"The 'Give Back': Is There Room For It?"

In my previous article, Unblinded, I challenged the actions of using the crisis standards of care scoring systems to allocate scares resources like ventilators and argued against a color-blind ideology. To take that argument further it is time to address the question of "if not that scoring system, then what?".

The Sequential Organ Failure Assessment score or SOFA is the clinical tool that has been most widely accepted as the scoring mechanism to address which patient, in a crisis standards of care situation, has the better survival potential if provided the scarce resource. Although recognized as an imperfect scoring system, SOFA is generally accepted because it is what we have and gives clinicians an opportunity to feel decisions are being made in an unbiased, data driven, utilitarian way. Taking the implicit bias human element out of the scoring provides some sense of fairness in a clearly inequitable system. The problem with this view is that the system is not fair, the tool is biased, and using it will result in continued harm towards populations of color.