Prominent bioethicists have promoted the preservation of life-years as a rationing strategy in response to the Covid-19 pandemic. Yet the philosophical justification for maximizing life-years is underdeveloped and has a complex history that is not reflected in recent literature. In this article, we offer a critical investigation of the use of life-years, arguing that evidence of public support for the life-years approach is thin and that organ transplantation protocols (heavily cited in pandemic-response protocols) do not provide a precedent for seeking to save the most life-years. We point out that many state emergency-response plans ultimately rejected or severely attenuated the meaning of saving the most life-years, and we argue that philosophical arguments in support of rationing by life-years are remarkably wanting. We conclude by offering a fair alternative that adheres to the standard duties of beneficence, respect for persons, and justice.

中文翻译：

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Covid-19 大流行中的生命年和配给：批判性分析

著名的生物伦理学家提倡将保存生命年作为应对 Covid-19 大流行的配给策略。然而，最大限度延长生命年的哲学依据尚不成熟，而且其复杂的历史并未反映在最近的文献中。在本文中，我们对生命年的使用进行了批判性调查，认为公众支持生命年方法的证据很少，而且器官移植方案（在大流行应对方案中大量引用）没有提供先例寻求挽救最多生命年。我们指出，许多州的紧急响应计划最终拒绝或严重削弱了拯救最多生命年的意义，并且我们认为支持按生命年配给的哲学论据非常缺乏。最后，我们提供一个公平的替代方案，遵守仁慈、尊重人和正义的标准义务。