Triage in a Pandemic: Equity, Utility, or Both?

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Abstract

In terms of the setting of priorities for resource allocation, two general principles are important. These are equity and utility. Based on these two concepts, there are two historically discrete models for triage of limited resources. These are the French egalitarian model based on equity and the British military model based on utility. Modern paramedic and emergency room care in multiple casualty situations favors the triage model based on utility. Modern ICU care favors the triage model based on equity. There are issues to be addressed in both triage responses. In a pandemic, both the utilitarian model and the equity model are active, and their applicability changes as the trajectory of the pandemic progresses.

Keywords: Pandemic, triage, equity, utility

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References

[1]Legal constraints are beyond the scope of this contribution but are discussed in the New York State Task Force on Life and the Law, Ventilator Allocation Guidelines (NYTFLL 2015, 61-71).

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