Racism without racists and consequentialist life‐maximizing approaches to triaging

Abstract

Consequentialist life-maximizing approaches to triaging prescribe that everyone ought to have an equal chance of living a typical lifespan, through the saving more life-years (or saving most lives) principle, which emphasizes the youngest-first principle and in some cases a lottery approach, often at the expense of the old and the sick. Although this approach has already been criticized by several bioethicists, this article provides a different kind of criticism to the life-cycle viewpoint, one thathas not yet been explored at length; namely, we contend that the life-maximizing approach entails a form of racism without racists in its attitude towards Black people. More specifically, we contend that by neglecting the idea that current societies are not post-racial, it privileges White individuals and disadvantages Black people in the triaging process, curtails equal opportunities for Black people, reinforces white normativity, and neglects African culture. We end the article by pointing towards an Afro-communitarian relational triaging approach that does not face the same difficulties as consequentialist life-maximizing approaches do.

Operative public values as a tool for healthcare decisions: the social value and clinical criteria of triage

“…But the current paper differs from previous ones in at least five ways. Firstly, in contrast with previous work that was focused specifically on a specific social criterion -the social harmony one -in this article, I am defending social values in triage in general [3,4]. Secondly, contrasting with the arguments made before, I do not think that the social value criterion needs to be universal in the sense of being the same in different cultures.…”

“…I have previously defended that social value is a good criterion for triage [3,4]. But the current paper differs from previous ones in at least five ways.…”

“…On the other, it does not meet the complications that the clinical criteria meet in terms of valuing those who are healthier but also members of the most advantaged groups in society (usually, white, males in the upper classes). In other words, the social value criterion does not imply racism without racists, unlike the clinical triage decisions tend to do [3].…”

“…Nonetheless, I have elsewhere suggested a possible method for storing this kind of information and helping healthcare professionals to make decisions [3,4]. The reality of health emergencies is that these require decisions under incomplete information.…”

“…Consequently, these individuals are less likely to survive and need more resources compared to individuals from less discriminated against ethnic groups and higher social classes who, throughout their lives, have had access to health resources and good quality of life. I have recently developed an article with a colleague where we show that life-maximizing approaches to triaging imply a form of racism without racists [3]. Racism without racists is a concept we adopted from Eduardo Bonilla-Silva.…”