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A proposal for formal fairness requirements in triage emergency departments: publicity, accessibility, relevance, standardisability and accountability
  1. Davide Battisti1,
  2. Silvia Camporesi2
  1. 1Department of Law, University of Bergamo, Bergamo, Italy
  2. 2Department of Political Science, University of Vienna, Vienna, Austria
  1. Correspondence to Dr Davide Battisti, Department of Law, University of Bergamo, Bergamo 24129, Italy; davide.battisti{at}


This paper puts forward a wish list of requirements for formal fairness in the specific context of triage in emergency departments (EDs) and maps the empirical and conceptual research questions that need to be addressed in this context in the near future. The pandemic has brought to the fore the necessity for public debate about how to allocate resources fairly in a situation of great shortage. However, issues of fairness arise also outside of pandemics: decisions about how to allocate resources are structurally unavoidable in healthcare systems, as value judgements underlie every allocative decision, although they are not always easily identifiable. In this paper, we set out to bridge this gap in the context of EDs. In the first part, we propose five formal requirements specifically applied for ED triage to be considered fair and legitimate: publicity, accessibility, relevance, standardisability and accountability. In the second part of the paper, we map the conceptual and empirical ethics questions that will need to be investigated to assess whether healthcare systems guarantee a formally just ED triage. In conclusion, we argue that there is a vast research landscape in need of an in-depth conceptual and empirical investigation in the context of ED triage in ordinary times. Addressing both types of questions in this context is vital for promoting a fair and legitimate ED triage and for fostering reflection on formal fairness allocative issues beyond triage.

  • emergency medicine
  • resource allocation
  • public policy
  • ethics-medical

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  • Contributors Both authors contributed equally and are responsible for the overall content as guarantors.

  • 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 None declared.

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

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