Triage in Times of COVID-19: A Moral Dilemma

J Health Soc Behav. 2022 Dec;63(4):560-576. doi: 10.1177/00221465221080958. Epub 2022 Apr 2.

Abstract

We present evidence from choice experiments on hypothetical triage decisions in a pandemic. Respondents have to decide who out of two patients gets ventilation. Patients are described in terms of attributes such as short-term survival chance, long-term life expectancy, and their current ventilation status. Attributes are derived from the ethical discourse among experts regarding triage guidelines during the COVID-19 pandemic and differ in the extent to which they are salient from a utilitarian or deontological perspective. Empirically, we find that although nonexperts agree with experts in prioritizing utilitarian attributes in triage decisions, nonexperts also consider the adherence to the norm of wearing face masks as particularly relevant. Furthermore, our study supports Greene and colleagues' dual-process model of moral judgment; we find that utilitarian attributes are more decisive for respondents with a greater inclination toward utilitarianism and for respondents with a greater tendency toward reflection.

Keywords: COVID-19; choice experiment; dual-process perspective; process dissociation; triage.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • COVID-19*
  • Ethical Theory
  • Humans
  • Morals
  • Pandemics
  • Triage