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The aim of this paper is to explore the legal tools the Spanish constitutional system holds to face a health crisis as serious in its scope and consequences and as lengthy in time such as that of the COVID-19 pandemic. First, we explain the state of alarm provided for in Organic Law 4/1981, 1st June, regulating the states of alarm, exception and siege; then, the provisions included in Organic Law 3/1986, on extraordinary measures in the field of public health. Both regulations have been the legal basis to adopt different state and regional health measures during this almost year and a half of the pandemic. The last July 14, the Spanish Constitutional Court made public the appeal of unconstitutionality lodged by more than fifty deputies of the Vox parliamentary group against Royal Decree 463/2020, of March 14 (articles 7, 9, 10 and 11), by which the state of alarm was declared for the management of the health crisis caused by COVID-19 and several regulations that modified that Decree or extended it. This judgement suggests a different legal response -the declaration of the state of exception- to deal with the health crisis and be critically analyzed in third place., (Copyright © 2022 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.)

The COVID-19 pandemic has been a clinical challenge, but also a legal and bioethical one. These three fundamental pillars are developed in the approach to prioritizing health resources in pandemic, clinical criteria, corresponding legal framework and applicable ethical principles. Initially, clinical criteria were applied to identify patients with the best survival prognosis, combining a clinical evaluation and the use of short-term and long-term prognostic variables. But the decision to prioritize the care of one patient over another has a legal-political burden, which poses a risk of falling into discrimination since fundamental rights are at stake. The prioritization criteria must be based on principles that reflect as a vehicle philosophy that which we have constitutionally assumed as a social and democratic State of Law, which did not respond to utilitarianism but to personalism. Any philosophy of resource distribution must bear in mind the scientific and constitutional perspective and, with them, those of fundamental rights and bioethical principles. In the prioritization of resources, ethical principles must be consolidated such as respect for the human dignity, the principle of necessity (equal need, equal access to the resource), the principle of equity (which advises prioritizing the most vulnerable population groups), transparency (fundamental in society's trust) and the principle of reciprocity (which requires protecting the sectors of the population that take more risks), among others., (Copyright © 2022 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.)