. Since the COVID 2019 pandemic has had different impacts on racial and ethnic groups, some U.S. states have given racial and ethnic minorities preferential access to COVID-19 vaccines, leading to controversy over the moral and legal permissibility of doing so. I examine three arguments for affirmative action-the compensation, equality-of-opportunity, and antidiscrimination arguments-and argue that both the equality-of-opportunity and antidiscrimination arguments have the potential to provide well-founded justification for racebased affirmative action for the allocation of scarce medical resources. I also consider further moral requirements that instances of affirmative action based on both or either of the two arguments should comply with for them to be justified. This article aims to determine whether it is morally right to treat members of socially disadvantaged racial or ethnic groups favorably when allocating scarce medical resources and, if so, when and why it is the case.The recent coronavirus 2019 (COVID-19) pandemic, which has caused mass deaths globally, has had different impacts on racial and ethnic groups. In the United States, for instance, the COVID-19 death rate among racial and ethnic minorities such as Black people, Latinos, and Native Americans is much higher than it is for White people. 1 Moved by such racial disparities, some have suggested the need for proactive measures to prioritize the access of racial and ethnic minorities to scarce medical resources such as vaccines, antibody and antiviral drugs, and even ventilators. 2 In fact, some 1 Adjusted data for age differences in race groups reveal that 1 in 203 Black people, 1 in 195 Latinos, and 1 in 163 Native Americans have died from COVID-19, compared to 1 in 317 for White people (see Gawthrop 2023). 2 Melinda Gates, philanthropist and cochair of the Gates Foundation, said: "In the U.S., [those who need a vaccine after health care workers] would be black people . . . and many other people of color. They are having disparate effects from COVID-19" (Ducharme 2020).