|
Substantive values
|
|
Distributive justice or fairness
|
Fairness in how resources are allocated across members of a group.
|
8 (26.7)
|
Farrell (2020) [81]; Han (2020) [35]; Leclerc (2020) [42]; Seethala and Keller (2020) [82]; Rhodes (2020) [83]; Steinberg (2020) [84]; Vergano (2020) [53]; Vincent and Creteur (2020) [50]
|
|
Duty to plan
|
Planning for the management of ethical issues that may arise.
|
2 (6.7)
|
Han (2020) [35]; Committee (2020) [47]
|
|
Duty to provide care
|
“Palliative care protocol (when patient does not qualify for critical care allocation).”; “The concept of triage by a senior clinician(s) without direct clinical obligation and a support system to implement and manage the triage process.”
|
13 (43.3)
|
Christian (2010) [85]; Christian (2014) [11]; Cinti (2009) [86]; Daugherty Biddison (2014) [87, 88]; Devereaux (2008) [89]; Eastman (2010) [90]; Einav (2014) [91]; Han (2020) [35]; Herrerros (2020); Lin and Anderson-Shaw (2009) [23]; Powell (2008) [24]; Rubinson (2005) [92]; Silva (2012) [93]
|
|
Equality
|
“Triage decisions will not be based on race, ethnicity, gender, disability, insurance status, immigration status, social class, or other non-clinical factors.”
|
4 (13.3)
|
Marckmann (2020) [46]; Montgomery (2020) [52]; Rhodes (2020) [83]; Steinberg (2020) [84]
|
|
Equity
|
“Triage decisions during the epidemic should apply to all patients who may require intensive care, not just COVID-19 patients.”
|
17 (56.7)
|
Cheung (2017) [94, 95]; Christian (2010) [85]; Christian (2014) [11]; Cinti (2009) [86]; Devereaux (2008) [89]; Dries (2014) [96]; Daugherty Biddison (2014) [87, 88]; Eastman (2010) [90]; Emanuel [10]; Herrerros (2020); Leclerc (2020) [42]; Powel (2008) [24]; Tillyard (2010) [97]; Silva (2012) [93]; Real de Asua (2020) [32]; Rhodes (2020) [83]; Steinberg (2020) [84]
|
|
Reciprocity
|
Resources allocated based on societal contributions (e.g., caregivers, healthcare providers - feelings of reciprocity).
|
5 (16.7)
|
Daugherty Biddison (2014) [87, 88]; Daugherty Biddison (2018) [98]; Eastman (2010) [90]; Emanuel [10]; Silva (2012) [93]
|
|
Stewardship
|
“Triage decisions regarding the provision of critical care should be guided by the principle of seeking to help the greatest number of people survive the crisis.”
|
20 (66.7)
|
Cheung (2017) [94, 95]; Christian (2010) [85]; Christian (2014) [11]; Cinti (2009) [86]; Daugherty Biddison (2014) [87, 88]; Daugherty Biddison (2014) [87, 88]; Daugherty Biddison (2018) [98]; Eastman (2010) [90]; Emanual (2020); Han (2020) [35]; Janig (2020) [30]; Marckmann (2020) [46]; Powell (2008) [24]; Rubinson (2005) [92]; Silva (2012) [93]; Steinberg (2020) [84]; Tabery and Mackett (2008) [99]; Real de Asua (2020) [32]; Rhodes (2020) [83]; Tillyard (2010) [97]
|
|
Trust
|
“Review of triage decisions (daily retrospective review).”
|
10 (33.3)
|
Christian (2014) [11]; Chung (2017); Cinti (2009) [86]; Daugherty Biddison (2014) [87, 88]; Daugherty Biddison (2018) [98]; Lin and Anderson-Shaw (2009) [23]; Powell (2008) [24]; Rubinson (2005) [92]; Silva (2012) [93]; Tabery and Mackett (2008) [99]
|
|
Procedural values
|
|
Reasonable
|
Critical care resources be allocated based on specific triage criteria, irrespective of whether the need for resources is related to the current disaster/pandemic or an unrelated critical illness or injury.
|
12 (40)
|
Cheung (2017) [94, 95]; Christian (2010) [85]; Christian (2014) [11]; Daugherty Biddison (2014) [87, 88]; Devereaux [89]; Dries (2014) [96]; Eastman (2010) [90]; Einav (2014) [91]; Lin and Anderson-Shaw (2009) [23]; Powell (2008) [24]; Rubinson (2005) [92]; Silva (2012) [93]
|
|
Open and transparent
|
“The criteria for triage should be transparent, public, and as shared as possible. The triage process is the responsibility of the entire society.”
|
14 (46.7)
|
Cheung (2017) [94, 95]; Christian (2010) [85]; Christian (2014) [11]; Daugherty Biddison (2014) [87, 88]; Daugherty Biddison (2018) [98]; Han (2020) [35]; Lin and Anderson-Shaw (2009) [23]; Marckmann (2020) [46]; Real de Asua (2020) [32]; Rubinson (2005) [92]; Silva (2012) [93]; Seethala and Keller (2020) [82]; Steinberg (2020) [84]; Valiani (2020) [29]
|
|
Inclusive
|
“Hospitals should establish procedure in advance of a crisis. These protocols should be developed regionally and with input from stakeholders (including the public).”
|
7 (23.3)
|
Cheung (2017) [94, 95]; Christian (2010) [85]; Christian (2014) [11]; Daugherty Biddison (2014) [87, 88]; Daugherty Biddison (2018) [98]; Rubinson (2005) [92]; Silva (2012) [93]
|
|
Responsive
|
“Prioritization guidelines should differ by intervention and should respond to changing scientific evidence.”
|
4 (13.3)
|
Devereaux (2008) [89]; Emmanuael (2020); Real de Asua (2020) [32]; Valuani (2020)
|
|
Accountable
|
“Triage Review Board-to oversee switch from traditional ethics of individual autonomy to an ethics of public health.”
|
5 (16.7)
|
Christian (2014) [11]; Lin and Anderson-Shaw (2009) [23]; Seethala and Keller (2020) [82]; Tabery and Mackett (2008) [99]; Valiani (2020) [29]
|
