Triage – Prioritising Intensive Care Resources under Pandemic Conditions

In emergency medicine, the term “triage” refers to procedures by which, in the event of a great shortage of life-sustaining medical treatment resources, patients are assigned to groups with higher or lower priority for treatment. During the coronavirus crisis, the term “triage”, which originated in military and disaster medicine, became the focus of a public debate about how to deal with situations where the intensive care treatment needs of a large number of severe cases of Covid-19 far exceed the available resources (personnel resources and ventilation capacities).

In its Ad Hoc Recommendation “Solidarity and Responsibility during the Coronavirus Crisis”, the German Ethics Council – already at the beginning of the pandemic – dealt with the basic normative precepts that apply to tragic intensive care decisions in situations of acute overburdening. In taking up the topic of triage again with this Bioethics Forum, the Council has two objectives: on the one hand, to reflect on prioritisation scenarios that have been discussed in Germany in the course of the crisis for the handling of pandemic-related shortages of (intensive care) medical resources. On the other hand, some of the ethical and legal conflicts associated with triage situations are examined in a way that points beyond the current pandemic with its specific problems. Among other things, answers are sought to the following questions:

• What ethical and/or legal goods are at stake when prioritisation decisions become unavoidable under pandemic conditions?
• What are the ethical and legal bases for procedures supporting the decision-making on treatment priorities if resources are scarce due to a pandemic?
• How should medical associations’ guidelines for decisions on prioritising access to intensive care resources be evaluated from a legal and ethical perspective?
• What strategies have been established in clinical practice to avoid and manage triage situations and how should they be assessed?

Please switch to the German version of this website to see the programme and a video recording of the event (in German). The event is held in German.