COVID-19, triage decisions, and indirect ethics: A model for the re-evaluation of triage guidelines

The COVID-19 pandemic has overwhelmed healthcare systems in several countries and has led to situations in which the number of critically ill patients has exceeded the number of ICU beds and ventilators. In anticipation of a potential shortage of ventilators, many countries developed triage guidelines to handle such situations. However, at the current stage in the pandemic there have been a few initial indications that these guidelines may suffer from problems of feasibility. If these suspicions are confirmed in the time to come when systematic studies are conducted, this will provide a strong reason for re-evaluating the guidelines. This article provides a model for the re-evaluation of the existing triage guidelines that draws on insight into indirect ethics and which is designed to ensure that we can learn from the costly experiences during the course of the COVID-19 pandemic.