• Bernardo Aguilera.
• Department of Bioethics, The Clinical Center, National Institutes of Health, United States; Departamento de Bioética y Humanidades Médicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile. Address: Department of Bioethics, National Institutes of Health, 10 Center Drive, Building 10, Room 1C118, Bethesda, MD 20892-1156, United States. Email: bernardo.aguilera@nih.gov. ORCID: 0000-0003-2409-8324.
• Medwave. 2020 Jun 16; 20 (5): e7935.

AbstractThe current COVID-19 pandemic has the potential to overwhelm the capacity of hospitals and Intensive Care Units in Chile and Latin America. Thus local authorities have an ethical obligation to be prepared by implementing pertinent measures to prevent a situation of rationing of scarce healthcare resources, and by defining ethically acceptable and socially legitimate criteria for the allocation of these resources. This paper responds to recent ethical guidelines issued by a Chilean academic institution and discusses the main moral principles for the ethical foundations of criteria for rationing during the present crisis. It argues that under exceptional circumstances such as the current pandemic, the traditional patient-centered morality of medicine needs to be balanced with ethical principles formulated from a public health perspective, including the principles of social utility, social justice and equity, among others. The paper concludes with some recommendations regarding how to reach an agreement about rationing criteria and about their implementation in clinical practice.

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