CYIL vol. 12 (2021)

petr šustek CYIL 12 (2021) even hypocritical. However, it only stems from the basic aim of the Statement, i.e., providing health professionals and providers of health services with sufficient legal certainty. Even though the first come, first served rule might not be the best guiding principle, the positive Czech law at the moment hardly allows any other. 2. The Czech Academy of Sciences’ Allocation Framework As early as in March 2020, a small team from the Research Unit for Medical Law and Bioethics at the Czech Academy of Sciences’ Institute of Law published its “Ethical and Legal Framework for the Creation of Guidelines for the Decisions Regarding Scarce Resources Allocation in the Provision of Health Services in the COVID-19 Pandemic”. 24 The authors were philosopher Vladimír Černý and lawyers Adam Doležal and Tomáš Doležal. In October of the same year, the revised version 25 (Framework) was issued, which we will work with in this paper. 26 The first part of the Framework is fully dedicated to ethical considerations. Similarly to the Statement, but in a more explicit and detailed way, the Framework refers to Beauchamp’s and Childress’ medical ethics of four principles: beneficence, nonmaleficence, justice, and autonomy. 27 Nevertheless, according to the Framework, the principle of autonomy might be diminished in situations of crisis since some patients will not be able to get the care they want. 28 Hence, the authors propose four special principles of medical ethics for epidemic or pandemic crises: 1) the principle of maximising benefits achievable through scarce resources, 2) fairness, 3) support to those who help others, and 4) prioritisation of patients with the worse health condition. 29 24 See ČERNÝ, David, DOLEŽAL, Adam, DOLEŽAL, Tomáš. Etická a právní východiska pro tvorbu doporučení k rozhodování o alokaci vzácných zdrojů při poskytování zdravotních služeb v rámci pandemie COVID-19 [Ethical and Legal Framework for the Creation of Guidelines for the Decisions Regarding Scarce Resources Allocation in the Provision of Health Services in the COVID-19 Pandemic]. 1 st ed. Kabinet zdravotnického práva a bioetiky Ústavu státu a práva AV ČR. (March 2020.) accessed 10 June 2021. 25 See ČERNÝ, David, DOLEŽAL, Adam, DOLEŽAL, Tomáš. Etická a právní východiska pro tvorbu doporučení k rozhodování o alokaci vzácných zdrojů při poskytování zdravotních služeb v rámci pandemie COVID-19 [Ethical and Legal Framework for the Creation of Guidelines for the Decisions Regarding Scarce Resources Allocation in the Provision of Health Services in the COVID-19 Pandemic]. 2 nd ed. Kabinet zdravotnického práva a bioetiky Ústavu státu a práva AV ČR. (October 2020.) accessed 10 June 2021. 26 The Framework further analyses the issues of informed consent and vaccine allocation. However, these last- mentioned problems do not fit into the scope of this paper. 27 See BEAUCHAMP, Tom L., CHILDRESS, James F. Principles of Biomedical Ethics. 7 th ed. Oxford University Press, Oxford 2013. 28 See ČERNÝ, David, DOLEŽAL, Adam, DOLEŽAL, Tomáš. Etická a právní východiska pro tvorbu doporučení k rozhodování o alokaci vzácných zdrojů při poskytování zdravotních služeb v rámci pandemie COVID-19 [Ethical and Legal Framework for the Creation of Guidelines for the Decisions Regarding Scarce Resources Allocation in the Provision of Health Services in the COVID-19 Pandemic], pp. 7–8 . 2 nd ed. Kabinet zdravotnického práva a bioetiky Ústavu státu a práva AV ČR. (October 2020.) accessed 10 June 2021. 29 See ibid., p. 8. nedostatku vzácných zdrojů [Decision-making in patients in Intensive Care in the Situation of Lack of Scarce Resources]. Anesteziologie a intenzivní medicína. (2020, Vol. 31, No. 5), p. 250.

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