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The Covid-19 pandemic has put triage at the centre of public and bioethical discussions. Triage commonly refers to situations of emergency in which vital healthcare resources are to be distributed among patients outnumbering the supply. Due to limited capacities of intensive care units and ventilators, medical associations in many countries, often in cooperation with ethics committees, have formulated guidelines that aim to provide orientation for medical staff and to ensure transparency and trust.
The most prominent and widely accepted criterion that is referred to in all guidelines is short-term medical prognosis. It is generally understood as referring to a patient’s probability to benefit from and survive ICU treatment in the near term. However, despite a far-reaching consensus about its importance as a key triaging criterion, a comprehensive and systematic discussion and normative reconstruction of short-term medical prognosis is yet missing. But it is highly called for: Both in national triage guidelines and in bioethical discussions (i) short-term medical prognosis is often defined rather vaguely and understood in different ways; (ii) the normative justification of short- term prognosis is taken for granted or at least not given much attention; and (iii) its relation to other possible criteria (e.g. long-term prognosis or age) is often not clearly stated and explained. The proposed project addresses all these research gaps. Its central aim is to develop a pluralistic and pragmatic justification and defense of short-term medical prognosis as the only primary (first-order) criterion in triage. Beyond that, the project also aims to elucidate the concept of discrimination in the triage context against a background of social injustice, and touches upon the debate of potentially automatizing triage decisions through the introduction of algorithms.
Financed by: SNF
Duration: 2023 to mid 2025
