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Ethicists, doctors and triage decisions: who should decide? And on what basis?
  1. Silvia Camporesi1,
  2. Maurizio Mori2,3
  1. 1 Global Health and Social Medicine, King's College London, London, UK
  2. 2 Department of Philosophy, University of Turin, Turin, Italy
  3. 3 Consulta di Bioetica, Turin, Italy
  1. Correspondence to Dr Silvia Camporesi, Global Health and Social Medicine, King's College London, London WC2R 2LS, UK; silvia.camporesi{at}


We report here an emerging dispute in Italy concerning triage criteria for critically ill covid-19 patients, and how best to support doctors having to make difficult decisions in a context of insufficient life saving resources. The dispute we present is particularly significant as it juxtaposes two opposite views of who should make triage decisions, and how doctors should best be supported. There are both empirical and normative questions at stake here. The empirical questions pertain to the available level of evidence that healthcare professionals would rather not be left alone with their ‘clinical judgments’ to make triage decisions, and to the accounts of distributive justice that doctors and healthcare professionals rely on, when making triage decisions. The normative questions pertain to how this empirical evidence should inform guidelines on how prioritisation decisions are made in a context of emergency, and who gets to have the authority to do so. This debate goes beyond the discussion of the care of critically ill patients with COVID-19 and has broader implications beyond the national context for the discussion of how to relieve moral distress in contexts of imbalances between healthcare resources and clinical needs of a population.

  • resource allocation
  • research ethics
  • policy guidelines/inst. review boards
  • history of health ethics/bioethics
  • ethics committees/consultation

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  • Contributors Both authors contributed equally to this manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests MM is a member of the Italian National Bioethics Committee (CNB) and sole author of a Minority Report to the CNB on 'COVID-19 and clinical decision-making in conditions of resource shortage' referenced in this article.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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