Racial Bias in Ventilator Triage Guidelines

Screenshot from the Journal of Medical Ethics Forum, highlighting an October 12, 2021 journal article with the title "The Sequential Organ Failure Assessment (SOFA) and revised ventilator triage guidance: since we are still implementing outdated and more inequitable frameworks now, will we learn any lessons longer term?" By Harald Schmidt, Dorothy E Roberts, and Amaka D Eneanya

Harald Schmidt, Dorothy Roberts, and Amaka Eneanya published an article (alt link) in the Journal of Medical Ethics in 2021 (e-pub; print publication 2022) in response to the activation by many states of “Crisis Standards of Care” policies during the pandemic. Among other things, these policies guide the rationing of ventilators based on Sequential Organ Failure Assessment (SOFA) scores. Arguing against the presumed objectivity of SOFA rankings, and their employment for ventilator allocation, the authors demonstrate that “Black patients presented with higher average SOFA scores than white patients (9.2 vs. 7.5) and SOFA-only based triage assigned Black patients substantially fewer ventilators than white ones (44% vs 54%).” — Mara Mills