BMA conference on justice/fairness in COVID: Jonathan Montgomery speaking about the need for national guidance on resource allocation, problem of multiple/conflicting guidelines.

Suggests need for 'one guidance to rule them all'.

(Some scepticism in comments citing need for flexibility and individual expertise. Not sure about this - where does 'individual expertise' bleed into bias?)

Speaker focuses on guidance that can be useful for '3am' decision-making, i.e. user-friendly

A focus on frailty - I have had concerns about this in the past: frailty may be relevant if it tracks chance of benefit, i.e physical frailty. But frailty scores include dependency on care: one can be dependent on care (and so 'very frail') but not physically frail.

OK, speaker has just acknowledged this point.

Notes tension between 'acceptability for outsiders' and usefulness in actual decision-making for those who have to make such decisions. (Something it's important for those of us doing ethics from outside to bear in mind - it's easy to criticise.)

Next speaker - Joanna Coast - focuses on the importance of capabilities (rather than 'health') for resource allocation.

Use of qualitative methods to find out what capabilities matter to individuals.

Talks about use of capabilities in broader policy, e.g. prioritising Christmas as enabling social capabilities (though doesn't address the disparity between this and other religious festivals...)

Discussion now about the use of age as a criterion: Raanan Gillon notes that he would be happy not to take priority, but is reluctant when others tell *him* that he ought to do so!

Perhaps relevant to note: telling those who are happy to 'step aside' due to age will also involve telling those who aren't, some of whom may have had far less privileged lives.

JM worried about guidelines crowding out professional judgement - not a fan of 'algorithmic' guidance (an issue that @joshp_j and I are writing about at the moment).