COVID-19 is a highly contagious infection with no proven treatment. Approximately 2.5% of patients need mechanical ventilation while their body fights the infection.1 Once COVID-19 patients reach the point of critical illness where ventilation is necessary, they tend to deteriorate quickly. During the pandemic, patients with other conditions may also present at the hospital needing emergency ventilation. But ventilation of a COVID-19 patient can last for 2–3 weeks. Accordingly, if all ventilators are in use, there will not be time for (...) patients to ‘queue up’ to wait for those who arrived earlier to recover. Those who need a ventilator will die if they do not receive access to one quickly. Many nations now face the prospect that they failed to prepare appropriately for this foreseen risk of pandemic (another issue worthy of legal analysis) and that their populations will need far more ventilators than the health service can supply. For many weeks, the UK has been anticipating a surge of COVID-19 infections that could leave patients queuing in hospitals for ICU care. Luckily, social distancing has ‘flattened the curve’ and this problem might not arise. There is still a degree of risk, however, and other countries will not be so lucky. At some point, during this pandemic or the next, all countries will need to answer hard questions about whether and when scarce ICU resources (such as ventilators, beds and staff) should be either withheld or withdrawn from certain groups of patients solely for the purpose of providing them to others. Attempts to answer these questions can be found in a wide range of ICU triage protocols and ethical guidance documents, many of which embrace the foundational principle of ‘save the most lives’. Unfortunately, this worthwhile goal has generated many suggestions that could violate the law. This article identifies …. (shrink)

This paper is concerned with the uses of history in science. It focuses in particular on Anglo-American genetics and on university textbooks—where the canon of a science is consolidated, as the heterogeneous approaches and controversies of its practice are rendered unified for its reproduction. Tracing the emergence and eventual standardization of geneticists’ use of a case-based method of teaching in the 1920s–1950s, this paper argues that geneticists created historical environments in their textbooks—spaces in which students developed an understanding of the (...) laws of genetics through simulations of their discovery and use. Witnessing the unfolding of Mendel’s and Morgan’s experiments and performing genetic crosses on paper, students learned not only the rules that were explicitly taught as such, but also the experientially-based, tacit skills needed to find and follow these rules. This didactic system taught them how to go on when confronting new situations, and in doing so, provided geneticists with an important disciplinary tool, freeing the first steps of their student’s enculturation from the physical infrastructure of the laboratory. (shrink)