PT - JOURNAL ARTICLE AU - Benjamin Tolchin AU - Sarah C Hull AU - Katherine Kraschel TI - Triage and justice in an unjust pandemic: ethical allocation of scarce medical resources in the setting of racial and socioeconomic disparities AID - 10.1136/medethics-2020-106457 DP - 2021 Mar 01 TA - Journal of Medical Ethics PG - 200--202 VI - 47 IP - 3 4099 - http://jme.bmj.com/content/47/3/200.short 4100 - http://jme.bmj.com/content/47/3/200.full SO - J Med Ethics2021 Mar 01; 47 AB - Shortages of life-saving medical resources caused by COVID-19 have prompted hospitals, healthcare systems, and governmentsto develop crisis standards of care, including 'triage protocols' to potentially ration medical supplies during the public health emergency. At the same time, the pandemic has highlighted and exacerbated racial, ethnic, and socioeconomic health disparities that together constitute a form of structural racism. These disparities pose a critical ethical challenge in developing fair triage systems that will maximize lives saved without perpetuating systemic inequities. Here we review alternatives to 'utilitarian' triage, including first-come first-served, egalitarian, and prioritarian systems of allocating scarce medical resources. We assess the comparative advantages and disadvantages of these allocation schemes. Ultimately, we argue that while triage protocols should not exacerbate disparities, they are not an adequate mechanism for redressing systemic health inequities. Entrenched health disparities must be addressed through broader social change.